The first UK interdepartmental audit of intraoperative radiotherapy builds confidence in the delivery of this treatment.

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.

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