The new TELUS API integration allows Ocean to read and update values for patients within the EMR, without requiring the user to open the patient's chart. Although this API provides some great new functionality for Ocean users (such as automated kiosk check-in), it has some limitations that require workarounds, outlined below.
Background
Unfortunately, some important data elements in the API are not currently accessible to Ocean (see tablet below). As a result, these fields cannot be pulled from the EMR and displayed on the tablet (or an Ocean eForm), nor can they be updated by Ocean when a patient changes it.
The ability to update some of these fields is important for certain Ocean workflows, such as when a patient updates their demographic on a kiosk or when a patient fills out a form that is mapped to a PS Suite custom form (e.g. perinatal questionnaire).
Fortunately, enhanced functionality of the Ocean Toolbar has been developed to work around this limitation. The Ocean Toolbar can set these missing values automatically for users, but only once the patient's chart is opened.
Mechanism of Action for the Ocean Toolbar to Detect and Update PS Suite Fields
When Ocean sees a field update request for one of the fields that the API does not support, it places it in a special "Ocean Temporary Note". This note contains the value of the field in a structured format. Once the chart has been opened, the Ocean Toolbar will detect and interpret this temporary note and proceed to automatically set the field value in PS Suite directly.
In the case of a custom form that should be populated based on answer to an Ocean eForm, the Ocean Toolbar will detect that a custom form or other form is desired, automatically inserting the custom form into the chart and populating its values.
Some other fields, such as surname, are not updated automatically for safety reasons. However, the Ocean Toolbar can instead automatically send a message ("yellow sticky") to the administrative team to request the field update.
Note: An important side effect of this workaround for PSS's limitations is that the PS Suite user initials recorded for the insertion of these extra notes are recorded as the user opening the chart (i.e. the user to triggered the change), rather than the initial instigator of the change (such as the user who sent the referral or queued the Ocean form). In reality, there is no actual user responsible for the change, but PS Suite's current design enforces that it record something. This has led to some concerns from some users when reviewing "change logs" when the chart-opening user's initials are found.
Fortunately, after consultation with multiple privacy officers across many different PS Suite clinics, this side effect has not been felt to be a significant medico-legal risk, since it is still straightforward to determine conclusively who-did-what when additional scrutiny is required at the database auditing level. Furthermore, the actions recorded in this case are merely mechanical administrative "clean-up" tasks that are determined by earlier clinical entries in the audit logs, rather than clinically-meaningful events themselves. Nonetheless, the issue has been raised with TELUS as part of the wider request to address these API limitations. In the interim, clinics are free to avoid using the Ocean Toolbar in light of this issue. We encourage its use due to the substantial benefits that its integration provides and the widespread acceptance of this behaviour across the PS Suite community.
Summary of TELUS API Field Limitations
| EMR Field | Accessible to Ocean | Updatable by Ocean | Comments |
|---|---|---|---|
| Surname | Y | using Ocean Toolbar | |
| First Name | Y | using Ocean Toolbar | |
| Health number province | Y | using Ocean Toolbar | |
| Health number | Y | using Ocean Toolbar | |
| Health number version code | Y | using Ocean Toolbar | |
| Health number expiry date | Y | using Ocean Toolbar | |
| Health number eligibility code | N | using Ocean Toolbar | |
| Preferred method of contact | N | using Ocean Toolbar | |
| Next of kin / Emergency contact | N | using Ocean Toolbar | |
| Emergency contact relationship | N | using Ocean Toolbar | |
| Emergency contact is POA | N | using Ocean Toolbar | |
|
Note: The demographic fields not listed above (phone number etc.) are generally fully supported. |
|||
| Custom forms | N | using Ocean Toolbar | |
| PS Suite messages / tasks / "yellow stickies" | N | N | |
| CPP Field: FH | Y | N | |
| CPP Field: PROB | Y | N | |
| CPP Field: HPH | Y | N | |
| CPP Field: RX | Y | N | |
| CPP Field: ALLR | Y | N | |
| CPP Field: IMMU | Y | N | |
| CPP Field: PERS | Y | N | |
| CPP Field: REMIND | N | N | |
|
CPP Field: RISK
|
Y | using Ocean Toolbar | Recreational drug use cannot be updated directly in the "RISK" CPP field. |
| Balance owing ($) | N | N | Status of the patient's private billing balance, as indicated by the green "$" in the appointment schedule (e.g. an overdue private payment). Since the API does not provide access to any billing-related information for patients, Ocean cannot access this value. |
| Custom vitals (e.g. @MyVital: 123) | N | Y | |
| Core vitals (e.g. BP) | N | Y | |