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Adopting digital care management brings a wave of positive change for a care team. Taking advantage of digital transformation delivers better management of care, more secure data handling, better coordination and improved responsiveness. Given the importance of such system, and the importance of managing change in teams that are already extremely busy, selecting a supplier of digital care management services and solutions is critical.
This document provides guidelines derived from best practice compiled by suppliers of over 2000 registered services, including what works best, what risks to consider and how to avoid them, as well as what to look for in a supplier so that you get the product and service that is best for you and your care teams. Other industry bodies, such as the United Kingdom Home Care Association (UKHCA), have also published similar guidance.
Digital transformation of care practices is at present the greatest opportunity for positive change in the context of care provision. Successful implementation is known to result in:
The selection of a product starts with the internal definition of what the care provider wants to achieve. This can be reactive (due to external factors such as a negative inspection rating) or proactive (to gain a competitive advantage over other providers).
In parallel to this, the provider, the owner, the board or a budget holder, will task a team with consulting software providers, learning about their solutions and their services. Define clearly who will lead on this effort and make sure your teams are given time to be involved in the selection process. The team in charge must have an open mind about what technology can achieve for care teams, providers, people receiving support and their families.
When care managers, senior care workers, nurses and care workers are involved in the selection process the adoption tends to be easier.
The team tasked with consulting suppliers will create a shortlist of suppliers, and from this shortlist, key stakeholders and budget holders will then select the preferred supplier.
Ensure that terms and conditions are aligned with your requirements. Areas to consider include:
Get a clear understanding of how the product is designed, basic building blocks, security and resilience:
Working with the preferred supplier you will then agree:
Most providers will be able to facilitate low risk evaluations – this is usually done through easy contract cancellations in the first few months. For large providers with multiple registered services, a pilot may be used to evaluate more than one product – although costly, this may be a sound approach when your procurement process fails to identify a clear preferred solution.
For creating a roll out plan, always consider:
Digital systems for care management have proven to reduce risks and increase transparency. However, there are risks, predominantly related to change which must be acknowledged and managed during the procurement process. These include:
|Risk||Risk Avoidance Actions and Mitigration|
|Staff resistance to change and loss of key staff||Involving key staff in the selection process is likely to decrease the likelihood of staffing dissatisfaction; ensure staff is briefed in advance of training and roll-out, listen to concerns and address them – some providers may have brochures or other items to help with raising awareness and internal communication; internal workshops pre- and post-deployment can be used to ensure good communication and engagement;|
|Data loss or data breach||Seek reassurance with the supplier as part of the technical evaluation. How long have they been registered with the ICO? How do they report issues of data breaches to you? Which continuous improvement and monitoring processes do they have in place? Ensure your supplier allows you to control which devices have access to records – authorising or revoking access (e.g. registered manager’s home computer);|
|Devices being lost||Introduce charging stations, ensure devices are tracked, either with a device count on handover or digitally if suppliers allow for this. Some suppliers will be able to track devices remotely and wipe them remotely in case they are lost;|
|Poor adoption, worsening of quality of records||In the same way your team performs record audits on a paper-based system, it’s important that these continue when on a digital system. Some suppliers may offer functionality regarding audits;|
|Risk of CQC seeing the use of technology in a negative light||Managers can keep a crib sheet, mapping compliance to how they use their systems. Suppliers will be able to provide evidence of how CQC endorses the use of digital tools;|
|Poor governance around password management||Integrate basic IT security into your internal training plans – as a minimum explain people in your teams, they must not share passwords, and passwords must remain confidential. You must also ensure accounts for care workers are deactivated when they cease working for you;|
|Perception of tech as a barrier to engagement with person receiving support||Record the care notes at the point of care and let the person you support know what is being recorded. This can even be extended, when there is capacity, to people receiving support contributing or creating their own records;|
|Access to information for external stakeholders||Ensure this is understood by your teams – most systems offer proxy access to personal data – either for family access, GPs or other providers – this must be controlled. Ensure suppliers provide specific training on these areas of functionality and how to manage them;|
|Scope of tech supplier responsibility vs. provider duty of care responsibility||Ensure that the terms and conditions are clear regarding scope of responsibility regarding data governance and security, as well as your responsibilities as data controller and the supplier’s responsibilities as a data processor.|
When choosing a supplier for digital care management, you may want to consider the following aspects of evaluation. Different care providers will take each aspect as more or less critical for the choice. Considering the complexity and risk of adopting a system, you may want to consider aspects of evaluation as well as aspects of culture fit. Here are some examples of aspects you may want to consider as part of your evaluation:
Digital solutions help you streamline your data governance obligations. GDPR and the Data Protection Act 2018, define the responsibilities of the data controller, i.e. the legal entity, and the data protection officer (DPO), the person who determines the purposes for which and the manner in which any personal data is to be processed.
By contracting a digital care planning supplier, you need to consider how the supplier is going to fulfil their obligations as a data processor.
Information about your obligations and those of data processors can be obtained from the Information Commissioner’s Office or the National Care Forum.
You also need to be mindful of the scope for which the supplier is responsible. When the supplier is providing you with a locked down handheld device then the supplier will be responsible for information security end-to-end. However, if you choose to source your own devices, or if the supplier does not manage your devices, you are responsible for managing the data while in the device until it gets to the app – this includes how the data is handled by the phone’s keyboard, any speech to text software or other applications that may intercept data being typed before it gets to the supplier’s app.
Once the product is in use, you need to consider how your onboarding of new team members will have to include training modules to cater for the use of electronic care recording systems; when you choose a product that is easy to use, most carers are trained by their peers; but you need to consider how to address this training requirement – as well as information security guidelines for each user of the product.
Suppliers will give you a range of options, including:
When choosing devices, it is important that you are mindful that:
Introducing an electronic care system is a significant change with impact on the work routines of your teams; it is sensible to inform the people you support, their families, district nurses, GPs, commissioners and community care teams of your plans to adopt digital, as well as the advantages for the quality of care you provide, and how people you support, their families and other visitors will benefit from this initiative.