This paper describes ‘ACE’ (Assessment and Continuous Evaluation): a unique system of communication and documentation successfully developed for use in a large psychiatric service with a strong commitment to community based psychiatry. The system has three components – a uniform approach to case management, a comprehensive set of patient record documents and a patient information management database. These three are integrated in design so as to achieve the aims of providing a predictable and consistent approach to managing cases, making the monitoring of essential information such as case loads, throughput etc. easier and efficient and accommodating continuous auditing of the system.

Elsewhere, we have argued for the need to redesign patient records in psychiatric services [1] this paper we describe the process and result of the redesign of the patient record system in the Division of Psychiatry in Geelong, Victoria, and which may be Of interest to many who are embarking on or are currently engaged in a similar exercise. We could find little practical advice in available literature to assist.

In this paper we describe the development of the Mental Health-Patient Information Management System (MH-PIMS), which is an information management system designed for use in a modern, primarily community-based, mental health service. MH-PIMS is a computerised database which was designed by clinicians and is supported by a case management system and complementary patient record set-together called the Assessment and Care Evaluation (ACE) system. The paper also describes the ACE system. MH-PIMS can generate patient reports of use to case managers and teams in managing their caseloads and is of use to senior clinicians and service managers for audit and strategic planning purposes.

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.