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Mobizio // HCS
www.theaccessgroup.com/hsc0845 835 0172 [email protected]
Your guide to a paperless care business
2Mobizio // HCS
Introduction Across health and social care the use of paper is being phased out
The NHS has a target to go completely paperless by 2020 and with good reason; the use of paper in data intensive industries like healthcare and social care compromises productivity, quality of care and data security.
As a result, the social care sector is now rapidly adopting software and technology to digitise an array of important processes from finance and payroll to care planning and delivery.
Moving from paper to digital processes brings enormous benefits, both in efficiency and care quality. However, changing the way your business operates always carries a certain level of risk, mainly from improper procurement or poor change management planning.
This guide informs care providers not only of what a paperless care business looks like but also how change related risks can be minimised.
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Care software explained Scheduling and rostering software
Scheduling and rostering software has become a standard part of running a domiciliary care business.
Scheduling was and still is a major challenge that all care providers have to contend with.
Prior to using rostering software providers were forced to manually create rotas, send them by post and communicate any changes individually over the phone.
Processing timesheets accurately to payroll and calculating travel time both represented massive administrative burdens and potentially legal issues. Rostering software is used to overcome all of these challenges and more.
Care planning software
Electronic care record software is a more recent introduction, with the first software hitting the market in 2013/14. Since then uptake by care providers has been enormous. Principally electronic care record software (with a mobile app), enables care staff to complete care documents – such as care plans, assessments and daily notes - on mobiles, tablets and through web browsers in the back office.
This creates a shared record and removes the need to type up or duplicate data, so that care businesses can reduce their back office admin and overheads. This enables them to reduce outgoings and dedicate more time and resources to driving up care standards.
Some care record software also automates a range of processes including multiple workflows, automated incident reporting and escalation.
Care delivery software
The latest developments in care software are centred around care delivery. Using mobile apps carers can see exactly which medication to give and activities to complete in each visit. Carers then log these as complete or not complete and add their daily notes to a visit by speaking into their phone or typing.
Some software uses this information to alert providers to any missed medications, logs medications given or not given in an electronic MAR chart, creates a log of each visit and gives the back office a live dashboard showing what is happening in any care visit in real time.
A complete package?
It is important to bear in mind that all care software is slightly but importantly different and most software on the market will not have all of the above features.
For example, some may not have a complete selection of digital forms. Others will not have a proper eMAR solution, or calculate travel time or integrate with Google Maps.
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The business caseWhy it is important
Building a business case is a necessary part of any software procurement process. For large organisations this will be a formal procedure in which a project’s costs, projected benefits, potential risks and success criteria are presented.
Even if this kind of formal procedure is not necessary for your business, the process of evaluating all of the above will enable you to give your project a clear scope, objectives and budget. It will also help you plan more effectively.
Additionally, as you identify the various benefits for different stakeholders, the information in your business case will assist in selling the project to your colleagues, local authorities and potentially service users and their next of kin.
In the beginning
The first step in a business case is to establish how your current ways of working can be improved.
We have compiled some examples commonly found in the business cases of home care companies, who are aiming to reduce paper based processes. These focus on identifying areas of improvement in both efficiency and care quality.
Please note these are not complete lists and you are likely to identify further areas of improvement as you evaluate your existing processes.
The business case part 1: Efficiencies
Identify how much time your business currently spends on activities resulting from:
• Time spent typing up, filing and other admin caused by the use of paper based care plans, assessments and reviews
• Time spent collecting/replacing daily care notes and MAR charts from the homes of service users
• Fuel costs of collecting daily care notes and MAR charts from the homes of service users
• Time spent and fuel costs of amending care plans kept in service user’s homes
• Time and fuel costs of adding medications to MAR charts
• Time spent creating rotas
• Cost of posting rotas/time spent emailing rotas
• Time spent changing rotas, organising cover and communicating changes
• Time spent entering timesheet information into payroll and billing systems
• Time spent creating financial reports
• Cost of printing paper copies of care documents
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The business caseCalculating the costs
If the figures for the above activities are not readily available to you, ask those members of staff responsible to keep track of how much time is spent on each of these over a four to six week period. This will ensure end and start of month activities are included in your evaluation.
Multiply the number of hours spent on each activity by the wage paid to those members of staff who carry out the activity. This will tell you how much each activity is costing the business.
For example:
Each of our two care coordinators spend eight hours each week typing up care plans, assessments, notes and other documents. As our care coordinators are paid £10.00 per hour, this amounts to the business spending £160.00 each week on this admin activity alone.
Do this for each activity you have identified and you will have a complete figure of the potential savings and improvements in efficiency to be made by digitising your processes.
The business case part two: Safety & care quality
The safety of service users cannot be quantified in the same manner as efficiencies. However, there is considerable scope for building a business case for digitisation around service user safety.
The main area to consider is the increased visibility and responsiveness to issues that care software is able to give care providers.
Consider for example, currently:
• What visibility do you have for missed/late/short/long care visits?
• How long does it take for incidents to be reported?
• What visibility do you have to ensure these processes are completed on time?
• Does the business experience delays in missed medication or missed visits being reported?
• Does the business experience incidents which go unreported?
• Are incidents always escalated to the right person/s?
• Is the business able to effectively track the progress of incidents from being reported through to investigation and closure?
• Is the business able to report and analyse on incidents to highlight specific areas of concern (for example a carer who needs retraining or inadequate equipment)?
• How does the business ensure visits have been completed?
• How does the business ensure carers’ qualifications are up to date?
• Is the business able to track and report on outcomes?
• How does the business ensure service users have a regular carer or team of carers?
• Are our records of medication and incident management always to hand, ready for inspection?
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Planning correctlyNow that you have identified the challenges your business is facing, you can create a list of requirements to assess which software is the best for your business.
Many large organisations go through a lengthy tendering process. For smaller organisations this is unfeasible and impractical. However, anyone procuring software should always have a set of ‘Qualification Criteria’. This will enable you to judge one product against another in a systemised fashion.
Your qualification criteria should be based on the projected improvements in efficiency, cost savings and care quality in the previous sections.
Other qualification criteria
Additional to the criteria you have developed in the ‘Business case’ section above, your qualification criteria should also evaluate technical aspects of the software and its provision.
Below are two tables - which you can build on - that include some of the most important areas of concern for care providers procuring care management software.
Tips from:
Steve Harris, Managing Director Sentinel Care Services
“Ensure you know your business processes, they will change as a result of the introduction of digital technology and the opportunities it affords.”
“Change management, the process of ensuring your staff ‘own’ the journey, without their ownership resistance builds that affords the opportunity for criticism.”
“Define your expectations and make your software provider aware of those expectations.”
“Embrace the opportunities and don’t be afraid to change, if done correctly you and your business will benefit.”
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Technical qualification criteria
Criteria DetailResponse: Yes/No and notes
Is it cloud based? Does the software run on the cloud? Can it be securely accessed on any device using a log in and password?
Does it require an on-site installation?
Compatibility Does the mobile app work on both Android and iOS (Apple) devices?
Does the web portal run on any browser?
Configurability To what extent can I customise the software to my needs, e.g. can the software provider or I create customised forms and/or alerts?
Are there significant costs to this? Am I able to do this myself through the web portal?
User roles Are there user groups (e.g. manager/coordinator/carer) with different levels of access and permissions?
Can I create or modify these user groups and their access levels to fit my business’ needs?
Integration Are the different pieces of software (e.g. care records, care delivery, scheduling and payroll) all integrated?
What information is shared between the software (e.g. call monitoring data, service user records, employee records etc.)?
Will carers need to use two separate mobile apps to ‘clock in and out’ and update care notes?
Will I still need to duplicate data (if so how much and how often) from one system into another?
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Technical qualification criteria
Criteria Detail
Next of kin engagement
Can next of kin or other external persons be given automatic email updates on their loved one’s care?
Can next of kin or other external persons be given access to the system if desired?
Is there an additional charge for this?
Reporting Is there an inbuilt reporting module?
What areas of the business and care provision can I report on?
Can I create my own bespoke reports from scratch?
Will I be stuck with a stock set of reports?
Can I export the data – if so in what format?
Document management
Can I upload documents directly into a service user’s record?
Can I re-download documents from the web portal?
Can I search for documents?
What formats (Word, PDF, XLS etc.) can the documents be?
Altering Does the software automatically alert the office to any/all of the following:
• Missed visits
• Late visits
• Short visits
• Long visits
• Missed medications
• Missed care activities
• Incidents
Can I create my own bespoke alerts using the software?
Can I choose which medications/activities trigger alerts if missed?
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Technical qualification criteria
Qualifier Detail
Timescales How long does setup typically take for an organisation of my size?
Training How long does training take?
Are there training materials or online videos I can use in the future to help train new members of staff?
Security Is their company ISO27001 certified?
Can I deactivate lost/stolen devices through the web portal?
Is two-factor authentication an option?
Support What are their ‘Service Level Agreements’ (Time taken to solve different types of issues)?
When is their support desk available?
Hardware Can they assist or advise on the procurement of hardware (i.e. mobile devices, NFC tags etc.)
Number of social care clients
How many separate clients do they have in health and social care?
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Making the moveArranging demonstrations
If you’ve followed the preceding steps you will be well equipped with a clear idea of what challenges you would like software to solve, the benefits of doing so and which technical and business attributes you want to see from suppliers and their software.
You are now ready to see what the market has to offer and arrange some demonstrations. Simply go to the supplier’s website where there will be an option to ‘Contact Us’ or ‘Arrange a Demonstration’.
During any demonstration, remember that there is no such thing as a silly question. Simple, everyday questions can often uncover basic but important flaws in software.
Try to get an answer to all of the qualification criteria you have put together in the previous sections.
Case studies and reference sites
Following the demonstration be sure to ask the salesperson to send you any case studies they have, recent ones if possible. You should be able to download these from the company website too.
The world of social care is close knit. Reach out to people you know and see if they have any experience of the software in question. While second hand anecdotes cannot be wholly relied upon, direct experience can.
Finally ask if the company can set up a call with a client of theirs. Note that for larger software providers these can sometimes be more difficult to arrange, due to the volume of reference requests made and the strain this could put on those clients able to give a reference.
During any reference call discuss how long they have been using the software and how it has benefited their business.
Ask if they have experienced any major issues or minor drawbacks. Another important area to discuss is the quality of support and implementation and anything else you feel is especially relevant to your business.
A reference call is also a fantastic opportunity to ask someone who has already implemented the software what lessons they have learned from the process and what they would do differently if they were to repeat it.
You can then apply these lessons to your own implementation to avoid potential pitfalls and optimise your change management.
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Bringing people on boardImplementing new software always works best when the organisation as a whole has ‘bought in’. To do this you will need to show your colleagues how the software will not only help you as a business, but also how it will help them in their day to day duties.
Below are some examples which you can add to and expand on.
Registered Manager:
• Enhanced visibility of care quality across the business
• Ability to quickly run reports on care quality, staff performance and more
• Records will always be up to date
• Investigation process (for complaints, incidents) etc. can be driven automatically
Care coordinators:
• Rotas created automatically
• No need for paper timesheets
• Automatically match carers to service users to maintain continuity of care
• Use reports and alerts to track service user outcomes and intervene when necessary
• Carry out assessments, risk reviews, consent forms etc. on tablets – no need to duplicate data
• Employee management ensures carer training, spot checks etc. are up to date
• Better management of the recruitment process
Care supervisor:
• Instant, detailed alerts for any missed medications and incidents
• Alerts for missed, late and short visits
• Live feed of information from the point of care
• Reduce preventable medication errors with printed MAR charts
• eMAR charts and visit logs created automatically – no need to retrieve from service user’s homes
• Greater visibility of care delivery to ensure carers are adhering to the care plan
• An end to duplicating (typing up/scanning/copying) assessment forms, care plans and the like
Carers:
• Mobile app gives you all the information you need for each visit in including notes from previous visits and tasks to complete
• Speak into the device, instead of writing or typing notes
• Up to date rota deployed straight to your mobile
• Spend less time on admin, have more time for care duties
• Office will be alerted automatically to any incidents/missed meds giving you peace of mind and enabling you to spend more time on care
Next of kin:
• Ability to log in to a portal and/or receive live email updates to check on their loved one’s care giving you peace of mind
• Safer, more person centred care
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Bringing people on boardBriefing document
How you choose to present the benefits of your new software to your staff is up to you.
One particularly effective method is to prepare and distribute a short, friendly document, explaining firstly what your software is, what it does and how widely it is used.
You can then use the ‘buy in’ values above to explain how the software will help each part of your team and business.
The document should also include some indication of when staff will start using the software, what training will be provided and how they can best prepare in the meantime.
Ensure that the document is enthusiastic in tone. It is always a good idea to include images of the app which you can usually find on the software provider’s website.
Change champions
Often certain members of staff will emerge, who from the beginning recognise the benefits of digitising processes.
These people can be your ‘change champions’, who can lead the rest of your carers in seeing the benefits of change from their own perspective. As care providers have found, this is often more effective than a purely top-down perspective.
Tips from:
Matthew Kalupka, Managing Director Home Counties Carers
“The thought of training the staff is always daunting but if you have chosen well, then the benefits and ease of use of the software will mean the staff are keen to get up and running.
When it comes to getting staff enthusiastic about the software communication is key.
Sell the benefits, explain why the software is needed, see if there are a couple of staff particularly keen who can be “champions” of the software. Their fellow carers might take better to their positivity and excitement than the Managers of the business.”
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What’s next?By following the steps outlined in this document you will have built a considerable and convincing business case for digitisation.
You will have equipped yourself with the necessary criteria to assess one provider and their software against another.
Alongside selecting the software you need, you will be able to foster a powerful enthusiasm in your team, who will understand the benefits of digitisation for all and will be less daunted by the prospect of change.
The next step for you to take is to put all this to use. Each journey to something better, in life or in business begins with a single step. The road to digitisation is one all care providers will have to take sooner or later. For you this journey can begin now.
To hear more about the Access Group’s software for care providers click here for a no obligation consultation.
Part two: How to implement your softwarePart two of our Guide to the Paperless Care Business will be available soon. It will guide you through the entire process of implementing your selected software, including getting the right hardware, setting up your new system and training your staff.
To receive an advanced copy simply register your interest
Mobizio // HCS
www.theaccessgroup.com/hsc0845 835 0172 [email protected]
About Access
Access is a leading health & social care software provider, supporting over 700 UK care organisations with residential and domiciliary care management, finance, HR, payroll, and business intelligence solutions. Our customers benefit from an organisation-wide solution from a single supplier. Clients range from small independents to some of the UK’s biggest care providers including City & County Healthcare, Home Instead Senior Care, HC-One, Four Seasons and Age Concern.
www.theaccessgroup.com© 2017 The Access Group
Our thanks to Steve Harris of Sentinel Care, Matthew Kalupka of Home Counties Carers and all the many care providers who have assisted us in compiling this resource for the care sector.
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