The ehealthtracker decision support tools, by Desuto, guide staff to choose the best course of action when they are making complex decisions about care.
Users, typically doctors, nurses, social workers, care home owners and managers, who are required to make decisions for those who lack mental capacity utilise the tools by answering a short series of questions with mostly yes or no answers. At each stage the tool provides the user with guidance to ensure that their decisions are lawful, ethical and evidence based.
Unlike some other decision support software, the ehealthtracker tools produce professionally written reports of the factors considered and the final decision. The reports can be downloaded, edited and personalised before being printed or entered into an electronic records system.
The most significant impact of the tools is the time that they save in making decisions and writing reports.
To date, given that 6300 reports have been produced, we estimate that over 9000 hours of staff time have been saved through the use of ehealthtracker tools.
We have testimonies from a nursing home owner and a local authority manager describing improvements in staff decisions and time savings.
Our core aims in the health and care field are to provide technology that supports staff to:
• Provide care based on core values of fairness, respect, equality, dignity and autonomy.
• Provide care that is lawful.
• Have a better understanding of human rights based care.
• Be professionally accountable.
• Reduce the time needed to document care decisions and write reports.
• Increase time spent providing direct care to service users.
The tools are not an alternative to other IT systems that organisations may have invested in but provide an add-on that will enhance existing systems.
Our current tools focus on the legal requirements of the Mental Capacity Act but there are many more possible applications for our system in health and social care including screening assessments, consent, treatment planning for specific conditions, risk assessment and management across a broad range of contexts, compliance, regulation preparation, GP reporting and safeguarding procedures.
Our decision support system also has the potential to impact across other professional arenas including police work, criminal justice and teaching by:
• Providing real-time expert guidance
• Providing problem based learning
• Reducing time spent making decisions
• Reducing time spent writing reports
• Reducing costs
• Increasing compliance
• Reducing the risk of litigation
Substantial accomplishments to date
Developed a Mental Capacity Act decision support tool for Cornwall County Council in 2009/10 prior to launching ehealthtracker.
Secured financial contributions from two local authorities to support early development work.
A survey showed that users believe the tools increase knowledge and make assessments easier and faster with 96% of respondents saying they would recommend the tools.
More specific comments included:
“A great tool – has helped us a lot already in meeting the requirements as set out in Law.”
Since early 2015 the ehealthtracker tools have been listed on the Social Care Institute for Excellence website.
The tools are currently free to use. With minimal spend, it currently has over 235 organisations and 2,153 individuals as registered users representing a niche market of ethical, well informed, tech savvy leaders and managers in health and social care.
We intend to totally remodel the existing platform whilst developing a comprehensive suite of decision support tools that will appeal to our target market.
We intend to move from a free to use site to a subscription based product.
Our planned pricing structure is based on a basic suite of 3 tools per subscription. Additional tools would be charged extra per tool.
A small organisation with up to 5 staff/users would pay £39.95 per month for the basic suite and a larger provider with up to 100 staff/users £199 per month. From our experience working with care home owners we believe that this is affordable and will reduce the likelihood of smaller organisations sharing a single login.
For organisations above 100 staff/users we'll apply a sliding scale volume discount which maintains a realistic price for larger public organisations that, with the relentless focus on efficiency savings and their own IT capability will favour the cost of subscription against in-house development. For a large community trust with 2000 staff/users the monthly subscription will be £2,096 per month (£25,154 annually).
Use of proceeds
The initial funding round will pay for technical improvements to the website and user interface. We expect the co-founders to be joined by office sales/support staff working to convert existing users into paying customers .
The chief technical officer will work full time during the intensive development phase . The lead medical advisor will work on a part-time basis without pay for 12 months.
Early health and care based development work will remain in-house with active engagement of expert stakeholders.
We will externally source design, graphics, sales and marketing expertise as required.
The ehealthtracker suite of tools are aimed at busy health and social care staff such as doctors, nurses, therapists and carers, who need to make the right decisions quickly. The software analyses complex care situations, guides the user to choose the best course of action and reduces the time taken to record decisions.
The IT infrastructure across health and social care services is changing fast. In 2011 the UK Government set out comprehensive plans for actively promoting the use of innovative technologies in healthcare in its plan for growth. In 2013 the health secretary Jeremy Hunt announced, "the NHS should go paperless by 2018 to save billions, improve services and help meet the challenges of an ageing population". A study of mobile health technology undertaken at this time had demonstrated significant benefits including increased productivity; increased time spent with patients, reduced travel and reduced duplication.
We believe that these developments are potentially a tipping point in the growth of the ehealth ecosystem that could lead to a proliferation of applications providing health decision support. A systematic review of ehealth developments in 2008 recognised that computerised decision support systems (CDDS’s), ‘perform best when integrated with other clinical information systems such as an EHR’, but it is only now that EHR, CDSS’s and mobile technology are set to combine and realise their full potential within ehealth.
Over 102 billion apps were downloaded worldwide in 2013 and this figure is expected to surpass 265 billion in 2017. Business based applications provided by Microsoft and Google have also seen massive growth with 630 million business users expected to grow to 1.158 billion users by 2022. We now live in a mobile world where consumers, and this includes those working in health and social care, expect to have instant access to vital information to do their job.
Characteristics of target market
There are approximately two million people in England and Wales who lack mental capacity to make some decisions for themselves due to learning disability, dementia, mental health problems or stroke and brain injury. Our Mental Capacity Tools tools are aimed at the services providing care to these individuals.
As a smaller developer positioned in health and social care our current user base is healthy and we believe offers significant opportunity for growth.
Care homes 15817
Local Authorities 350
Community care providers 1495
Domiciliary care providers 9042
Mental Health Services 1949
Hospitals NHS and private 1582
Dental practices 10633
Ambulance services 253
Prison healthcare services 155
Total Potential Customers 102042
Our marketing activity will escalate through the first year in line with the different phases of development that the website and tools will see.
Over the first year we intend to identify which approaches are most effective in order to maximise results and minimise cost.
During website redevelopment phase (November 2015 - January 2016) we intend to:
Contact our current users to offer 50% discount on paid for site when it goes live.
Produce printed and e-brochure to market current tools to existing and new customers
Run social media campaign using facebook, twitter, instagram to highlight developments to the site that existing and new customers can expect
During go-live phase (February 2016 onwards) we intend to:
Utilise 'trade' press releases and targeted advertising
Post on health and care professional networks via Linkedin and professional forums
Develop a targeted PPC advertising campaign
Offer a free quotation and expression of interest service via website followed up by marketing manager who will make direct contact with customer
During post go-live phase we intend to:
Post free training presentations based on use of tools using Udemy.
Utilise the blog section of the website to promote tools and to provide guidance and support of legislative frameworks to users.
Attend relevant trade events and conferences where we can directly target health and social care lead professionals.
Although large companies such as Capita, Servelec and Infermed have the capability to develop tools similar to ehealthtracker, we have found that they tend to focus on records management, integration and other larger-scale solutions for a wide range of mainly general medical scenarios.
Desuto use experts who are active in their field and therefore able to anticipate and respond to specialist developments very quickly and with deep knowledge. In a context where information is complex and rapidly changing we believe this agility provides a competitive advantage.
We anticipate that because of this, more specialist application development and innovation is likely to come from smaller, more agile and expert developers, as it does in the app store or the google-apps marketplace.
We believe that Desuto is well placed to compete alongside other companies involved in the development of more specialised decision support applications. Through engagement of stakeholders and experts we can develop and test an increasing number of highly specialised decision tools that will integrate with EHR systems and will operate on mobile devices.
Desuto has the following strengths:
With almost zero marketing our ehealthtracker system has already attracted a healthy customer base.
Unlike electronic record keeping systems ehealthtracker is the first system, to our knowledge, that combines detailed care decision guidance based on carefully researched algorithms, high quality written reports and form completion.
Our expertise, agility, early positioning, track record and growing user base provide a competitive advantage.
We have developed and deployed our system over two years with the involvement of and feedback from stakeholders.
We are continually revising and redeveloping the tools in response to feedback in order to improve the user experience.
We are readily equipped to provide expert help and support to our users.