Digital psychiatry has become increasingly important and understanding of certain aspects is essential for practising clinicians. This article discusses electronic patient records (EPRs), from their origins to current and future use, the growth and embedding of outcome measurements, the use of social media, and learning and research in virtual arenas.

The National Service Framework (NSF) for coronary heart disease (CHD) requires that all people with established CHD are identified and managed systematically; accurate and complete electronic patient records (EPRs) are thus essential. This project aimed to first establish the completeness and consistency of recording electronic information about CHD (diagnosis, risk factor monitoring and aspirin usage) across a group of general practices and secondly, to provide feedback on their performance. The third part of the project planned to evaluate the effect of this feedback on the general practices’ electronic data recording but this is not reported in this article. Twenty-two of 26 general practices in one Primary Care Trust (PCT) participated. A random sample of 75 people with a Read code for CHD and/or who were taking one or more of five drugs used in CHD were selected from each of the 15 practices using Egton Medical Information Systems (EMIS) to manage their EPRs. The remaining seven practices used Torex electronic clinical system and from each of these practices, a random sample of 25 patients with a Read code for CHD was selected. Sample sizes were pragmatic rather than being chosen for possible statistical significance. At each practice the patients’ paper patient records and EPRs were searched for information about CHD diagnosis, risk factor monitoring and aspirin usage. Results were fedback and discussed with each individual practice and presented to the PCT. Electronic recording of CHD diagnosis was fairly complete but recording of risk factor monitoring and aspirin usage was more inconsistently recorded. Providing feedback to the general practices raised practitioners’ awareness of strengths and weaknesses in their electronic record keeping. Work to improve EPRs needs to be ongoing, to ensure that there is complete and easily accessible information about people with CHD so that their care management can be planned and implemented effectively.