Mental health informatics and the rhythm of community care

Information systems in psychiatry must be released from the asylums and updated Clinical care in British psychiatry has been changing radically in the past two decades. Lifelong care for chronically disabled patients in institutions is giving way to networks of day hospitals, mental health centres, and small residential units. Care in hospital is now reserved largely for episodes of acute mental illness. But the information systems that record what patients, staff, and services are doing are still rooted in the asylum, and lack of appropriate data is impeding clinical work and the development of services. The Department of Health is reviewing the mental health minimum dataset (the information that NHS provider units must pass to purchasers and to the department). This offers an important chance to ensure that the right data are collected in the right way. What information should be collected, and who needs to use it? At the point of care, staff need user friendly, accurate, and confidential information about patients' past and current problems and care, particularly when emergencies arise outside normal working hours. Electronically held current clinical summaries can also ensure that staff know their responsibilities in each patient's care.1 The Clinical Standards Advisory Group has recently emphasised the value of maintaining a register of patients' care plans.2 Providers managing clinical teams need to …