# Marion J. Ball

Marion Jokl Ball is a South African-born American scientist, educator, and leader in global Biomedical and Health Informatics. She holds the Raj and Indra Nooyi Endowed Distinguished Chair in Bioengineering, University of Texas at Arlington, is Presidential Distinguished Professor, College of Nursing and Health Innovation and serves as the Founding Executive Director, Multi-Interprofessional Center for Health Informatics (MICHI), University of Texas at Arlington. She is Professor Emerita, Johns Hopkins University School of Nursing and Affiliate Professor, Division of Health Sciences Informatics, Johns Hopkins School of Medicine. A member of the National Academy of Medicine (NAM), she is a pioneers of Informatics in Nursing and in Medicine and a founding member of the Technology Informatics Guiding Education Reform (TIGER), a global grassroots initiative that formalized in 2006 to enable nurses and later, the multi-interdisciplinary healthcare workforce in 34 countries to best make use of Health Informatics principles, methods, tools, and resources. Ball is the author/editor of over 35 books and over 200 articles in the field of Health Informatics.

## Biography and career

Ball received her bachelor’s and master’s degrees in mathematics from the University of Kentucky, Lexington, KY, U.S., where she started her career as a programmer and instructor at the Medical Center after graduation. Serving as the director of the Computer Systems and Management Group at The Temple University Philadelphia, PA, U.S. she worked in parallel on her doctoral thesis in Medical Education. In 1978, she obtained her Doctor of Education (EdD) from Temple University. Moving to The University of Maryland at Baltimore in 1985, she was appointed Director, Academic Computing and later, Vice President Information Services and Chief Information Officer as well as professor at the School of Medicine and adjunct professor of information systems. In the years to follow (1985–2020), Dr. Ball combined academic appointments with leadership positions in the computer and consulting industry. She held an Adjunct Professorship position at The University of Maryland, School of Nursing, at the Uniformed Services University of the Health Sciences in Biomedical Informatics and at Johns Hopkins University, School of Nursing. At the same time, Ball served as Vice President at First Consulting Group, later as Vice President, Clinical Informatics Strategies at Healthlink, Inc., and finally, in various positions as a Senior Advisor in IBM’s Research Division. In 2020, she moved fully back into academia as the co-founder of the Multi-Interprofessional Center for Health Informatics (MICHI) at the University of Texas at Arlington. She co-directs MICHI together with Gabriela M. Wilson.

## Springer Health Informatics Series

Started as Computers in Health Care in 1988 edited by Kathryn J. Hannah and Marion J. Ball, the series Health Informatics – as it is now called – has expanded from a few to over 120 books covering the vast diversity of topics in Health Informatics including “Healthcare Information Management Systems”, “Terminology, Ontology and their Implementations”, “Mental Health Informatics”, “Clinical Research Informatics”, and “Evaluation Methods in Biomedical and Health Informatics”.
This series has accompanied the evolvement and further development of Biomedical and Health Informatics as an international scientific discipline. Some of its books published in the early days of the series, appeared in the 5th edition, such as “Nursing Informatics: Where Caring and Technology Meet” which was the book that started the series.

## Technology Informatics Guiding Education Reform (TIGER)

TIGER began as a grassroots initiative for preparing the nursing workforce for the new challenges of a digital healthcare system. Bringing together more than one hundred nursing leaders from seventy organizations, the TIGER Summit of 1 November 2006, resulted in a white paper and report that defined action steps in the areas of 1. Management & Leadership, 2. Education, 3. Communication & Collaboration, 4. Informatics Design, 5. Information Technology, 6. Policy and 7. Culture, called the seven TIGER pillars. In 2014, TIGER transitioned to the Healthcare Information and Management Systems Society HIMSS where Ball served as an international co-chair of TIGER.
As the demand, complexity, and sophistication of competencies in Health Informatics increased over the following years, TIGER developed a comprehensive framework of recommendations of health informatics for nurses. The framework included a methodology of surveying international experts in the field, summarized their relevance ratings for competencies according to roles nurses can have, and illustrated findings them via case studies. As the initiative reached out to interdisciplinary healthcare professionals to address their Health Informatics needs, TIGER developed a second framework, the International Framework for Recommendations of Core Competencies in Health Informatics 2.0 which covers the roles direct patient care, health information managers, executives, chief information officers, engineering and health IT specialists and science and education. Over the years, Ball has remained active as a TIGER leader by supporting its strategic direction.

## Nursing and health informatics

Ball is one of the educators and scientistis who established Nursing Informatics as a discipline and contributed to its evolvement in the healthcare arena. “She was a prime mover in establishing the nursing informatics program at the University of Maryland.”. Through her many books in this area, she influenced nurses and other clinicians. She has served as a bridge builder between technology and the caring professions since 1988. Her works addressed beginners, as well as advanced students, and the clinical workforce and has been translated into many languages. It is her understanding of Nursing, Health, and Medical Informatics “that technology is only an enabler; success depends on attention to human factors and collaboration across boundaries.”.

## Health and hospital information systems

Ball’s interest in organization wide health information systems is rooted in her practical experience of information management systems which she had gained in various executive positions held at the Temple University at Philadelphia and the University of Maryland at Baltimore from 1968 to 1996. In the early years of the International Medical Informatics Association (IMIA), she was appointed program chair of the IMIA working conference centered on hospital information systems (1978 in Cape Town, South Africa), the first of its kind worldwide. In a review over twenty years later, she pointed out “In 2002 as in 1979, HIS [hospital information systems rem. editor] must be integrated in the hospital's organizational structure; financial and economic benefits depend upon using technology as an enabler of improved clinical outcomes; and education and training remain critical to the successful use of technology solutions“. These requirements that coined the vision of information systems proved to be substantial 30 years later and still today.

## Health on the Net (HON)

Health on the Net was a Non-Governmental Organization (NGO) and a non-State actor in official relations with the World Health Organization (WHO). The site search tool certified medical and health information on websites, apps for mobile devices, and for social networks. The certification process was based on the HONcode, a list of requirements reflecting how transparent, reliable and trustworthy the information was. HON was founded in 1995 by a group of international scientists led by Jean Raoul Scherrer and based in Geneva, Switzerland until 2022. Ball served on the Board of HON from 1998 to 2019.

## Health record banking

With the advent of Personal health record systems to empower the patients and citizens to access, visualize, manage, and share their health data, the need for resources enabling the secure and trusted data management arose. Coming from the area of Consumer Health Informatics, Ball joined the Health Record Banking Alliance and provided a conceptual model together with Jonathan D. Gold. The model instructed how to securely manage health data from citizens to make information available in cases of emergency and in other circumstances such as medical research. The model was inspired from the concept of financial institutions serving as safe and independent transaction platforms.

## Most recent awards and honors

* 2023 Glaser Award
* 2021 Distinguished Fellow, American Medical Informatics Association (AMIA)
* 2020 The Academy of Medicine, Engine ering and Science of Texas (TAMEST), Member
* 2017 International Academy of Health Sciences Informatics (IAHSI), elected as a Founding Member

## Publications
### Most important and recent books

* Ball, Marion J; Hannah, Kathryn J; Gerdin Jelger, Ulla; Peterson, Hans, eds. (1988). Nursing Informatics: Where Caring and Technology, 1st Edition. Springer. doi:10.1007/978-1-4757-4160-5. ISBN 978-1-4757-4160-5. S2CID 37543086.
* Ball, Marion J; O’Desky, Robert I; Douglas, James W; Albright, Judith V, eds. (1991). Healthcare Information Management Systems: A Practical Guide, 1st Edition. Springer. doi:10.1007/978-1-4757-4043-1. ISBN 978-1-4757-4043-1. S2CID 19406276.
* Ball, Marion J; Silva, John S; Douglas, Judith V; Degoulet, Patrick; Kaihara, Shigekoto, eds. (1994). The Health Care Professional Workstation. Proceedings of an International Medical Informatics Association (IMIA) Conference. Washington D.C., 14–16 June 1993. Elsevier Science, Ireland. ISSN 0020-7101.
* Hannah, Kathryn J; Ball, Marion J; Edwards, Margaret, eds. (1994). Introduction to Nursing Informatics, 1st Edition. Springer. doi:10.1007/978-1-4757-2246-8. ISBN 978-1-4757-2246-8. S2CID 36395054.
* Ball, Marion J; Douglas, Judith V; Gerets, David E, eds. (1999). Strategies and Technologies for Health Care Information: From Theory Into Practice. Health Informatics. Springer. doi:10.1007/978-1-4612-0521-0. ISBN 978-0-387-98442-1. S2CID 32114550.
* Ball, Marion J; Douglas, Judith V, eds. (1999). Performance Improvement Through Information Management: Health Care's Bridge to Success. Health Informatics. Springer. doi:10.1007/978-1-4612-0519-7. ISBN 978-0-387-98452-0. S2CID 30344847.
* Hübner, Ursula H; Wilson, Gabriela M; Shaw Morawski, Toria; Ball, Marion J, eds. (2022). Nursing Informatics: A Health Informatics, Interprofessional and Global Perspective, 5th Edition. Springer Nature. doi:10.1007/978-3-030-91237-6. ISBN 978-3-030-91237-6. S2CID 251021695.
* Kiel, Joan M; Kim, George R; Ball, Marion J, eds. (2022). Healthcare Information Management Systems: Cases, Strategies, and Solutions, 5th Edition. Health Informatics. Springer Nature. doi:10.1007/978-3-031-07912-2. ISBN 978-3-031-07912-2. S2CID 78565431.

### Children’s books

* Ball, Marion J, ed. (1972). What is a Computer?. Houghton Mifflin Company, Boston. ISBN 978-0-395-13772-7.
* Ball, Marion J; Charp, Sylvia, eds. (1978). Be a Computer Literate!. Creative Computing Press. ISBN 978-0-916-68808-0.