Provider Network FAQ

Directory Listings contain a variety of settings that can be configured to support the many ways that Ocean can be used. The settings available within a particular Health Service Offering can be adjusted to curate the appearance and behaviour of each health service offered on your Directory Listing. Detailed information on how to access these settings and what each of them means is provided below.

How do I access the settings?

Once a Health Service Category has been specified as an 'Offer' (also known as a 'Health Service Offering (HSO)') within the 'Service Details' section of a Directory Listing, additional offering-specific settings can be configured.

What do the settings mean?

Details

Program Name

This is the name of the health service being offered on your Directory Listing in the Ocean Healthmap. This value is prepopulated with the name of the Health Service Category that you added as an 'Offer'. It can be adjusted to be more specific/accurate with respect to the service that you provide (especially in the case that you are unable to locate a Health Service Category in Ocean that exactly matches the service you offer).

Description

This is the description of the health service being offered on your Directory Listing in the Ocean Healthmap. It is displayed to users when they select the offering within your Directory Listing. It can be used to provide additional information regarding the service being offered.

Website

A specific website URL that is relevant for this specific offering can be specified here. The website URL is displayed to users when they select the offering within your Directory Listing on the Ocean Healthmap.

Languages

This setting allows you to specify the language(s) that you support for this this specific offering. The languages are displayed to users when they select the offering within your Directory Listing on the Ocean Healthmap.

Public Email

A specific public-facing email address that is relevant for this specific offering can be specified here. The email address is displayed to users when they select the offering within your Directory Listing on the Ocean Healthmap.

Options

Accepting Referrals

This setting is used to indicate if you are currently accepting eReferrals for this specific offering.

When set to 'Yes', and the 'Accept eReferrals' checkbox within the 'eReferral Policy' section of your Directory Listing has been enabled, the 'Send eReferral' button on your Directory Listing in the Ocean Healthmap is available for users to submit an eReferral for this specific offering. If the 'Accept eReferrals' checkbox is disabled, the 'Send eReferral' button will not appear.

When set to 'No', the 'Send eReferral' button on your Directory Listing in the Ocean Healthmap becomes disabled when this specific offering is selected. This prevents users from being able to submit an eReferral for this specific offering.

When set to 'Unknown', the presence of the 'Send eReferral' button on your Directory Listing is controlled by the state of the 'Accept eReferrals' checkbox within the 'eReferral Policy' section of your Directory Listing.

Notification Email(s)

This setting is used to specify the email address(es) that should receive the email notification when a new eReferral/eConsult has arrived at your Ocean Site for this specific offering. If no email addresses(es) is/are specified in this setting, Ocean will send the email notifications based on the fallback logic documented in this article: Where do eConsult and/or eReferral notification emails get sent to?

Accepting Ocean eConsults

This setting is used to indicate if you are currently accepting eConsults for this specific offering.

When set to 'Yes', the 'Send eConsult' button becomes available on your Directory Listing on the Ocean Healthmap.

When set to 'No', the 'Send eConsult' button on your Directory Listing in the Ocean Healthmap becomes disabled when this specific offering is selected. This prevents users from being able to submit an eConsult for this specific offering.

When set to 'Unknown', the 'Send eConsult' button will not appear on your Directory Listing (unless at least one other offering has been set to 'Yes').

Wait Time 1

This setting indicates the value that is currently being displayed for the Wait 1 Time in the Ocean Healthmap search results for this specific offering. This is also the value that Ocean searches against when a user utilizes the 'Maximum Wait 1 time' advanced search criteria in the Ocean Healthmap. Clicking on the value redirects you to the Wait Time management area for the Directory Listing.

Wait Time 2

This setting indicates the value that Ocean searches against when a user utilizes the 'Maximum Wait 2 time' advanced search criteria in the Ocean Healthmap. Clicking on the value redirects you to the Wait Time management area for the Directory Listing.

Custom Referral Form

This setting allows you to specify a custom referral form that is unique to this specific service offering. When a user initiates an eReferral/eConsult for this specific service offering on the Ocean Healthmap, they will be presented with the specific form chosen here.

Note: If your Directory Listing has been configured to redirect referrals to a Central Intake listing, please review the following article to learn more about which referral form is presented when, and where the referral will be subsequently routed to: How are referral forms managed for sites with Central Intake?

Requisition File

This setting allows you to upload a requisition file for this specific service offering. It is displayed and is available for download to users when they select the offering within your Directory Listing on the Ocean Healthmap.

Patient Handout

This setting allows you to upload a patient handout file for this specific service offering. It is displayed and is available for download to users when they select the offering within your Directory Listing on the Ocean Healthmap. A hyperlink which downloads the patient handout file is also included in patient and provider notification emails regarding the status of a referral sent for this specific service offering.

Reference

This setting displays the unique reference value for this specific service offering in Ocean.

The following User Roles require a Professional ID to be provided in the Clinical Contact Information section of the Ocean user account before an eReferral/eConsult can be sent:

• Allied Health Professional
• Family Physician
• Nurse
• Nurse Practitioner
• Physician Assistant
• Resident
• Specialist

Background

The goal of this setting is to assist Regional Authorities in capturing an accurate number of eReferral/eConsult targets (i.e., clinicians receiving eReferrals/eConsults) available in their region via the Ocean Healthmap.

Determining your Number

Keeping in mind the goal of capturing an accurate number of eReferral/eConsult targets within a particular Regional Authority, it is important to recognize that clinicians may often be associated with one or more Directory Listings on the Ocean Healthmap.

Accordingly, when users are selecting a number for their Directory Listing, they should be mindful of whether or not a particular clinician has already been accounted for under a separate Directory Listing that has also been approved by the Regional Authority. This is to ensure that a single clinician is not "double-counted" as an eligible eReferral/eConsult target within the region.

Some common scenarios are provided below as guidance:

Updating your Number

Once the 'Number of Clinicians' value has been initially set in the Directory Listing settings, it should be reviewed and updated at least once annually to account for any changes.

Patient Notification Emails

Provider Notification Emails

Automatic provider email notifications contain only an English version of the status update message at this time.

Yes, the Ocean Portal offers a variety options for filtering the referrals that are currently shown to you.

This is valuable for Ocean Sites that have a large number of clinicians that send referrals, as it offers the ability for users to focus their view to only referrals that are relevant to them, and minimizes the amount of patient health information shown to users within the Ocean Site.

Filtering using the Search Bar

To quickly locate a specific or group of referrals, you can take advantage of the search bar in the top left corner.

Filtering Status Folders

Group-level filters are available across all status folders within the respective folder group, while folder-specific filters are only available within certain status folders.

Group-Level Filters

• The 'Listing' filter allows you to filter your eReferrals/eConsults by the Directory Listing that they are currently owned by.
• The 'Service' filter allows you to filter your eReferrals/eConsults by the requested Health Service Category(s).
• The 'Referring Clinicians' filter allows you to filter your eReferrals/eConsults by the user(s) who sent them.

Folder-Specific Filters

• The 'Reviewer' filter allows you to filter your eReferrals/eConsults by the assigned reviewer user(s).
• The 'Priority' filter allows you to filter your eReferrals/eConsults by the assigned priority value.
• The 'Protocol' filter allows you to filter your eReferrals/eConsults by the assigned protocol value.
• The 'Appt Date - Start' and 'Appt Date - End' fields can be used to view only eReferrals with an appointment booked in the specified date range.
• The 'Patient Email' filter allows you to filter your eReferrals/eConsults based on the presence of a patient email address within the referral/consult.

You can easily find a specific Referral Reference (referralRef) value within the relevant referral's Event Log.

This value is a unique reference number for the referral in Ocean, which can be helpful for troubleshooting and/or or tracking purposes.

What is HRM®?

Health Report Manager (HRM®) is a digital health solution developed by OntarioMD that enables clinicians using an OntarioMD-certified EMR to securely receive reports electronically from participating hospitals and independent health facilities. This transfer of information typically occurs near the end of the referral lifecycle when a specialist is sending a consultation report/letter back to the referring clinician.

Clinicians in Ontario using the Ocean Provider Network can send and receive consultation reports for eReferrals using HRM's integration with Ocean and their OntarioMD-certified EMR.

Ocean-HRM Message Sender Configuration

Sender Approval

To send messages and documents in Ocean via HRM, clinicians must obtain a 'UPI' identifier from the OntarioMD service desk by calling 1-866-744-8668 or emailing support@ontariomd.com.

Once the 'UPI' identifier has been obtained, clinicians must send it to the OceanMD Support team for backend configuration in Ocean. You will be notified when your Ocean site has been approved to send HRM reports.

Sender Configuration

Ocean-HRM Message Receiver Configuration

Receiver Approval

To receive messages and documents via HRM, clinicians must first be approved by OntarioMD. OntarioMD periodically provides a list of approved receiving clinicians to OceanMD to update in the Ocean platform.

This list is used by Ocean to determine whether a clinician should receive a message via HRM in addition to the existing eReferral message and email notification mechanisms in Ocean.

If you are interested in becoming an approved HRM receiver, contact the OntarioMD service desk by calling 1-866-744-8668 or emailing support@ontariomd.com.

Receiver Configuration

Sending Messages via HRM

Once you have fulfilled the 'Ocean-HRM Message Sender Configuration' requirements outlined above, you are able to send HRM messages within an Ocean eReferral.

Receiving Messages via HRM

If you have completed the 'Ocean-HRM Message Receiver Configuration' requirements outlined above and an HRM message is sent to you via an Ocean eReferral, you will be notified via the standard messaging and email notification mechanisms in Ocean.

You will additionally receive the HRM message in your OntarioMD-certified EMR. The core content for all HRM messages is standard across all OntarioMD-certified EMRs, containing: report category (LOINC), report body, author, date, etc.

An example is shown using the PS Suite EMR below, for reference:

Example of a typed HRM message

Example of a file attachment include in HRM message.

Troubleshooting & Support

For all troubleshooting inquiries please contact the OceanMD Support team.

Some helpful troubleshooting tips are provided below:

• If you attempt to send an HRM message and no status icon appears to the right of the message within the eReferral, this means Ocean made no attempt to send the message via HRM. Verify that at least one referral stakeholder is live on HRM, and registered as an HRM receiver in Ocean using the verification process outlined above.
• If you attempt to send an HRM message and the red failure icon appears, click on the icon for additional details.
  • If available, take note of the 'Transaction ID' value and the corresponding error message and send them to the contact the OceanMD Support team

The eReferrals & eConsults area of the Ocean portal is used to view, manage, and action the different requests your Ocean Site receives. For certain statuses and request types, Ocean modifies the colour of the text for quick reference.

Colour Coding

Definitions

The terms "Health Service Categories" and "Health Service Offerings" are often used interchangeably, however it is important to truly understand the difference in their meanings.

What are Health Service Categories?

Health Service Categories are a defined list of terms that are used in the Ocean Healthmap to support simpler searching, filtering, and Directory Listing creation. This defined taxonomy is used to help categorize the Health Service Offerings on a Directory Listing in the Ocean Healthmap.

A complete list of the defined Health Service Categories is available here.

What is a Health Service Offering?

A Health Service Offering is a customizable, searchable description of a service that is listed on the Directory Listing in the Ocean Healthmap. Health Service Offerings are mapped to the most appropriate Health Service Category.

In many cases, a Directory Listing may simply use a defined Health Service Category as their Health Service Offering, however, the option for full customization is possible using Health Service Offerings.

Why do they both exist?

The Ocean Healthmap is a comprehensive, map-based directory that makes it easy to search and access health care services. This is made possible through the use of a defined list of possible health care services - namely Health Service Categories. The defined list of Health Service Categories allows for discrete categorization of services offered by all health care providers on the Ocean Healthmap. This ensures that when a specific health care service is being searched for, the applicable providers of that service are properly accounted for in the search results.

However, it is important to acknowledge that a single defined list of possible health care services will not always capture the nuances of the service(s) being provided. This is addressed through the use of Health Service Offerings. The Health Service Offerings presented on a Directory Listing in the Ocean Healthmap can be customized to reflect greater accuracy of the specific name or nuance of the health care services being offered.

For example, a clinic offering dermatological services could add the specific 'Dermatology' Health Service Category as a Health Service Offering on their Directory Listing, but only offer a subset of specific services or programs. To communicate this nuance to potential referrers browsing the Ocean Healthmap, they can customize the name of the offering for accuracy - such as renaming it to 'Pigmented Lesion / Mole Clinic' if they only offer these specific dermatological services.

Referrers who are browsing the 'Dermatology' category on the Ocean Healthmap would see the clinic's Directory Listing with the 'Pigmented Lesion / Mole Clinic' Health Service Offering, since it is truly the 'Dermatology' Health Service Category with a customized Health Service Offering name.

If you are unable to locate a Health Service Category in Ocean that exactly matches the services you offer, we recommend adding the most similar Health Service Category as a Health Service Offering on your Directory Listing. You can then customize the name of the offering to more accurately reflect the specific services you offer.

How do I customize the name?

You can customize the name of your Health Service Offering by following the steps below:

Can I request additional Health Services Categories?

No, you cannot request that additional Health Service Categories be added as they are a standardized and defined list in Ocean. Under certain circumstances, additional synonyms for Health Service Categories may be added to enhance the searching and filtering capabilities within the Ocean Healthmap.

If you work with another Ocean user(s) who will be sending eConsults and/or eReferrals on your behalf, you will want to invite them to create an Ocean user account and set them as your Clinical Delegate(s).

Add a Clinical Delegate(s) to your Ocean user account

How do I add handout files?

A Clinical Delegate has the ability to send eReferrals on behalf of another Ocean user. Depending on the User Role selected in your Account Settings, your experience when sending an Ocean eReferral as a Clinical Delegate will be different. As the scope of practice for each user on your Ocean site varies, the sending experience and wording of an eReferral changes to reflect the relevant scope.

Special Considerations

Due to the possible variation in the scope of practice of users on your Ocean site, additional features have been implemented to meet this consideration.

Physician Assistants and Residents

Nurse Practitioners

Directory Listings Enforcing Referrer Restrictions

Ocean uses a popular, powerful search engine called Elasticsearch [https://www.elastic.co/what-is/elasticsearch] to find relevant health service directory listings. Elasticsearch allows Ocean to use multiple criteria when searching for listings, including text keywords, location, distance, wait time, subspecialty information, and other properties.

Search Criteria
The primary search criteria is usually typed by the user, such as "cardiology" or "North Toronto Medical", similar to how Internet searches like Google work. These searches perform a keyword-based search that scans the listing's title, description, and service offerings for matches. Users also have the option of selecting a specific value from an automatic dropdown list, such as "MRI", to precisely find listings that are specifically tagged as offering these services.

Users can add additional constraints on top of this primary search, such as spoken language, using the "Advanced Search". To avoid returning distant results, the search uses the currently-visible map boundary as an initial constraint. After an initial search, a user has the option to search the "whole directory", which removes this map boundary constraint. Similar to Google Maps, users may also click to drag the map around, then click the button in the new area of the map to "Search This Area."

Sorting
When a user triggers a search in the healthmap, Ocean uses a default sort preference that relies on the relevance "score" provided by ElasticSearch, which may be guided by factors such as keyword matching. In addition, Ocean applies a simple weight to the score to ensure the following listings are prioritized, in the following order:

• User favourites
• Site favourites
• Government central intakes and rapid-access clinics (as designated by Provincial Ministry of Health)
• Listings that are currently accepting eReferrals or eConsults
• Listings that redirect to a central intake eReferral site
• Other listings

Users also have the option to use the drop-down sort option to further sort the default results, which will impact the order of results. Ocean offers a sort by distance (shortest distance measured from the patient's home or the central map pin, if the patient's address is unavailable), or by the shortest Wait Time (Wait 1 / Wait 2). After a sort order has been applied to a search, it is retained for subsequent searches in the same session.

Please Note: As a matter of policy, Ocean does not make individual adjustments to promote or demote listing results. Search order results may change at any time, based on the ElasticSearch relevance calculation.

When including attachments on eConsults/eReferrals, there are certain file size and type limitations that providers should be aware of.

The folders in the eReferrals & eConsults page are used to manage your site's eConsults and eReferrals. Each folder is described here to help you process and manage incoming and outgoing consults and/or referrals.

• General Folder Group

  • Needs Review

    Any consults and/or referrals that have been flagged for review.

    For Me

    Any consults and/or referrals that have been flagged for your review specifically.

    Recently Viewed

    Any consults and/or referrals that you have recently viewed.

  • 

• Received Folder Group

  • New

    Consults and/or referrals that have been received and have not yet been accepted or declined.

    Accepted as eConsult

    Consults that have been reviewed and accepted.

    eConsult in Progress

    Consults that have been responded to.

    Pending Booking

    Accepted referrals that have not been booked for appointments.

    Booked Unconfirmed

    Any accepted referrals that include appointments that have not been confirmed by the patient.

    Booked Confirmed

    Any accepted referrals that include appointments that have been confirmed by the patient.

    Awaiting Reply

    Any consults and/or referrals that have been marked as Awaiting Reply.

    Walk-ins

    Any consults and/or referrals that have been accepted as a walk-in appointment.

    Received (All)

    All consults and/or referrals that your site has received regardless of their current status.

    Completed

    Consults and/or Referrals that have been marked "Complete" following their appointment date.

    Forwarded (All)

    Any consults and/or referrals that your site has received and you have forwarded to another site.

    Declined

    Consults and/or Referrals that you have declined.

    Cancelled

    All canceled consults and/or referrals.

    Externally Managed

    Any consults and/or referrals that have been marked as Managed Externally.

  • 

• Sent Folder Group

  • Sent (All)

    All consults and/or referrals that have been sent from your site.

    Incomplete

    Any outgoing consults and/or referrals that have been saved for later completion (have not been sent yet). These referrals are only saved in Ocean for 30 days before they are automatically deleted.

    Awaiting Response

    Any consults and/or referrals that you have sent that have not yet been accepted by the recipient.

    Accepted as Walk-In

    Any sent consults and/or referrals that have been accepted as a walk-in appointment by the recipient.

    Accepted as eConsult

    Any sent referrals that have been accepted as an eConsult by the recipient.

    Pending Booking

    All referrals that have been sent from your site that are accepted and awaiting to be booked by the recipient.

    Booked Unconfirmed

    All referrals that have been sent from your site and include appointments that have not been confirmed by the patient.

    Booked Confirmed

    All referrals that have been sent from your site and include appointments that the patient has confirmed.

    Completed

    Consults that have been marked as completed after an eConsult response, and referrals that have been marked as completed following their appointment date(s).

    Declined

    Your sent consults and/or referrals that were declined.

    Cancelled

    Your sent consults and/or referrals that were canceled.

    Externally Managed

    Any sent consults and/or referrals that have been marked as Managed Externally.

  • 

• Other Folders

  • Deletion Warnings

    Consults and/or Referrals that are approaching deletion.

    Actions

    Use this menu to create an inbound request, view the directory, export consults and/or referrals, update wait times, or view a patient's referral history.

    Support

    Click here to contact the OceanMD Support team.

  • 

When managing incoming eConsults and/or eReferrals from the eReferrals page in the Ocean Portal, you may encounter icons or buttons that you are unsure of. Below is a list of the various icons and buttons that may appear and their meaning.

Icons within the eReferrals & eConsults page

Icon	Definition
	Column currently being sorted (and direction – ascending or descending).
	There is a message associated with the eConsult and/or eReferral.
	View this patient's previous eConsults and/or eReferrals.
	There is an attachment associated with the eConsult and/or eReferral.
	This patient's chart in the EMR cannot be found and Ocean is waiting for the EMR.
	A backup copy of the eConsult and/or eReferral has been exported from Ocean.
	The notes for this patient have been downloaded into the EMR.
	This patient has notes that are ready to be downloaded into the EMR.
	The eConsult and/or eReferral has been electronically forwarded to an eReferral recipient.
	The eConsult and/or eReferral has been manually forwarded to a fax recipient.
	The eConsult and/or eReferral has been marked as 'Urgent' by the referral sender (i.e., the value for the 'referralUrgency' eForm question on the referral form has been set to 'Urgent').

Icons within the eConsult and/or eReferral

Icon	Definition
	Edit patient level details (email, phone, address).
	A component of the eConsult and/or eReferral requires review (message, referral note, etc.).
	A component of the eConsult and/or eReferral that was previously requiring review has been reviewed.
	Add a canned note or Review/ Triage form to the eConsult and/or eReferral. Select a canned booking comment when scheduling appointments. Select a canned message in the eConsult and/or eReferral messaging pane.
	Send a patient note or resend patient appointment notification email.
	Add a new note to the master eConsult and/or eReferral (while viewing a child eReferral).
	The eReferral will be included in wait time calculations, because a date booked comment has not been chosen.
	Delete an attachment that has been added to the appointment notification email.

Buttons within the eConsult and/or eReferral

Button	Definition
	Accepts the eConsult and/or eReferral. If an appointment time is entered, the eReferral will move to your Booked Unconfirmed inbox (or Booked Confirmed if the Confirmed checkbox is selected). If no appointment time is entered, the eReferral will move to your Pending Booking inbox.
	Moves the eConsult and/or eReferral from the Awaiting Reply inbox to the appropriate inbox based on the eReferral status.
	Indicates that the eConsult and/or eReferral as complete and not requiring any further follow up. Will move the referral to your Completed inbox.
	Declines the eConsult and/or eReferral and moves it to the Declined inbox. Clicking this will prompt you for the reason and an optional message that will be sent to notify the sender.
	Forwards the eConsult and/or eReferral to the selected site for further follow up. Moves the consult/referral to your Forwarded (All) inbox.
	Acknowledges that you have read and accept the text that is in the window.
	Indicates that the component requiring review has been reviewed. Will move the eConsult and/or eReferral to the appropriate inbox based on the status.
	Sends the message and any attached files to the sender.
	Closes the window without saving any changes and returns to the previous screen.
	Saves changes made. Note: The window will remain open when this option is selected.
	Saves changes made and closes the window.
	Saves changes made and closes the window. Will move the eConsult and/or eReferral to the Awaiting Reply inbox. Note: This option appears in a dropdown menu beside Done when a message is sent from the eConsult and/or eReferral.
	Notifies the selected provider that an eConsult and/or eReferral requires their attention when flagging for review. Note: The consult and/or referral must be saved in order for the notification to be sent.

Sender and Receiver Actions

Download Referral Record

Opens a PDF document of the complete record in a new browser tab where it can be printed and/or downloaded, OR it downloads a TIFF file (dependent on the site's settings configured here). This record includes all scheduling information, notes, messages, and attachments included on the Ocean eConsult and/or eReferral.

Download Referral Note

Opens a PDF document of the note in a new browser tab where it can be printed and/or downloaded, OR it downloads a TIFF file (dependent on the site's settings configured here). This summary document only includes the patient, recipient, and referrer/sender information, as well as the contents of the note.

Download Patient Handout

Opens a PDF handout in a new browser tab that can be printed and provided to the patient. This handout includes patient information, recipient information (including a map of current consult and/or referral location), future appointment information for the patient, as well as any booking attachments added to the eConsult and/or eReferral.

Download Status Notification Sheet

Opens a PDF document in a new browser tab where it can be printed and/or downloaded. This document is directed to the sending/referring provider, and can be used to notify them of any status updates if they are not yet on Ocean. It contains patient, recipient, consult and/or referral status information, and any scheduling information present on the eReferral. 

Import into EMR

Triggers a new import of the consult and/or referral into the integrated EMR.

Export

Opens up a consult and/or referral summary that can be copied and pasted into the patient's EMR. For integrated EMRs, this summary will be stamped automatically into the patient chart notes at the time of sending/receiving the consult/referral.

View Event Log

• Opens up an event log of the various actions that have occurred on the consult/referral. The log includes the event type, date and time of occurrence, the user who actioned it, and the Ocean site and listing it was actioned from. The Event Log is also where the  reference is found, and the purge date.
• 

View Patient History

Used to review a patient's referral history. These include any consults and/or referrals sent or received by the same Ocean site, for the same patient. If there are no previous consults and/or referrals for that patient to review, you will not see this option in the Action menu.

Reclaim Ownership of Referral

When a consult and/or referral has been revoked from a site, or declined at a site, the site will have the opportunity to reclaim ownership back to their site if they need to action on it further.

Resubmit (Last Recipient)

This option will be found on Cancelled or Declined consults/referrals, and can be used to resubmit them to the last site they were previously cancelled from, or declined at. For additional information on this functionality, please refer to this support article.

Sender Specific Actions

Cancel Referral

Used to cancel a consult and/or referral. This option should only be chosen by the sender when a consult and/or referral to the current provider is no longer necessary. When clicked the user is prompted for a reason for cancelling, and the consult/referral is moved to the Cancelled folder of the sender site. The consult/referral is also flagged for review by the recipient site, and can be found in their "Needs Review" tab with an automated message informing the site the consult/referral was cancelled.

Note: This option will be called Cancel eConsult, if the referral has been responded to as an eConsult.

Redirect (New Recipient)

This option will be found on Cancelled or Declined referrals/consults, and can be used to redirect the referral/consult to a new recipient, while reusing the patient demographics and attachments from the original referral/consult. For additional information on this functionality, please refer to this support article.

Receiver Specific Actions

Forward

• This action allows you to forward the consult and/or referral to another target, belonging to the same or different Ocean site. When clicked, the user is prompted to choose a listing from the Forward Referral pane, that pulls in listings from the Ocean Healthmap. Once the desired listing is selected, and the consult/referral is forwarded, it will move to your site's "Forwarded (All)" folder where you can continue to access and receive updates regarding it.
• 

Note: The consult and/or referral can be electronically forwarded to listings on the Ocean Provider Network (designated by the green arrow), or manually forwarded. If manually forwarded, you will be prompted to print and fax the consult/referral before selecting the Forward option in Ocean.

Revoke Forward

This action is only available on Forwarded consults and/or referrals. If it was forwarded in error, or it simply needs to be directed, you can revoke it back to your site. The action of revoking will move the consult/referral back to your site's New tab. At the recipient site the consult/referral will be flagged for review, with an Ocean automated message stating that the consult/referral was revoked and the reason why, in both the Messaging and Notes pane. Any PHI will be scrubbed from the consult/referral at that time.

Notes: If you attempt to revoke forward a referral that already has been scheduled at the receiving site, you will be prompted to ask the site to remove the appointment information before doing so, to prevent any booking confusion in the future. If you attempt to revoke forward a referral that has already had a subsequent forward, you will be prompted to reclaim ownership of that referral instead. This will also send an automated message to the recipient site, flagging the referral for review and informing them the ownership was reclaimed.

Add Related Referral

This allows you to create a copy of the consult and/or referral, that can be assigned it's own health service offering and description, and be managed separately from the original. 

Await Reply

This moves the consult and/or referral to the "Awaiting Reply" tab, where it will sit until you receive the required information from the sending site (usually requested in a message on the consult/referral), and can action on the consult/referral further.

Delete

Deletes the referral.

Mark as Test/Unmark Test

Used to flag whether this is a test consult/referral or not. When marked as test, it is excluded from the site's analytics.

Referrals are kept for a minimum of 1 year/ 365 days after they are sent/received or transcribed in Ocean. This is the default storage time for a referral if no other actions are taken.

A deletion warning email is sent 14 days ahead of the purge deadline. Clinics may choose to extend the purge date of the referral using the actions described below.

Actions That Extend the Purge Deadline

The actions listed below can extend the storage time/purge deadline beyond the default 365 day storage time.

• Adding an Appointment Date
  The referral will be kept for 30 days after the last booked appointment in Ocean. If this date falls before the 365-day mark, the referral will be kept for the default 365 days. *
• Adding an 'Anticipated Wait Time to Appointment'
  If an anticipated wait time is added to the referral, it will be stored for the wait time period plus 60 days, calculated from the date the referral was originally received/entered in Ocean.
  • Example: Referral is received on January 1st, 2024. An anticipated wait time of 14-18 months is added on March 1st, 2024 (2 months after receipt) The referral will be kept until May 1st, 2025 (14 months after January 1st, 2024, plus 60 days)
• Forwarding to Another Directory Listing
  The referral purge deadline will be 1 year after the latest forward date.
• Flagging for Review
  The eReferral/eConsult will be kept for 1 year after the referral was flagged for review using the 'Needs Review' feature. 
• Manually Extending the Purge Deadline
  Clicking the refresh button on the referral (from the 'Deletion Warnings' folder list view) will extend the purge deadline by 60 days.

*NOTE: If a referral is sent to a Rapid Access Clinic/Assessment Center listing, the purge deadline will be 1 year from the initial assessment date.

• Checking the Purge Deadline for an eConsult/eReferral

  • To check the purge deadline for an eConsult/eReferral at any time, click on the 'Action' menu in the referral and select 'View Event Log'. The scheduled purge date will be displayed at the bottom of the event log.
  • 

For sites receiving eReferrals, it may be valuable to know if the patient has been referred to your site before, and some details of the previous referral(s). Fortunately, you can view a patient's "Referral History" directly from the eReferrals & eConsults View of the Ocean Portal.

Note: A health number and birth date must be included in the referral, in order for Ocean to identify the patient's referral history. This is because these two values are used to generate a unique patient identifier that is stored in Ocean with the referral.

Similar to referral analytics, because this referral history contains no patient health information (PHI), this data is not purged from Ocean over time. This means that if you were to receive a referral for a patient today, their referral history can still be viewed ten years from now.

If a previous referral is still in Ocean at the time that it's viewed, this referral can be selected from the "Referral History" window. This will open the referral, allowing you to view further details about this referral.

There are three methods to view a patient’s previous referral(s) (i.e. "Referral History"), as outlined below.

Automatic email notifications are triggered for both patients and senders whenever an eConsult/eReferral status is changed from 'New' to 'Booked'/'Cancelled'/'Declined', or an Anticipated Time to Appointment is specified within the referral, or a referral's appointment date or time is changed.

Simply "Accepting" an eConsult/eReferral does not typically send an email notification (unless it is accepted as a result of specifying an 'Anticipated Time to Appointment', or you are in the uncommon scenario that the eReferral is submitted under an eRequest specifically configured to do so).

Determining which email address(es) notifications are sent to depends on the conditions under which the consult/referral was sent and the nature of the notification.

Notification Email Rules

You must be an Admin user at your Ocean site to configure these settings.

If you are a receiving site that accepts eConsults and/or eReferrals and imports them into a non-integrated system, you may want change the file format of the downloaded consult and/or referral to one that is compatible with your system. Ocean currently supports two file options to choose from: PDF or TIFF

If the patient’s email address and consent to receive eReferral notifications via email was provided at the time the eReferral was sent, the patient will receive email notifications when any of the following changes are made to their referral.

• Sent Referrals

  • When the eReferral is first sent, the patient will receive an email informing them that a health referral was sent for them, and they will be notified when an appointment is booked.
  • 
  • If the eReferral is sent for a walk-in health service, the patient will receive the following email notification instead.
  • 

  Forwarded Referrals

  • When the patient’s referral is forwarded from a site such as a Central Intake to another site, they will receive an email notifying them of this action.
  • 

• Referrals with Estimated Wait Times

  • When an Anticipated Time to Appointment is provided by the referral recipient, the patient will receive an email notifying them of their anticipated time to the appointment.
  • 

• Booked Referrals

  • When an appointment has been booked for the patient's referral, or booking comments have been updated by the referral recipient, the patient will receive an email notifying them of their appointment booking with the option to confirm the appointment.
  • 

• Rescheduled Referrals

  • If the appointment booking date, time, or medium for a referral is changed, the patient will receive an email, notifying them of this scheduling change, again with the option to confirm the appointment.
  • 

• Appointment Reminders

  • If the referral recipient site has configured eReferral-based Appointment Reminders, the patient will receive a reminder notification a certain number of days before their scheduled appointment as shown in the screenshot on the right.

    Note: If the referral recipient has configured customizable EMR-based Appointment Reminders, the reminder will appear and behave differently than that the example shown in the screenshot on the right.

    Additionally, the patient may receive a Text Message reminder if this functionality has been enabled by the recipient site.

  • 

• Declined Referrals

  • If the referral is declined by the referral recipient, they can choose to notify the patient of this declination. A referral may be declined for various reasons, such as if the receiving site determines that it is not appropriate or if it is incomplete.
  • 
  • If the referral decliner chooses to notify the patient, the patient will receive an email, notifying them of this declination (booking comments will vary based on the reason for declining the referral).
  • 
  • If the referral decliner chooses not to notify the patient, the patient will not receive an email.
  • Note: In the case that a referral is forwarded from one recipient to another (e.g., specialist to specialist, or Central Intake to specialist), and the latter recipient declines the referral, the patient will not receive a notification that the referral was declined. Only the stakeholder which forwarded the referral will receive a notification that the referral was declined.

• Cancelled Referrals

  • If the referral is cancelled by the referring provider, they can choose to notify the patient of this cancellation.
  • 
  • If the referral canceller chooses to notify the patient, the patient will receive an email notifying them of this cancellation (booking comments will vary based on the reason for cancelling the referral).
  • 
  • Note: A referral may be cancelled likely because it has already been booked or the patient/referring provider has changed their mind about requesting the referral.

• Redirected Referrals

  • If the referral is canclled or declined and subsequently redirected by the referring provider, the patient will receive an email notifying them of this redirection, along with the reason for redirection (if one was provided by the referrer).
  • 

You must be an Admin user at your Ocean site to configure these settings.

If you are a receiving site that accepts eReferrals, and would like to configure your site to automatically close booked referrals, follow the steps outlined below. This will allow your site to automatically move referrals to the Completed folder without having to manually open and mark them as Complete.

You must be an Admin user at your Ocean site to configure these settings.

If you are a receiving site that accepts eReferrals and would like to configure the appointment time options that appear in the referral's scheduling pane, follow the steps outlined below. This will help mitigate appointment scheduling-related errors and make it easier to pick the time of the appointments.

Since Ocean is not an EMR/EHR and not a long term repository of health information for a patient, it is important to ensure that relevant clinical information is stored appropriately in a system of record (e.g., an EMR/EHR). This transfer of information should be reasonably timely and occur before the information is purged from Ocean.

This is most often acheived through an integration between the Ocean Site and the EMR/EHR. However, in the case that an Ocean Site is not integrated with an EMR/EHR, Ocean does support the ability to export a backup of all received referrals and their associated information. This can be done by following the steps below:

Final Comments

The referral export file(s) will contain patient health information and should be stored somewhere securely at your site.

Any time a user presses the 'Export' button, an audit log entry (EXPORTED_REFERRALS) is automatically generated documenting the date, time, and user that performed the export.

Referral information pulled in the export includes; referral reference, patient name, description, status, referral date, booked date (if present), referring site, recipient site, clinician, professional ID, patient phone number, patient email, internal comments, referrer comments, and the entire contents of the referral note.

The API also provides access to this referral information. For more details, please refer to: "Ocean Open API".

If your Ocean Site sends or receives referrals that are not imported directly into an EMR, you can download or print PDF copies of them from within the Ocean Portal.

In some workflows, it may be easier to batch print multiple referrals within a list at once. This can be done using Ocean's batch print function.

When setting up a listing, that has been claimed to your site, one of the key steps will be to add the Health Service Categories provided by the listing. Each category should be listed separately to allow consult and/or referral senders to locate you better on the Ocean Healthmap.

Health Service Categories can be added or removed at any time from a listing. These changes are made in the Admin Settings page in the Ocean Portal, by clicking Directory Listings. The table below outlines all the categories that are currently available in Ocean. If you have customized eForms, the Health Service Reference column may be helpful for form programming or back-end analytic work.

If your health service is not listed below, try searching for it directly in the map-based directory. You may find that Ocean links you to one of the health services below using one of the stored synonyms or keywords.

If you are unable to locate a direct match or synonym, you will likely be able to locate a similar or generalized version of your health service category in the list below.

Note that once you have added a health service category with one of Ocean's standard health service categories, you can assign a custom title to the offering to provide more context (such as renaming your category's title from "Ultrasound" to "Ultrasound - Abdomen").

Adding a Catchment Area to your Directory Listing

To add a catchment area to your Directory Listing, navigate to your listing's settings in the Ocean Portal, and complete the steps below.

Catchment Areas for specific Health Service Categories

To configure a service-specific catchment area:

Using a GeoJSON file for Direct Catchment Area Import

If you use a service such as Google My Maps, you can create your own catchment areas that can be exported as GeoJSON files that can be uploaded directly into Ocean.