Abstract
The major reorganisational tasks which confront mental health services over the next few years are clear. Each service must adopt a comprehensive case or care management system which ensures continuity of care and develops systems which support continuous quality monitoring and clinical effectiveness including the production and implementation of evidence-based clinical guidelines, clinical outcomes measurement and cost effective delivery of care. This will demand realtime monitoring of clinical, utilisation and cost data. Although there is now a veritable avalanche of material in the literature on the development of computerised information systems, particularly in relation to management information and also on the need for focusing on outcomes measurement, we can find little by way of descriptions or advice on the development of patient records to complement these challenees.
Either redesigning a service's patient record system or adopting and adapting a redesigned system from another service is a daunting prospect. However, most psychiatric services will need to do this if they are to have the ability to deliver a comprehensive case or care-manager-based service which can be continuously evaluated and to which routine outcomes measurement can be integrated in a clinically useful way.