Issues in the development of a computerized clinical information system for a network of juvenile homes

This article presents and reflects upon the formative evaluation of the development of a clinical information system for a network of juvenile homes. Several key problems were identified: The development of the system initially focused on inputs rather than expected outputs, and end users played only a minor role in the process. The system was overly ambitious, designed to fulfill many different expectations at one and the same time. Consequently, the instruments were cumbersome and not sensitive enough to note cultural differences among target populations. Administrative and organizational supports were not always adequate to the complexity of the system. The discussion considers the reasons for these problems and recommends ways of preventing and dealing with them. Some changes were introduced in the course of development and in response to interim reports of the evaluation, and to feedback from end users. The article points to the need for a coherent body of knowledge on the development of clinical information systems.