Psychiatric Services · 1984 · 11 citations · 2 references
ComputingHealth InformaticsPsychiatryClinical Information SystemsHealth Information SystemsMental Health CareClinical Decision Support SystemsClinical DocumentationData EntryHealthcare Database SystemsMedical Records ManagementSystem ImplementationClinical Data EntryClinical Data RepositoriesClinical Information System DesignComputer-assisted Clinical DocumentationComputerized Clinical DocumentationDesign PhilosophyMental Health Information Systems
The authors describe a computer-assisted psychiatric treatment planning system developed at the Jerry L. Pettis Memorial Veterans Hospital in Loma Linda, California. Using the File Manager, a VA-developed data base management system, they have developed a comprehensive, flexible system for writing, retrieving, and analyzing psychiatric treatment plans. The system permits rapid entry and retrieval of required treatment plans and produces a document that is clinically expressive and readable. It stores clinical data that may be analyzed for research, quality assurance, and management purposes. The authors discuss design philosophy, practical aspects of implementation, staff acceptance, and future applications to structured medical records.
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