Measuring clinical and functional outcomes in mental health is becoming an increasingly complex and costly endeavour. It is with considerable regularity that tens and hundreds of millions of dollars are spent to develop electronic health records, yet today functional integrated products that can operate across domains of health have yet to be identified. The purpose of this paper is to describe ways and means of measuring functional and clinical outcomes across complicated case mixes and treatment domains in hospital and community treatment settings.

Data from several electronic records and data sources (n = 100,000) are used to illustrate the burden of measurement, data quality and related issues that practitioners face when collecting, analyzing and interpreting data in the age of information and accountability in health care. A practical, flexible, modular, and dynamic tool for measuring functional and clinical outcomes across treatment and education settings is described (TRACT: treatment response application for client tracking).

Relatively simple, modular approaches to clinical and functional outcome measurement that are integrated into medical practice have the lowest burden and highest yield in terms of demonstrating evidence-based practice, treatment effectiveness, and system level accountability.

Simple modular approaches to measuring complex phenomena, such as the effect of multiple treatment interventions in complex environments and against backgrounds of comorbid disorders, are likely to have high quality yields in terms of identifying promising and evidence-based practices through use of the highest standards available to an examination of practice in the field.