Development of an on-line management information system for community mental health centers

The degree of Success attained by an organization is directly related to the decision making acumen of its administrators. An advantageous decision is more probable when an administrator has ready access to that information which relates both directly and indirectly to that decision. The multiplicity of decisions which face any administrator requires that a wide variety of data be collected and maintained by the various operations within an organization. Furthermore, the data must be readily accessible and easily aggregated into appropriate formats, so that the possible implications of alternative decisions can be examined. Management information systems (MIS) have been widely implemented in business settings as a systematic approach to collecting and reporting the information necessary for decision making. In recent years, attempts have been made to apply these concepts to mental health care delivery systems. In several ways, the components of a community mental health center (CMHC) are analogous to the components of a business structure, so that a cross-fertilization of techniques may take place. Both seek effective utilization of resources. Both must achieve effective resource utilization to continue to exist. And finally, both must meet the needs of consumers and stockholders (taxpayers). However, there are also differences between a CMHC and a business. For example, in a CMHC, information needs are very broad and include both administrators and researchers. Thus, a direct application of corporate management techniques to a mental health delivery system is not feasible. In recent years, various management information systems have been developed and implemented by mental health centers. Many of these systems are constructed from a combination of transaction processing and data base management techniques. A few systems (Elpers & Chapman, 1973; Kaplan & Smith, 1974; Kurke & Van Houdnos, 1974; Broskowski, Note 1) have been automated by means of electronic data-processing equipment. Several fundamentals for systems design have been learned in the process. First, the methods of data collection must be uncomplicated. All data-collection documents should be designed with the user in mind. Forms design should be simple, yet it should allow for the collection of all necessary data and be susceptible to modification. Routine data gathering should be maximized for clerical staff and minimized for clinical staff. Report generation should be timely and relevant to the needs of the individual mental health center. Reports should meet the needs of management, research, clinical activities, and funding agencies. Finally, the system must insure confidentiality of patient records. An awareness of these fundamentals is a necessary precursor for the appropriate systems design of an MIS. A comprehensive, on-line computerized MIS has been designed and is currently being implemented at the Salt Lake Community Mental Health Center. This MIS is a functional subset of the on-line psychiatric assessment system developed in cooperation between the College of Medicine of the University of Utah and the Salt Lake City VA Hospital (Johnson, Giannetti, & Williams, 1975; Johnson & Williams, 1975; Williams, Johnson, & Bliss, 1975). Thus, the Utah system now provides a management information system as well as psychiatric assessment services. The purpose of this paper is to describe the systems design and development of this on-line management information system.