What is a Regional Authority?

A Regional Authority (RA) is a concept within the Ocean Platform, designed to enable regional or provincial programs to centrally manage and administer various aspects of their Ocean deployment. Designated Regional Authority users are given access to an Ocean Site that is configured with additional functionality to empower those users to independently manage key program elements without needing direct assistance from OceanMD.

Specifically, designated RA users can do the following from their Regional Authority Ocean Site:

Approve Directory Listings on the Ocean Healthmap
Approve/accept responsibility for Site licences for Ocean eReferrals, eConsults, Patient Messaging and Reminders, and Online Booking
Upload and manage Regional Authority agreements
Access reports and analytics for Regional Authority usage and licences

These features are intended to streamline administration across multiple sites, ensuring that regional or provincial programs can efficiently manage their Ocean solutions at scale.

What makes a Regional Authority unique?

Approvals Area

Since the primary purpose of a Regional Authority is to assist provincial program entities in administrating the rollout of Ocean within their jurisdiction, there are unique functionalities that have been created specifically for Regional Authority Ocean Sites to assist with this.
Many of these functionalities are found within the 'Approvals' area of the Regional Authority Ocean Site, which can be accessed using the Menu.

Reminder: The 'Approvals' area is only accessible if the Ocean Site has been configured as a Regional Authority by OceanMD system administrators.

The different functionalities found within the 'Approvals' area are detailed below:

Listing Approvals

By default, Ocean Sites will incur fees when they receive an eReferral/eConsult unless the recipient Directory Listing has applied to and been approved by a Regional Authority.

The 'Listing Approvals' tab displays a table view of all Directory Listings (and their associated Ocean Site) that have applied to and/or been approved by your Regional Authority Ocean Site.

For a Directory Listing to appear in the table, a Site Admin within the Ocean Site that owns the Directory Listing must manually submit an application to the Regional Authority (i.e., Step 8 in "Update Your Directory Listing Settings").

When a new application is submitted, an email notification is sent to the 'Clinical Administrator / Ocean Support Contact' email address set within the Regional Authority Ocean Site to alert them of the pending application.

The search box at the top of the table can be used to search for a specific Directory Listing(s) using a key term.

The 'Needs Approval' checkbox can be used to filter the table to only display Directory Listings that have applied to the Regional Authority but have yet to be approved (i.e., a status of 'Pending').

The 'Approve' button can be used to approve a Directory Listing under the Regional Authority.

Note: Regional Authority users must have Site Admin access to approve a Directory Listing.

Upon approval, an email notification will be sent to the applicant Ocean Site's Clinical Adminstrator/Ocean Support Contact' email address(es) indicating that the application has been approved.

Important: Prior to approving a Directory Listing, Regional Authority users must ensure that they have reviewed the listing in accordance with any standardized processes or approval criteria defined by the provincial program entity.

The 'Decline/Remove' button can be used to decline a Directory Listing's currently-pending application to the Regional Authority, or remove a previously-approved Directory Listing from the Regional Authority.

Note: Regional Authority users must have Site Admin access to decline a Directory Listing.

Upon declination/removal, an email notification will be sent to the applicant Ocean Site's Clinical Adminstrator/Ocean Support Contact' email address(es) indicating that the application has been declined.

Important: Prior to declining/removing a Directory Listing, Regional Authority users must ensure that they have reviewed the listing in accordance with any standardized processes or declination criteria defined by the provincial program entity.
At the time of declining an application/removing a previously-approved Directory Listing, the Regional Authority is prompted to specify a reason for the declination/removal. This reason is included in the declination email notification.

Clicking the 'Edit' button to the right of a Directory Listing allows Regional Authority users to view and edit the 'Number Of Clinicians' value and the associated 'Comment'.

Site Licence Approvals

Th 'Site Licence Approvals' tab is helpful for provincial programs to manage the implementation and assumption of licence fees for Ocean's Patient Engagement products and control an Ocean Site's contribution to an external Service Request Repository.

Note: By default, end user Ocean Sites will incur licence fees when using Ocean Patient Messaging and/or Online Booking unless a Regional Authority has first assumed responsibility for the fees.

The table displays all Ocean Sites that have at least one Directory Listing which has applied to and/or been approved by the Regional Authority.

For each Ocean Site, the respective number of Directory Listings that have been approved, the number of Patient Messaging Licences that the Regional Authority has assumed responsibility for, the number of Online Booking Licences that the Regional Authority has assumed responsibility for, and the estimated Site Licence Fees per Month are displayed.

Column Value Notes

Under the '# of Approved Directory Listings' column, a value of '0' indicates that at least one Directory Listing within the Ocean Site has applied to the Regional Authority, but it has not yet been approved (i.e., it is currently Pending).
Under the '# of Patient Messaging Licences' column, a blank value indicates that the Regional Authority has not assumed responsibility for licence fees related to Patient Messaging for the Ocean Site.
- A value of '0' indicates that the Regional Authority has assumed responsibility for licence fees related to Patient Messaging for the Ocean Site, however no licences have been activated within the Ocean Site.
Under the '# of Online Booking Licences' column, a blank value indicates that the Regional Authority has not assumed responsibility for licence fees related to Online Booking for the Ocean Site.
- A value of '0' indicates that the Regional Authority has assumed responsibility for licence fees related to Online Booking for the Ocean Site, however no licences have been activated within the Ocean Site.

To manage the Site Agreement for an Ocean Site, Regional Authority users with Site Admin access can click the 'Manage' button on the right hand side.

Within the 'Manage Site Agreement' page, Regional Authority users can:
• Enable the ability for an Ocean Site to contribute data to a Service Request Repository (if one has been set)
• Assume responsibility for licence fees related to Patient Messaging and Online Booking at an Ocean Site

Signed Licence Agreements

The 'Signed Licence Agreements' tab allows you to find and view users that have signed the Regional Authority Licence Agreement by enabling the 'I accept the Terms of Use' checkbox at the time of sending their first referral to a Directory Listing that has been approved by the Regional Authority.

When first viewing the 'Signed Licence Agreements' tab no users will be displayed by default. To search and/or view users, use one of the following options:

Option 1: Set the 'Find by' criteria to 'Name', enter the search term, and then click the magnifying glass icon to execute the search.

Option 2: Set the 'Find by' criteria to 'Version' and select the desired Regional Authority Licence Agreement version. The table below will display all users that signed the selected version of the Regional Authority Licence Agreement.

Any user on the Regional Authority Ocean Site (i.e., even users without Site Admin access) can invalidate a user's signed Licence Agreement by clicking the 'Edit Licence' button for the relevant user and selecting 'Invalidate'.
Note: The 'HINP Agreement Signatory' setting and accompanying 'Update HINP' button are obsolete.

Once a user's signed Licence Agreement has been invalidated, they will be re-prompted to enable the 'I accept the Terms of Use' checkbox the next time they send a referral to a Directory Listing that has been approved by the Regional Authority.

Important: Prior to invalidating a signed user Licence Agreement, Regional Authority users must ensure that they have adhered to any standardized processes or criteria defined by the provincial program entity.

eConsult User Approvals

The 'eConsult User Approvals' tab allows you to find and view users that have applied to and/or been approved by the Regional Authority to join an eConsult Program.

To apply to join an eConsult program, users click the 'Submit Application to Regional Authority' button within their user account settings.
Note: Only users with the following 'User Roles' are permitted to submit an application: Specialist, Family Physician, Nurse Practitioner.

Province-specific User Interface

Note: Depending on the 'Province' value set within the user account, the name and description of the setting may be different:

When set to Ontario, the setting is named 'TReC Application' and includes an Ontario-specific description.

When set to Nova Scotia, the setting is named 'NSHA eConsult PoC Application' and includes a Nova Scotia-specific description.

When set to any other province/territory, the setting is named 'eConsult Application' and includes a generic description.

Once a user's application has been submitted, they will appear within the 'eConsult User Approvals' table.

The search box at the top of the table can be used to search for a specific user by name/username.

The 'Needs Review' checkbox can be enabled to filter the table to only display users that have submitted an application but have yet to be approved (i.e., an application status of 'Pending').

The 'Approve' button can be used to approve a user's application to join the eConsult Program. Upon approval, an email notification will be sent to the email address associated with the Ocean user account informing them of the approval.

Important: Prior to approving an application, Regional Authority users must ensure that they have reviewed the user application in accordance with any standardized processes or criteria defined by the provincial program entity.

The 'Decline/Remove' button can be used to decline a user's currently-pending application, or remove a previously-approved user. Upon declination/removal, an email notification will be sent to the email address associated with the Ocean user account informing them of the declination.

Important: Prior to declining/removing an application, Regional Authority users must ensure that they have reviewed the user/application in accordance with any standardized processes or criteria defined by the provincial program entity.
At the time of declining an application/removing a previously-approved user, the Regional Authority is prompted to specify a reason for the declination/removal. This reason is included in the email notification informing the user of the declination.

Once a user's application has been approved, the 'Respond as eConsult' checkbox and the 'Billing time' setting are made available to the user within the 'Messaging' area of any eReferral/eConsults received at their Ocean Site.

Reminder: Users providing eConsults should ensure that their Ocean Site has been configured to display the eConsult status folders and that the Health Service Offerings on their Directory Listing have been configured to accept Ocean eConsults (unless the user is participating in the Ontario-specific eReferral to eConsult Initiative).

'Export Listings' Button

This export provides a CSV file containing all Directory Listings that have applied to and/or been approved by the Regional Authority Ocean Site. The export includes Directory Listings that are in a 'Pending' and/or 'Approved' state.
'Export Listing' Data Dictionary

'Export Sites' Button

This export provides a CSV file containing all Ocean Sites that own at least one Directory Listing that has been applied to the Regional Authority Ocean Site.
'Export Sites' Data Dictionary

'Export Users' Button

This export provides a CSV file containing all Ocean users that have accepted the terms of use of the Regional Authority's Provider Licence Agreement at the time of sending an eReferral to a Directory Listing that has been approved by the Regional Authority Ocean Site.
'Export Users' Data Dictionary

'View Licence Agreement' Button

This button can be used to view the current version of the Licence Agreement that has been uploaded to the Regional Authority Ocean Site. Once clicked, the current version of the Licence Agreement is displayed, and the current version identifier can be seen at the bottom of the Licence Agreement viewing window.

'Upload New Licence Agreement' Button

This button can be used to upload or update the Licence Agreement for the Regional Authority.

In the 'Version' field, specify a version identifier to be associated with the Licence Agreement version that is being uploaded.
In the 'Licence File' field, click 'Choose File', select the relevant HTML file from your computer, and click 'Upload'.
Upon uploading, the previous version of the Licence Agreement will be immediately overwritten with the newest version.

Licence Agreement Notes

After a new version of the Licence Agreement is uploaded to the Regional Authority Ocean Site, all users who send referrals will need to re-enable the 'I accept the Terms of Use' checkbox at the time of sending their first referral to a Directory Listing that has been approved by the Regional Authority after the version update has been made.
After a new version of the Licence Agreement is uploaded to the Regional Authority Ocean Site, all Directory Listings which were previously approved by the Regional Authority will be automatically updated with the latest version of the Regional Authority Licence Agreement.
- Provincial program entities are responsible for ensuring that referral recipients (i.e., those with a Directory Listing(s) approved by the Regional Authority) are made aware of any changes to the Licence Agreement that is applied to their Directory Listing(s).
When crafting your HTML file we advise against using Microsoft Word since it can generate non-standard HTML formats which are not accepted by the Ocean HTML uploader.

Regional Authority Surveys

Each Regional Authority Ocean Site has the option to embed three survey links into the eReferral/eConsult workflow to collect Patient Reported Experience Measures (PREMs) and Provider satisfaction data. Regional Authorities may take advantage of up to three free Ocean Studies for this purpose, or use a third-party survey tool.

For more information, please refer to the following article: What is a Regional Authority Survey and How Can I Set it Up?

Regional Authority Analytics

By default, de-identified analytic values are always captured at Ocean Sites that receive eReferrals/eConsults. This gives individual Ocean Sites the ability to analyze a variety of metrics for their received referrals/consults, such as referral patterns, decline rates, and wait times. For more information on this topic, please refer to Supporting Analytics in eConsults and/or eReferral eForms and Accessing eReferral Analytics.

In the context of a provincially funded deployment of Ocean, it is valuable to have insight into this de-identified data across all Ocean Sites that are participating in the program. Ocean achieves this by providing Regional Authority Ocean Sites with access to all de-identified analytic data for referrals sent to Directory Listings that have been 'Approved' by the Regional Authority (as described above).

Note: Regional Authority Users must have Site Admin access to export analytic data.

This means that when a user on the Regional Authority Ocean Site exports referral analytic data, the .csv file output will contain the aggregated analytic data for referrals sent to any Directory Listing that has been 'Approved' by the Regional Authority.

Analytic Notes

Ocean only supports exporting up to 50,000 referral analytic records at once when executing the referral analytics export within the Ocean Portal.
- To export more than 50,000 referral analytic records, we recommend executing multiple reports with sequential 'Start date' and 'End date' values (e.g., export by month, or by calendar quarter).
Referral analytics can also be accessed through our Ocean API. For more details, please refer to the Ocean Open API.
- The Ocean Open API only supports exporting up to 1,000 referral analytic records at once.
While Ocean always collects 'Core Analytic' values by default, referral forms can be customized to capture additional 'Custom (ax_) Analytics' and 'Custom (fx_) Analytics'.
- For more information on Custom (fx_) and (ax_) Analytics, please refer to How do I add Custom Analytic values to my eReferral/eConsult form? and How do I create a custom Export Template for eReferral & eConsult Analytic Data?
- In the context of a provincially funded deployment of Ocean, the provincial program entity should consider any analytic-driven goals and ensure that the desired analytic values have been configured to be captured within the referral form(s) for each approved Directory Listing.

User Access Summary: 'Site Admin' vs. 'Non-Site Admin'

For convenient reference, the table below outlines the actions that can be taken within a Regional Authority (RA) Ocean Site by a user with or without Site Admin access:

'Site Admin' vs. 'Non-Site Admin' Action Summary Table

'Y' indicates the action can be performed, while 'N' indicates the action cannot be performed by the user.

Action	Non-Site Admin	Site Admin
Access the 'Approvals' area within the RA Ocean Site	Y	Y
Execute the 'Export Users' report	Y	Y
Execute the 'Export Listings' report	Y	Y
Execute the 'Export Sites' report	Y	Y
Click the 'View Licence Agreement' button	Y	Y
Upload a new Licence Agreement using the 'Upload New Licence Agreement' button	Y	Y
Click the 'Edit' button on a Directory Listing within the Listing Approvals table	Y	Y
Access the 'Admin Settings' area of the RA Ocean Site	N	Y
'Approve' and 'Decline/Remove' Directory Listings within the 'Listing Approvals' tab	N	Y
'Approve' and 'Decline/Remove' users within the 'eConsult User Approvals' tab	N	Y
Click the 'Edit Licence' button to 'Invalidate' a user within the 'Signed Licence Agreements' tab	Y	Y
Click the 'Manage Site Agreement' button for an Ocean Site within the 'Site Licence Approvals' tab	N	Y
Control an Ocean Site's contribution to a Service Request Repository within the 'Manage Site Agreement' area	N	Y
Control the RA Ocean Site's assumption of responsibility for Patient Messaging and Online Booking licence fees for end user Ocean Sites within the 'Manage Site Agreement' area	N	Y
Access Regional Authority-level referral analytics within the 'Reports' area of the RA Ocean Site	N	Y
Configure Regional Authority Surveys within the 'Site Features' area of the RA Ocean Site	N	Y