Online therapy providers are used within services to provide patient choice and create service sustainability with evidence-based programmes across mental health and long-term conditions. However, data flows between these platforms and patient records has historically been a manual process, losing much of the efficiency gained and providing capacity for data quality issues and human error.
Prism offers a simple, protected and secure method for services to connect patients to the benefits of online psychological therapies. It allows you to maintain – even improve – patient outcomes, enhancing the patient experience and providing patient choice by making a wider range of treatment options available in places, ways and at times that suit them.
Prism works by enabling services to refer patients for online therapy and to monitor their progress and outcomes directly within the patient record. As such, the system can maintain a single, integrated digital care record which is also reportable against the Minimum Data Set.
Developed with support from the NHS SBRI Healthcare initiative, we continue to work closely with Talking Therapies and with a variety of online therapy providers to offer a breadth of choice for patients and services.
Introduction to this guide
This information guide separates out how to use Prism into two parts. Firstly what an iaptus therapist/admin user will need to know and then what a Service Lead or other Superuser may find useful and will have access to. This is designed to support your service both in regards to training purposes and to ensure you can utilise the feature to its full extent.
Selection of an online therapy provider
The term “ehealth” covers a wide range of digital interventions used by healthcare services to support or deliver care to patients.
For mental health services, ehealth tools range from platforms to support remote treatment – where a patient and therapist communicate via secure video sessions – to online CBT modules, to online diaries recording and providing insight into a patient’s experience between appointments, and more.
These tools can be used as an alternative to face to face therapy, or to supplement it, based on a patient’s needs and preferences.
Prism partners offer a variety of innovative and dynamic online tools. Please raise a support log and ask to speak to our team if you wish to discover more about these partners and the types of intervention that might suit your service.
iaptus is not a reseller and will not be involved in any online therapy provider procurement process, but if there is a platform that you wish to connect with that we do not currently work with, please contact us to discuss the options available.
Overview – Using Prism
As a Therapist or Admin in iaptus
In this section, you will learn how to refer your patient to the Online Provider and how information will return back into iaptus.
Referring to Online Provider
Go to the ‘Care Pathway’ tab on the patient you wish to refer.
Click on ‘Refer to Provider’ and select an Online Provider from the dropdown menu.
Some providers use courses or require additional information in the form of notes. Please ensure that you enter this information here.
Tip: Where used, the First Review Date must always be in the future.
Press ‘Refer to Provider’ button to send the referral to the Online Provider.
Once the referral has been received by the Online Provider, they will initiate the relevant onboarding process. This varies from provider to provider but in most cases involves an automated invitation to the patient.
Tip: Ensure the therapist email in iaptus is the same as the one that is registered with the Online Provider if relevant.
A patient can only be referred once per episode to a particular provider. However you can refer a patient to multiple providers within a single episode if necessary.
Receiving data from the Online Provider
In the Navigation Bar on the left-hand side, there will be a new blue bar called ‘Incoming Online Contacts’. This acts as an inbox for all contacts coming back in from an Online Provider.
You can review the list of contacts from here and when clicked it will take you straight to the clinical contact for editing or review.
Within the ‘Clinical Contacts’ tab in the patient record, there is a new filter – ‘Online contacts’. This is reportable within hypercube and dashboards.
A prism contact is also identifiable in the clinical contacts tab by the small prism logo seen in the top right corner of the tiles on the carousel.
If a contact comes back as red, it will need editing as it doesn’t have all the minimum data set information required.
If a contact comes back as blue with a red border, it is complete. However, as the system has assigned the contact against an allocated therapist, it is important that the contact data is acknowledged as containing all the information as expected. As such, the system requires the contact to be ‘Marked as reviewed’ before it can be cleared from the ‘Incoming Online Contacts’ inbox. This can be done by selecting the contact and pressing the ‘Mark as Reviewed’ button in the options, which then removes the red border.
The fields required for a contact to flow as a blue ‘complete’ contact (irrespective of service specific field configuration) are as follows:
Contact Date
Contact Time
Planned Care Contact Indicator
Attendance
Contact Duration
Integrated IAPT LTC Service Indicator
Appointment Purpose
Consultation Medium
Care Contact Therapy Mode
Psychotropic Medication Use
Language Code of Treatment
Primary Intervention
Interpreter Present
Along with the following questionnaires:
PHQ9
GAD7
WSAS
Merging Contacts
There are two ways for incoming online contacts to be merged with an existing appointment in iaptus if desired.
Under the following conditions, an incoming online contact will automatically merge into an existing unedited appointment:
- The appointment date matches that of the incoming contact
- The appointment consultation medium matches that which has been set up to flag an appointment for automated merging (please raise a support log with Mayden if you would like this functionality enabled).
Alternatively if these conditions are not met, or automated merging is not switched on, incoming online contacts can be manually merged with an existing appointment in iaptus.
With the appropriate online contact selected, click ‘Merge with appointment’. Please note that this option will only show for unedited Prism contacts.
This will open up a new section at the top of the contact with a dropdown menu to select the appointment you want to merge with. Contacts can be merged with any appointment within 8 weeks before or after the contact flowed.
Once you have selected the appropriate appointment to merge with, clicking confirm completes the merge. The appointment date, location, purpose, and consultation medium and contact duration (for automatic merging only) will be retained, along with the ‘Prism’ logo on the contact, status of the contact (complete or incomplete) and all data that was sent as part of the contact.
Tip: Merging a contact into an appointment cannot be undone. However, the original online contact can be reinstated from the User Activity section.
Changing the Allocated Therapist
If the allocated therapist needs to be changed for any reason, this can be changed by selecting the Change Therapist button on a contact that is either incomplete (red) or complete but unreviewed (blue with a red border). The only people who can change the allocated therapist are:
- Superuser admins working on behalf of the session therapist
- Superuser admins working on behalf of the episode therapist
- The session therapist
- The episode therapist
Internet Enabled Therapy
With the advent of MDS v2, NHS Digital introduced the concept of Internet Enabled Therapy (IET). This supports a different way of reporting online therapy interactions where data is included in an Internet Enabled Therapy Log, rather than individual contacts. iaptus supports the complexities of reporting around IET, but it has introduced some additional requirements.
The first is that all Prism contacts reportable as IET require the IET field to be completed. Most online providers will auto populate this for you with the appropriate provider and course information.
Second, NHS Digital now has a requirement to know the start date of an Internet Enabled Therapy log which must coincide with when the patient has their log in details. We have been able to incorporate that into the Prism API and advised Online Providers on how to inform your service of the start date of an IET log with an initial contact. Each Online Provider is working differently to show this information and you should liaise with them directly in regards to this.
PRISM Bulk Referrals
You can set up a saved bulk action for referring to online therapy providers by clicking on the Bulk Actions icon at the top of iaptus. This is where you will find any saved bulk actions, and are able to create new bulk actions to save time on recurring jobs. If you can’t see this section as an option, please raise a support log and your account manager will be able to enable this for your relevant user groups.
Once you click on ‘Add new’, the system will present you with the ‘Add new action’ window, where you will need to set an action name and select the action type (Refer to Online Provider).
You may then select the provider for the bulk action to refer to.
Depending on the provider you wish to refer to, you may be prompted to complete additional fields such as selecting a course or adding notes. These additional fields will appear according to individual provider requirements just as they do when making an individual patient referral to the provider.
Once you have saved this, you’ll then be able to see this saved action within the ‘saved actions’ tab.
This bulk action can now be performed in the same way as any other; by creating a saved search containing all patients you would like to perform the action to, and then clicking perform action and selecting the relevant search.
The system will review all of the patients in your search and flag any missing information that would prevent a referral from sending. The ‘Go to Patient’ column allows you to open the record in a separate tab and update it with the missing data. Returning to this tab and clicking refresh will then update the list to mark them as ‘Valid’. You can then continue to refer all ‘Valid’ patients to the provider.
Tip: The system can take a while to process and review all of the patients within your saves search when clicking ‘review and continue’ and preparing to run the Bulk Action. Please be patient whilst this process is completed.
As a Superuser in iaptus
As a Superuser in iaptus, there are additional tools to support the administration of Prism. This section will guide you through the Superuser menu ‘Online Providers’ section.
You can follow the same steps as a therapist or admin to refer a patient to an Online Provider.
Tab 1: Provider Manager
This shows which Online Providers you have switched on. Please do not attempt to add a new Online Provider to this section without first liaising with your iaptus Account Manager. If you wish to stop using an Online Provider, please notify your iaptus Account Manager.
Tab 2: Field Configuration
From the dropdown menu, select the relevant online provider. The lists provided indicate the fields sent by iaptus to the Online Provider. In the top section are the configured fields required in order to permit the connection with the selected Online Provider platform.
The section below called Mandatory fields lists the additional information required to be completed before referring to the Online Provider. The Optional fields will be sent to the Online Provider only if they contain data. Only the configured and mandatory fields must be complete before a referral can be sent.
Tip: All IDs within the top fields section will automatically be generated by iaptus.
When iaptus generates a Prism referral to any provider it utilises uniquely generated alphanumeric strings for the iaptus instance, patient, episode, and therapist. These are mandatory fields to support the Prism connection and mean that once the referral is sent, subsequent communications can use these strings to connect the records, instead of patient identifiable information.
Tab 3: Referral History
This is an area which will show all patients that have been referred to an Online Provider.
In the top right-hand corner, you can filter to view referrals by Patient ID, Provider, Referrer and Therapist.
Tab 4: MDS Mapping
Select the relevant Online provider from the drop-down menu and click search, then select the relevant dataset from the second drop-down.
Prism works by using the minimum data set values to talk between iaptus and the online provider. The mapping table allows you to customise how you would like to see this information. The List Item is what your users will see on the front end and the MDS Value is what is reported to NHS Digital. To add a new list item this must be done in List Management in the Superuser menu, and will then appear for you to select against the relevant mapping here. Once you have confirmed your List items, please remember to press the save button at the bottom of the screen.
If you choose to remove a List Item so that for a selected MDS Value there is no option available, iaptus will choose an archived Item so that it can display the data received. If this behaviour is not desired, please create a List Item for this MDS Value in List Management and then select the Item in this table and press ‘Save’.
When you first set up the Online Provider it is essential that you review this list and press ‘Save’ at the bottom of the page. It is not until you press ‘Save’ that the MDS values will map to the selected list items for all incoming data in the clinical contact.
Set-Up Process
When considering whether to set-up the ability to work with an Online provider, we recommend in the first instance that you speak with your Mayden Account Manager and they will be able to support you.
Timescales vary from service to service, but the typical procedure for setting up Prism is:
- To begin, please ensure you have liaised with your chosen Online Provider. Often configuration is required by the Online Provider before a connection from iaptus through Prism can be made.
- Your account manager will inform the Implementation Team that you are ready to set up Prism for your service.
- They will then be in contact with your chosen Online Provider to establish the connection. For some Providers this is a very quick process, for others this can take a few weeks.
- Once we have confirmation that the connection has been established, we will test a dummy patient on your behalf to ensure everything is running smoothly.
- A phone call will be arranged with yourselves, taking approximately 45 minutes to walk through the feature and an opportunity to ask any questions you may have.
- Prism set-up is now complete, but additional liaison may be required with your Online Provider in order to finalise any additional configurations.
If the Online Provider is not a Prism Partner
iaptus is not a reseller and will not be involved in any online therapy provider procurement process, but if there is a platform that you wish to connect with that is not mentioned on our website, please contact us to discuss the options available.