This volume contains the proceedings of the Twenty-second International Conference on Medical Informatics Europe MIE 2009, that was held in Sarajevo, Bosnia and Herzegovina, from 30 August to 2 September 2009. The scientific topics present in this proceedings range from national and trans-national eHealth roadmaps, health information and electronic health record systems, systems interoperability and communication standards, medical terminology and ontology approaches, and social networks to Web, Web 2.0, and Semantic Web solutions for patients, health personnel, and researchers. Furthermore, they include quality assurance and usability of medical informatics systems, specific disease management and telemedicine systems, including a section on devices and sensors, drug safety, clinical decision support and medical expert systems, clinical practice guidelines and protocols, as well as issues on privacy and security. Moreover, bioinformatics, biomedical modeling and simulation, medical imaging and visualization and, last but not least, learning and education through medical informatics systems are parts of the included topics.