Computers in clinical practice: applying experience from child psychiatry

Computers may be used to support information management, general administration, and clinical practice in a health service. I review the last use, drawing on examples in child psychiatry. Advances have been made over the past 30 years in the use of computer aided assessment, diagnosis, and treatment in many clinical specialties. The place of computers in clinical practice depends on whether they confer an overall advantage, im whether they are acceptable to patients and clinicians. Child psychiatry is a clinical specialty: management rests very much on the skills of the clinician, with little use of automated investigation or instrumental intervention.1 Thus, the principles governing the use of computers in this specialty may apply to many other clinical specialties. Coiera forecast the essential role of informatics in medicine in the coming century, describing it as fundamental to medicine as the study of anatomy.2 However, the application of modern technology frequently fails because of inadequate dissemination, which I hope to overcome, at least in part, in this review. #### Summary points This article explores the use of information technology in child psychiatry, a specialty that relies almost entirely on clinical skills, so many of the principles may therefore be applicable to other specialties Use of computers in clinical practice is at present largely limited to computerised versions of written tests or interviews Future developments may use technologies such as voice activated software, graphics, measuring response time, tailored testing, and virtual environments for tests that cannot be transcribed to written tests or performed during standard clinical interviews Outcome studies are needed to assess the impact of such technology Clinicians are best placed to identify specific potential developments and should be alert to the possibilities presented by the increasingly flexible and sophisticated technology available I searched three databases (Medline, PsychLit, and BIDS) for references to …