Fusion eCare Solutions helps capture information that matters to people with the About Me Standard

Fusion eCare Solutions, a supplier of care management software, has now become a PRSB Quality Partner following their achievement of conformance with the About Me Standard.

‘About Me’ includes the most important, non-clinical information that a person wants to share with health and care professionals, such as how to put them at ease during treatment, or what arrangements to make for family if they are hospitalised.

By undertaking conformance assessment for the About Me standard, Fusion eCare Solutions aimed to enhance the quality of care and improve the overall service user experience. They sought to ensure that healthcare providers have access to comprehensive person-centred information, including individuals’ preferences and needs, which would help them to deliver more personalised care.

They were looking for a standardised approach to capturing and sharing service user preferences and non-clinical information to eliminate information gaps and improve continuity of care. Their stakeholders also said they needed the personal information to be standardised so that it could integrate seamlessly with existing electronic health records and care management systems, which ‘About Me’ helped them achieve.

The conformance process required Fusion eCare to make updates to their existing system to align with the standard. These changes included modifications to data capture forms, integration with EHR systems, and staff training to ensure compliance. Fusion eCare said that it required a significant effort, but was worth it, as it makes it even easier to go through conformance against subsequent standards. They have already started working on conformance with other PRSB standards.

Challenges during the process, such as technical integration complexities and data privacy and security, were overcome by collaboration with tech teams and testing, as well as open communication with Fusion eCare’s customers to address their concerns and gather valuable feedback.

Since implementing the About Me Standard, Fusion eCare’s customers have reported a 15% increase in service users proactively sharing their preferences, leading to more tailored and effective care plan management. The supplier also received compliments for bringing this standard to their customers and ensuring compliance by March 2024, when care providers registered with the Care Quality Commission must have digital care records in place that support person-centred care, in line with the Department of Health and Social Care’s policy.

Ben Richardson, Business Strategy and Marketing Manager at Fusion eCare Solutions, said: “We are committed to continuously enhancing our solution to meet the evolving needs of our customers and the healthcare industry, and going through the ‘About Me’ conformance was the obvious next step for us. The conformance assessment process was an enjoyable and rewarding journey. The team at the PRSB are extremely friendly and were always on hand when we had questions to ask.”

Lorraine Foley, CEO at the PRSB, said: “Congratulations to Fusion eCare Solutions for achieving conformance with the About Me Standard. We are pleased to hear about the benefits that this milestone brings to their customers, and I have no doubts that it will help improve the health and care experience of many people, which is the ultimate goal. Their eagerness to achieve compliance and commitment to the conformance process has to be applauded, and we are delighted to support them on their further journey with PRSB standards.”

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Personalised care and support planning for people with severe mental illness

A review of a sample of current care plans, and the way they have been developed, may be helpful in identifying the priorities for this improvement. The PRSB Implementation Guide provides more detailed explanations about each element of the plan, including advice on how the planning process might be best conducted.
These questions might form a checklist for current plans to be compared with. 

1. Does the plan include an About Me section in which the service user, in their own words, can indicate the information they want to be available about their lives, their values, their interests, and priorities, available for all those who may care for them?
2. Is the approach to developing a care plan patient centred and engaging, allowing plans to be based on patient priorities goals, and aspirations, along with the actions they plan to take and the support that they will receive?
3. Is there space for a “formulation” to be recorded in which the person receiving care and the professionals who provide it, share and record the personal meaning and the origins of the person’s difficulties?
4. Are relevant procedures and therapies recorded?
5. Where relevant, are one or more contingency plans included for anticipatable disruptions, exacerbations, or deterioration, and do they include advice on what to do and points of contact for those called upon to respond?
6. Where relevant are additional supporting plans incorporated, (an example being an “educational and health plan” for someone with a neurodevelopment disorder)
7. Is a version of the plan available to a service user (if they wish to have it) in a form and format that they can understand and find to be of value?
8. How is a version of the plan available to the GP and other key parts of the health and care system?

Work conducted by PRSB and partners recently has looked specifically at the suitability of this approach to the development and documentation of care and support plans for people with Severe Mental Illness. This resulted in an updated version of the standard (v1.4), for use by any service and for any group of service users, but with some modifications to ensure that it meets the needs of this community. The approach to a patient centred process of identifying goals, hopes, and values, and the support needed to achieve them, is fully compatible with and can be conducted using, specific tools in use in mental health, such as DIALOG, DIALOG+, and ReQoL, for example. 

Where analysis indicates the need for improvement in the content and process of personalised care and support planning for patients with Severe Mental Illness, specific improvement projects should be instituted to co-design with service users and their representatives, and the relevant staff groups, new approaches, and documentation that would be of value in delivering improvement. The toolkit includes a range of existing resources that could be used to engage in this improvement work, including signposting to relevant existing approaches informed by patient experience-based design.

Moving to a single holistic plan

A review of a sample of current care plans, and the way they have been developed, may be helpful in identifying the priorities for this improvement. The PRSB Implementation Guide provides A key development, consistent with national policy on support for Personalised Care across all health and care sectors, is the move towards an individual with complex needs having a single, integrated, care plan, rather than a series of plans developed by different parts of the health and social care system in isolation of one another. For a patient with severe mental illness, the related concerns and challenges might form a very prominent part of such an integrated plan; many will also have concurrent health challenges and needs. The intention is that the relevant services work together to plan and wrap support around the patient and their family in an integrated way, rather than as a series of sequential or disconnected encounters in which the service user or their friends and family have to adopt the role of the integrator.

A starting point would be to agree priority groups of service users who may already have more than one care plan because they need care from more than one part of the system of health and social care. This could be initiated by looking at service users registered with some sentinel practices or PCNs. Alternatively, the approach might focus initially on people with defined co-morbidity or risk that entails collaborative care with agencies beyond specialist mental health services.

The focus here is on the process of care planning and agreement on what should be shared, rather than solely on the technology used;

1. What is the process to agree which professional will initiate care planning and act as the “lead point of contact” for the service user?
2. Will initial plans be agreed with the service user in joint consultations or sequentially? Where and how will they be conducted?
3. What will be the process to agree the elements of the plans which should be available to professionals and potential authorised users beyond the immediate care teams, (A&E services, Ambulance Services, Social services, etc.) with the service user’s consent?
4. How will elements of the plan be updated following consultations in a way which is proportionate, to allow contact and progress notes to be maintained by the service conducting the consultation, whilst avoiding unnecessary work for partners in care if there is no significant change to the personalised care and support plan?
5. What are the implications for workload, logistics, and administration arising out of these decisions?

The answers to these questions and others will best be elicited through focused joint working, grounded in real, or at least realistic examples. This will entail process mapping, and co-design with a range of professionals, service users, and families. Resources from the toolkit and outputs from the Simulation element of this project will be valuable. Some organisations would adopt an approach such as a Rapid Process Improvement Workshop, planned over several weeks and conducted over a number of sequential days, to develop prototype ways of working that could be tested in the field.