How to manage the evolution of a computerized information system

Existing computerized fiscal and patient information systems do not seem well suited for the mental health field. To design its own system, an institution would do better to form an information system staff rather than to use an outside software house, because doing it externally is less responsive, slower, and, for some tasks, simply impossible. The in-house staff must be selected to be competent generalists, at ease with computer technology. Working in close and friendly cooperation with various user groups, the systems evolve out of small beginnings. As the users gain working experience with early versions of a system, they are able to refine their goals, with the result that the final system meets their needs well, even though it may seem to be different from what was originally expected.