Common questions related to the Ocean Provider Network.
The following User Roles require a Billing Number to be provided in the Clinical Contact Information section of the Ocean user account before an eReferral/eConsult can be sent in the Ocean Healthmap, or transcribed into Ocean using the 'New Inbound Referral' feature:
Note: An exception to this rule exists, in which an intermediary Central Intake Ocean Site that is responsible for referral routing may perform additional electronic forwarding of an Externally Managed referral to a new referral recipient that is currently accepting Ocean eReferrals (e.g., in the case that it was declined by the initial recipient outside of Ocean).
When this occurs, the referral is removed from the 'Externally Managed' folder and automatically re-categorized into the appropriate status folder.
The 'Receive and Manage Externally' button is only available to referral recipients if their Directory Listing has been specially configured by an OceanMD employee.
This configuration is generally reserved for the following scenarios:
In most cases, an eReferral will no longer be updated in Ocean once a recipient marks it as 'Externally Managed'. Depending on the type of Directory Listing that the referral was sent to, you may need to follow-up in a different way to obtain status updates regarding the referral.
Note: If the Central Intake decides to subsequently electronically forward the referral to a new recipient who is accepting Ocean eReferrals (e.g., in the case that it was declined by the initial recipient outside of Ocean), the referral will be automatically recategorized into your 'Awaiting Response' status folder and it will be updated to include the details of the current recipient.
After marking an eReferral as 'Externally Managed', you should action the referral in accordance with your organization's defined process outside of Ocean.
If you are a referral recipient with a standard Directory Listing on the Ocean Healthmap, you can expect referrers to contact you (via the contact information supplied on your Directory Listing) regarding the current status of the eReferral.
If you are a user on a Central Intake Ocean Site, you should send a message to the referrer within the eReferral to inform them that the eReferral was manually forwarded outside of Ocean, who/where the referral was forwarded to, and contact information that the referrer can use to obtain future status updates regarding the referral.
Note: If the recipient of the manually forwarded referral declines the referral outside of Ocean and you choose to electronically forward it to a new recipient who is accepting Ocean eReferrals, the referral will be automatically recategorized into your Central Intake Ocean Site's 'Forwarded (New)' status folder and it will be updated to include the details of the current recipient.
Yes, in the case that a referral is now being managed in Ocean (rather than outside of Ocean), it can be removed from the Externally Managed status folder. This can be done using the following options:
Review the information of the Directory Listing and then click 'Forward Referral'.
During this step, a message will appear to inform you that electronically forwarding this referral will automatically remove it from the Externally Managed status folder.
The referral will be electronically forwarded to the new recipient, and be automatically re-categorized from the 'Externally Managed' folder to the 'Forwarded (New)' folder in your Central Intake Ocean Site.
At the referrer's Ocean Site, the referral will be automatically re-categorized into the 'Awaiting Response' folder.
At the recipient's Ocean Site, the referral will arrive in the 'New' folder.
When an Ocean eReferral is currently "owned" by a Directory Listing that has been specially configured by an OceanMD employee to support the use of the 'Externally Managed' functionality, a new 'Add to Externally Managed' or 'Remove from Externally Managed' button is available under the 'Action' menu within the eReferral.
No, eReferrals that have been marked as 'Externally Managed' do not trigger Deletion Warnings.
Yes, eReferrals that have been marked as 'Externally Managed' are included in referral analytic exports. They are denoted with a 'completionState ' value of 'EXTERNALLY_MANAGED'.
Ocean Sites that use an external system or process to manage their received referrals without ever returning to Ocean to update them at the end of their lifecycle can use the 'Automatically Close Referrals' functionality.
However, before enabling this functionality, Ocean Sites should be aware of the level of ambiguity that this functionality adds for other stakeholders involved in the eReferral lifecycle.
Note: Ocean Sites that update the status of referrals in Ocean for the entirety of the referral lifecycle should not use the 'Automatically Close Referrals' functionality.
In a typical eReferral lifecycle, the referral recipient marks the referral as 'Completed' once the appointment date has passed. This moves the referral into the 'Completed' status folder for all referral stakeholders, and makes it explicitly clear to the referring provider that the referral has truly been completed by the recipient. In this case, no message is added within the referral.
While this message clearly states that the closing of the referral was automatic, it does not make it explicitly clear to the referring provider whether or not the referral has truly been completed, nor does it provide any instructions on how referral stakeholders could expect an update on the true final state of the referral (ultimately leaving them "out of the loop").
Example: If a patient misses an appointment and the referral recipient fails to update the eReferral with rescheduled appointment information, the referral would be automatically completed a certain number of days after the original (missed) appointment. This causes the eReferral to appear to be 'Completed' to all referral stakeholders in Ocean, however the patient has truly not yet been seen by the referral recipient.
To ensure that all stakeholders are made aware of the true final status of referrals that have been automatically closed, it is important for referral recipient's who choose to use this functionality to have a process (outside of Ocean) to perform their due diligence on the rest of the referral's lifecycle, and to communicate the true status of the referral to other referral stakeholders in due course (outside of Ocean).
Note: eConsults/eReferrals in the 'Incomplete' folder do not trigger deletion warnings.
As of April 3rd 2025, Health Service Offering-specific configuration settings have been re-located directly within the main Directory Listing user interface. For specific details about each setting, refer to the 'Health Service Offerings' tab within the 'Directory Listings' support article.
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:
When a referral recipient is Creating Inbound Requests in Ocean for referrals they originally received outside of Ocean, the referrer's Professional ID is not a required field for any referrer User Role.
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.
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:
In the scenario of a one-to-one relationship between the authorized clinician and the Directory Listing, users should enter '1' as the 'Number of Clinicians'.
This indicates that the clinician in question receives eReferrals/eConsults only at this Directory Listing, and nowhere else.
In the scenario of multiple authorized clinicians sharing a single Directory Listing, users should enter the total number of authorized clinicians as the 'Number of Clinicians'.
This indicates that all clinicians in question receive eReferrals/eConsults only at this Directory Listing, and nowhere else.
In the scenario of no authorized clinicians being associated with the Directory Listing (e.g., a community service that does not have any clinicians working out of it), users should enter '0' as the 'Number of Clinicians'.
Note: When '0' is entered, users are required to include additional written context in the 'Comments' box explaining the rationale.
In the scenario of one authorized clinician being associated with more than one Directory Listing (e.g., an indepedent listing and an organizational listing), users should enter '1' as the 'Number of Clinicians' for the independent listing, and not include them in the organizational listing count.
For example, if Dr. Smith accepts eReferrals/eConsults at their independent cardiology practice (Listing A), and also works at a cardiology clinic that accepts eReferrals/eConsults (Listing B), Listing A should be assigned a value of '1', and Dr. Smith should not be included in the sum of clinicians at Listing B.
Note: This means that if all clinicians at the cardiology clinic also have their own independent cardiology practices that accept eReferrals/eConsults, then '0' should be entered as the 'Number of Clinicians' for Listing B, with an explanation of the rationale in the 'Comments' box.
Likewise, if some clinicians accept eReferrals/eConsults exclusively at the cardiology clinic (Listing B), they would account for the total number 'Number of Clinicians' that should be entered for Listing B.
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.
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.
Note: Filters are applied and saved on a user-specific basis. This means that each user on your Ocean Site has the ability to customize and save their filters to suit their personal preferences.
To quickly locate a specific or group of referrals, you can take advantage of the search bar in the top left corner.
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.
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.
Please note that the Ocean-HRM integration is curently in a closed pilot phase and not yet widely available.
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.
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.
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.
Once you have fulfilled the 'Ocean-HRM Message Sender Configuration' requirements outlined above, you are able to send HRM messages within an Ocean eReferral.
Note:
HRM messages can only be sent within an eReferral if:
After your message has been sent, you will see a checkmark icon to the right of the sent message confirming that the message has been sent via HRM in addition to the standard eReferral message and email notification mechanisms in Ocean.
Note: If the HRM message failed to send, you will see a red exclamation (!) icon instead of a checkmark.
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.
Note: Due to HRM constraints, a single HRM message containing both a typed message and a file attachment will appear in your EMR as two separate HRM messages - one containing the typed message, and a second one containing the file attachment.
An example is shown using the PS Suite EMR below, for reference:
For all troubleshooting inquiries please contact the OceanMD Support team.
Some helpful troubleshooting tips are provided below:
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.
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 and their interaction with the "Description" value of a referral.
A referral Description is the value associated with a referral that is used to describe the service being requested/provided.
Ocean supports the ability to set the Description for a referral to a pre-determined value based on referrer's answers to the questions on the referral form at the time of sending the referral. This advanced configuration option is achieved by dynamically setting a 'referralDescription' value for the referral via scripting in the referral form.
In some cases, referral recipients may also manually change the Health Service Category and Description value for a referral once it has been received at their Ocean Site. This can be helpful in the case where the recipient would like to adjust an incorrect or inaccurate Health Service Category and/or Description for the referral.
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' Health Service 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.
When a referral is sent for the customized 'Pigmented Lesion / Mole Clinic' Health Service Offering, Ocean maintains both the 'Dermatology' Health Service Category and 'Pigmented Lesion / Mole Clinic' Health Service Offering values in the backend for analytics and filtering purposes, and the Description value for the referral is typically inherited automatically from the customized 'Pigmented Lesion / Mole Clinic' Health Service Offering name.
However, in the case that clinical workflows or referral management processes may benefit from a more specific Description of the referral based on the answers to the referral form (e.g., the anatomical location of the pigmented lesion), the referral form may be configured to set a Description value different than the name of the Health Service Offering to convey this more conveniently (e.g., 'Pigmented Lesion - Left Shoulder').
If a mistake was made by the referring provider when filling out the referral form, the referral recipient also has the ability to manually change the Health Service Category and Description value for the referral to correct the mistake (e.g., changing 'Pigmented Lesion - Left Shoulder' to 'Pigmented Lesion - Right Shoulder').
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 Health Service Offering to more accurately reflect the specific service(s) you offer.
You can customize the name of your Health Service Offering by following the steps below:
If your Directory Listing contains multiple Health Service Offerings, make sure that you select the proper one from the list and then specify your custom Health Service Offering name in the 'Offering name' field.
For your ease of reference, the name of the associated Health Service Category will remain visible below the 'Offering name' field, and it will appear in parentheses in the list of offerings.
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).
Use the 'Add Clinical Delegate' button to select the user(s) that should have the ability to send eRequests on your behalf.
The dropdown list displays all users for all Ocean Sites that your user account is associated with. You may specify any number of Clinical Delegates.
Note: If you are an Ocean Site Admin, you can view and edit delegate relationships for all users on your Ocean Site. For more information, please refer to this article: Edit Delegates Page.
Using the file browser, select the appropriate handout file from your computer.
Note: You can add multiple handout files by uploading them one at a time.
Once the file(s) have been added, click 'Save' to save your changes.
The handout file(s) can now be found in your Directory Listing in the Ocean Healthmap, and will be included in the patient's email notification if they are referred for that health service offering.
Note: Since handout files are added to each individual Health Service Offering, you can attach different handout files for each of your offerings. Alternatively, you can add the same handout file(s) to all of your offerings.
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.
Note: Email notifications will not be sent to the Clinical Delegate user who initiated the eReferral on behalf of the referring provider. The notifications will only be sent to the referring provider selected in the 'Referrer's Information' dropdown menu.
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.
Note: Uploaded patients will be maintained in Ocean for 14 days before they are purged automatically from the site.
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.
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.
| 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'). |
| 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. |
| 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. |
Note: From the eReferrals page in the Ocean Portal, hovering over each of the icons for a moment will also bring up a tooltip displaying the icon's meaning.
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.
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.
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.
Once the eReferral/eConsult 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 eReferral/eConsult 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 to the recipient before selecting the Forward option in Ocean.
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.
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.
Note: eReferrals received in Ocean via a Website Form (i.e., configured with a 'Website Form Type' of 'eReferral') are kept for a minimum of 180 days by default if no other actions are taken.
14 days ahead of a referral's purge deadline, the referral will be flagged in the 'Deletion Warnings' folder in the eReferrals & eConsults area of the Ocean Portal. Additionally, Ocean Sites receive a weekly Deletion Warning email every Monday morning containing a list of items (i.e., eReferrals, eConsults, Website Form Submissions, Patient Notes) that are due to be removed from Ocean.
Note: eReferrals/eConsults that are 'Completed', 'Processed', 'Externally Managed', or 'Incomplete' (i.e., Saved for Later), will not trigger deletion warnings.
Clinics may choose to extend the purge date of the referral using the actions described below.
The actions listed below can extend the storage time/purge deadline beyond the default 365 day storage time.
Note: It is important to recognize that when an 'Anticipated Wait Time to Appointment' is added or updated, the anticipated wait time is specifically with respect to the date that the referral was originally sent (e.g., January 1st 2024 in the example below).
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 September 1st, 2025 (18 months after January 1st, 2024, plus 60 days), even if the anticipated wait time is later removed or reduced.
*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.
If you ever need to inquire about any Ocean eReferral(s) that have been sent or received for a certain patient in the past, you can easily look this up in the patient's eReferral history in Ocean.
For sites sending or receiving eReferrals, it may be valuable to know if the patient has been referred to or from 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.
If there is no referral for a specific patient currently sitting in the eReferrals & eConsults View of your Ocean Portal, you can still search for that specific patient's referral history.
This is useful if you have received a referral via fax and would like to see if there are records of any previous referrals for this patient in Ocean, for example.
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 emails are sent to the sender/referrer when:
The eConsult or eReferral is declined and returned to the original referrer*
*Note: If the referral has been previously forwarded to an additional stakeholder who then declines the referral, the original referrer will not receive a notification email regarding the declination.
Notifications will be sent to the first email address that is set, based on the following order of email addresses in the user's My Account page (found in the Ocean portal, clicking on your name at top right hand corner, and selecting "My Account"):
If the referring Ocean user has been removed from the Ocean site, notifications will be sent to the first email address that is set, based on the following order of email addresses in the Ocean Site:
If a delegate user sends a referral on behalf of a referring provider, Ocean will use the provider's user settings to determine where the notifications are directed as above.
Accordingly, the delegate user will not receive notifications themselves, unless the provider is no longer a user on the Ocean site, in which case email notifications will be sent to:
In the case that both the provider and the delegate have been removed from the Ocean site, email notifications will be sent to the first available email address from the following list:
Notification emails are sent to the receiver when:
Notification emails are sent to the patient when:
The eReferral is declined and returned to the original referrer*.
*Note: In some circumstances, the referral recipient may opt out of notifying the patient of the declination. Further, if the referral has been previously forwarded to an additional stakeholder who then declines the referral, the patient will not receive a notification email regarding the declination.
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.
Note: Patient email notifications are based on the recipient Ocean Site's configuration. If the recipient has configured the 'Send Patients Email Notifications' setting to 'No', the referred patient will not receive email notifications.
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.
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.
Note: You will want to ensure the number of days chosen provides your site with enough time to appropriately update referrals as "No Shows", or add additional appointments/slots to referrals that will be booked again, before Ocean automatically closes them.
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.
Note: If you would like to schedule an appointment outside of the options provided in the dropdown, you can continue to do so simply by typing in the full appointment time, rather than choosing from the dropdown.
Note: The intended audience of this support article is health information trustees/custodians. Non-trustee/custodian entities that are involved in referral management (e.g., a Regional Authority or Central Intake) should refer to their respective jurisdiction's legislation to determine their level of responsibility in ensuring that clinical information is stored in an appropriate system of record.
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:
Select your start and end date for your export. You can download data within a specific date range, based on the referral's modification date. Or, you can pull all data since you started receiving referrals by leaving both dates blank.
Note: If your specified date range exceeds 31 days and includes more than 500 referrals, you will be prompted to specify a date range of 31 days or less.
Select “Export unexported referrals only” if you would only like to export referrals that have not been previously backed up. If you want to export all referrals in the Ocean Portal, uncheck this box.
Note: Ensure this checkbox is enabled if you are exporting more than 500 referrals.
Select “Mark referrals exported” to mark the referrals as backed up once you've completed the export. This will add a green checkbox icon beside the referral in the Ocean portal, once the export is completed. If this box is left unchecked, the next time the export is done, the previously exported referrals will be pulled once again.
Note: Ensure this checkbox is enabled if you are exporting more than 500 referrals.
Finally, click "Export". This will export your data in a .csv file that can be opened using Microsoft Excel.
Note: If you are exporting more than 500 referrals, continue to click the 'Export' button to download multiple .csv file batches until a completion alert is shown.
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.
Choose the relevant status folder of referrals you would like to print.
If the referral status is not a requirement of your desired list of referrals to print, go to the 'Received (All)' or 'Sent (All)' tab.
Click the Print Referrals in View button within the 'Actions' menu in the bottom left corner.
Note: Ocean will print all of the matching referrals in the current folder, not just the number of referrals currently displayed.
Confirm the number of referrals you would like to print is correct, and click 'Print'.
Note: Ocean can only print a maximum of 100 referrals at one time.
If you have more than 100 referrals listed, you'll be prompted with the following Error window. Click 'OK', and then refine your filters as outlined in Step C to generate a list of 100 referrals or less and try again.
A new window with a single generated PDF containing all the referrals listed will appear.
Use the print button in your web browser's PDF viewer to print the full PDF.
