Many care providers are now looking towards a smarter way of working, and with the recent strain put on the care sector due to the Coronavirus pandemic, it seems now more than ever people will be looking to make the switch to digital.
In this guide to electronic care planning, we map out what the best ways of going about selecting an ECP provider are, and answer that all important question: what are the costs?
Electronic Care Planning (ECP) is a very recent and modern market, with most of its current players being fewer than 10 years old. As a result of this, pricing is often a topic of discussion: is it driven by its market, or is the market driving it instead? Is the market mature enough to represent a fair value or are providers offering a round number and see if it sticks? How is pricing calculated – by the number of staff, or people we support? How much is the upfront/setup cost, and how quickly does it start showing a good return on investment? How can I ease off this investment if I am a smaller provider? Can I get support from the Government/my local authority? This guide to electronic care planning tries to answer all these questions and leave you with enough material so that you can set a budget before you start looking for the most adequate ECP for your care provision.
Where should I start?
Let’s start with the basics: your budgeting for an ECP is usually broken down in three different types of payments: Licensing (recurring costs), Implementation (one-off initial costs) and add-ons (additional costs if there is a variation from the initial requirements).
1. Licensing: this is your subscription cost which will be the bulk of your budget; it should cover the usage of your solution, any server costs, security, backups, support, account management, and product development.
💡Tip: Always ask if the list above is included in your licensing cost. Nobody likes being surprised with a lower licensing price only to find out later that support or account management are add-on.
2. Implementation: this is your initial setup cost, which is usually roughly the equivalent of the first year of your licensing cost. It should cover any hardware, training, and setup fees.
💡Tip: Some companies might offer you implementation at a very low cost, or even for free. It’s
good to bear in mind that this may indicate that a company is relatively young and might not be as
robust as other, more mature providers.
3. Add-ons: Anything outside of the scope of the initial plan would fit this category. For instance, if you expand to get a new unit, require a couple of additional pieces of hardware, or require additional training, you should expect there to be a cost for these.
💡Tip: A transparent company will always be clear about any add-on costs. Be cautious if any Licensing or Implementation cost mentioned above fits into the “add-on” category, since you should expect them as standard.
I started my research, but licensing costs are wildly different across different ECPs, why?
Usually the cost represents a breakdown of the points mentioned above: the usage of the solution, server costs, security, backups, support, account management, and product development. A lower cost usually means some of these key elements is severely reduced or even not included.
Another important point is understanding whether the solutions is fully cloud-based, on-premise, or mixed. Most modern ECPs are fully cloud-based, which should be your preference: it will be much more robust, future proof, with regular updates, and you will be able to access your care records from anywhere (with the right permissions).
On-premise solutions usually have a higher implementation cost and require higher add-on fees when there is a maintenance problem. Cloud-based solutions are usually more expensive initially but being future proof, you are not surprised with hidden fees and required upgrades at any point.
💡Tip: ask the following questions to understand if the service will be within your expectations:
1) How often is the system updated with newer, better features and clinical updates from the sector?
2) Who receives support, how is it offered, and is it 24/7 all year round?
3) Is the data stored in the UK and how often are backups conducted?
The different types of licensing
Our guide to electronic care planning will break down the different types of licensing you can get. You will most likely encounter one based on the number of people you support, one based on the number of staff you have, and one based on the number of devices you are using.
1.Based on the people you support: this usually gives you a fair price because it’s directly based on your revenue.
💡Tip: some providers offer you discounts based on different brackets so try to use that to your advantage. Also, clarify whether this impacts the capacity or occupancy of your numbers
2. Based on the number of staff you have: roughly a similar cost to the one above depending on the ratio of staff to people you support.
💡Tip: ensure you have enough accounts for every member of staff or you will start losing accountability if people start sharing accounts. It might save you a very small cost initially, but it can have dramatic impact in evidencing care on a later stage.
3. Based on the number of devices you are using: usually more common in legacy ECPs, you will only pay for how many devices you require. Usually a good option if you have a low ratio of staff to people you support.
💡Tip: Same as above, ensure every member of staff has access to the ECP at any point in time. If you neglect this, the ECP can become a downgrade from paper, since there will be times where staff will have no access to care plans, or no way of evidencing their care.
As a smaller care provider, how do I tackle the high cost of the implementation?
As with any decision, this will have an impact on your business. You should look at your options, even once you have picked your favourite ECP. Our guide to electronic care planning provides some ideas for how you can mitigate the implementation cost to a minimum:
1. Can you do one or more training days remotely? Usually the cost is reduced in this case, and there are many benefits such as multiple people being able to join, the ability to record the session and reuse it in the future, and ultimately best use of time. With the world adapting to the spread of Covid-19, this is likely to become the norm for many.
However, try keeping remote sessions only to staff who is comfortable doing this – and support staff struggling with technology with face to face training.
2. If you have more than one home, try joining the senior staff together, cutting the cost in half. The more homes you have, the more cost efficient it can be. But bear in mind too many might shift a workshop environment to a less practical “classroom” approach which might not be ideal.
3. Look into alternative hardware options. Cheaper hardware usually means more headaches in the long run, but if you have a strong policy for hardware handling in place, it might be worth looking at all the options.
4. Financing is another option – ask your ECP provider if they can recommend anyone or do your own research if you’re more comfortable doing so. It’s not unusual to see single Care Homes splitting the implementation cost across 12 or 24 months.
How quickly do I see a return on my investment?
Picking an ECP is invariably a decision to which Care Providers say “I don’t know how I did not do this earlier” since it’s one of the quickest returns for a business which relies so heavily on data. You can split the benefits into tangible (direct saving in cost) and intangible (indirect saving in cost) savings. When you take notice of intangible savings is when you truly realise the advantages of an ECP.
1. Tangible savings: stationery, paper, printer leasing, printer ink, files, binders, pens, you name it. Any expense you currently have with paperwork is almost immediately reduced to almost zero. Archiving is another factor you will realise in the mid to long term: whether you store your archived paperwork in a shed, your attic, a room, or externally with a storage company, this is either direct capital or an asset that you will be saving: usually this means you will either make significant savings or be able to have an extra room in your care setting.
2. Intangible savings:
- Increased quality and quantity of notes evidenced, which leads to improved and more personalised care given, which often reflects on an improvement in the quality of care offered by the care provider.
- Floor staff time saving: staff do not have to spend 40-60 minutes writing notes in the end of the shift, meaning you use their time more effectively and efficiently.
- Staff happiness: gone are the days where staff struggled with technology. With ECPs becoming easier to use and intuitive, the staggering majority staff now prefers working for a care provider using an ECP than one using paper.
- Time spent looking for past evidence, producing reports, auditing, and being inspected drops drastically: in some cases, sessions of 2 days are reduced to 15 minutes. Notes stop being written purely for evidencing purposes but are instead organised, targeted, and influencing future decisions about a person’s care provision.
Adopting an ECP is not a question of if but when. More and more care providers are adopting ECP, which is giving them a business advantage over other providers who are still reliant on paper-based records. More emphasis is being placed upon the value and benefits ECP can provide, with even the likes of inspectors and commissioners endorsing using this approach to recording care. Take advantage of this by comparing the already mature ECPs in the market since it’s not a new sector anymore, and you will quickly reap the benefits described in this article.
💡Tip: reflect or measure how long it’s taking your senior team to do audits, reporting, and staying on top of care plan reviews. This should be a great foundation for how much you will be able to budget in your decision. Repeat the same exercise for your costs on staff recruitment, retention, and overall happiness in writing paper notes every day.
💡Tip: When picking an ECP, prepare your meeting well by setting a list of criteria you are looking for by including not only required features but also what is included in the cost breakdown. The better prepared you are, the less hidden fees will surprise you.
💡Tip: Moving to an ECP is a massive business decision. Ask your peers, local providers, and communities for a reputable provider rather than being driven purely by cost – cheap is not always best.
💡Tip: Do not neglect the quality of Support and Account Management. An ECP requires a significant process of change management in your care provision, so think of it as a journey and never as an end goal.