Minor Update to Ocean's v0.11.1 DocumentReference Resource

A minor update to the Ocean HL7 FHIR V0.11.1 payloads is scheduled for March 21st, 2024: 


In the DocumentReference resource, Ocean currently specifies the referral identifier with the prefix "referral-" and the attachment identifier with the prefix "attachment-".   These prefixes will be removed so that the identifier will simply be a UUID in order to align with the V0.11.1 DocumentReference profile.  Examples of the current and future formats are provided below:

Current Format: { "reference": "urn:uuid:referral-1c5d5318-f8c7-4714-8d2c-95081fdaa2c9" }

Future Format: { "reference": "urn:uuid:0fa5b45e-5d6d-445f-85e9-ffe76f41b8b6" }


Integrators using the v0.11.1 APIs are encouraged to review their implementations to confirm compatibility with this change.   They will be able to test compatibility with this change in the Ocean staging environment (staging.cognisantmd.com) between between March 19, 12:00 AM EST - March 21st 12:00 PM EST.


NOTE: This change is not relevant to implementations using the v0.10.0 APIs and no action is required.


Please contact Ocean Support team with any questions.   


Referrer's Billing ID in the HL7 FHIR Payload

Several integrations have requested that the eReferral Sender's billing identifier be included in the HL7 FHIR payload to facilitate their ability to receive referrals from new sending providers. Ocean will be adding this into the v0.10.0 and v0.11.1 FHIR payloads in an upcoming release. It will be sent in the 'Practitioner.identifier' property in the format of:

  "system": "https://fhir.infoway-inforoute.ca/NamingSystem/ca-on-ohip-billing-id",
  "value": "12345678"

The billing ID is entered by the user into their user account or into the referral form at the time of sending. The availability and accuracy of the billing ID is the responsibility of the Ocean sender; Ocean does not have a means to validate it.

This is a non-breaking change, so it should not impact any existing implementations. If you have any questions or concerns, please use our request form to contact us.

New Versions of Ocean's HL7 FHIR eReferral APIs and SMART Launch

FHIR v0.11.1

Ocean offers HL7 FHIR eReferral APIs based on the Ontario HL7 FHIR eReferral Implementation Guide v0.10.0. These have been used to integrate over 20 different vendor systems in order to enable referral receivers to manage referrals within their point-of-services systems.

Ontario has released v0.11.1 of the implementation guide, which includes support for integration with Ontario Health's digital health assets, such as OTN eConsult. Ocean will be building v0.11.1 APIs to enable Ontario Ocean users to send and manage eConsults within Ocean without having to log into the OTN eConsult platform.

OceanMD recognizes the investment its integrating partners have made to date and will continue to offer and maintain the v0.10.0 APIs. These APIs will be available to integrators that have already begun development.

As of October 2023, new integrators that have not already initiated development to the v0.10.0 APIs will be strongly encouraged to develop to the v0.11.1 APIs to leverage the improvements in modeling and validation that have been incorporated into it.

SMART $everything

Clinicians appreciate the ability to single-sign-on into Ocean's Healthmap with the patient in context. When they select a referral target, the patient's demographics are pre-populated for them, saving time and avoiding typographical errors.

Many point-of-service systems have already leveraged the SMART framework to launch Ocean as a SMART app to accomplish this.

Two improvements to Ocean's existing SMART app launch have been identified:

  1. Because Ocean encrypts PHI, it is necessary to have the Shared Encryption Key (SEK) passed in the SMART sequence to avoid requiring the user to enter the SEK in order to decrypt the PHI. In the current implementation, the SEK is passed as a parameter in the JWT token (in step 9 of the sequence described in the Ocean SMART App Launch Overview). While this is compliant with the OAuth protocol, it is an extension from other SMART apps. It also means that each site's SEK has to be programmed individually into the SMART launch sequence.
  2. It would be beneficial to referral senders if the SMART launcher could provide additional clinical data and attachments (as FHIR resources) during the contextual launch sequence beyond Patient.read.

Ocean will be updating its SMART launch sequence in September 2023 to incorporate these two improvements.

  1. Implementers will be able to specify that Ocean should retrieve the SEK from the site's Cloud Connect module as part of the SMART allow-list setup. This will eliminate the need to extend existing SMART designs with the SEK.
  2. Implementers will also be able to specify that Ocean should request access to the FHIR $everything endpoint. The FHIR server can determine the breadth (which FHIR resources) and depth (how far back in time) should be provided to Ocean.

Because these are both breaking changes, Ocean will support both SMART launch sequences so that there is no impact to live integrations. Vendors intending to use the newer version of the SMART launch should explicitly state this when sharing their SMART allowlist parameters so that the correct sequence will be setup by the Ocean Support team.

Questions regarding these announcements can be submitted to the OceanMD Support team.

Change to Ocean's API Authentication Framework Planned for December 15th Release

A non-breaking change to the authentication framework that Ocean uses when sending outbound API messages (both Ocean's Open API and FHIR-based API) is scheduled to be released on the night of December 15, 2022.   We have confirmed that the new framework is functioning properly in our staging environment with several integrated partners.   

If any unexpected behaviours are observed with API integrated sites in either the production (ocean.cognisantmd.com) or test (test.cognisantmd.com) environments after the December 15th release, please contact support@cognisantmd.com with the environment name, Ocean site number, referral IDs, any error messages received, and a description of the unexpected behaviour.