Provider Network FAQ

What are 'Externally Managed' eReferrals?

In certain cases, eReferral recipients may choose to action an eReferral using a restricted 'Receive and Manage Externally' action button within the eReferral.

This causes the eReferral to be automatically categorized into the 'Externally Managed' status folder for both the referring and receiving Ocean Sites.
As a general rule, once an eReferral has been marked as 'Externally Managed' it is typically no longer updated in Ocean by the referral recipient.

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.

Who can access the 'Receive and Manage Externally' button?

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:

Ocean Sites that strictly receive eReferrals using a custom API integration which does not provide subsequent eReferral status updates to Ocean.
Non-integrated Ocean Sites that receive eReferrals but manage and update the status of the referrals using external systems (e.g. a Health Information System).
Central Intake Ocean Sites that may manually forward eReferrals outside of Ocean (e.g., via fax) but do not subsequently track and update the eReferral status in Ocean beyond the current recipient's decision to accept or decline the referral.

Is there an indication when a Directory Listing is configured in this way?

Yes. When a standard Directory Listing is configured with this option, a note is applied to the Directory Listing in the Ocean Healthmap to inform referrers. The note states:
"This listing does not update the eReferral status in Ocean. Contact the listing directly as needed for follow-up."

Central Intakes Externally Managing eReferrals

In the case that a Central Intake Directory Listing is configured in this way, a slightly different note is applied to the Directory Listing in the Ocean Healthmap. The note states:
"This central intake listing may not always show updates to the eReferral status in Ocean. Referral updates will appear for service providers that provide details on appointment dates and times."

An eReferral I sent has been marked as 'Externally Managed'. What do I do now?

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.

If the eReferral was originally sent to a standard Directory Listing on the Ocean Healthmap, you can follow-up directly with the recipient using the contact information provided on their Directory Listing in the Ocean Healthmap.

If the eReferral was originally sent to (or automatically redirected to) a Central Intake Directory Listing on the Ocean Healthmap, a user from the Central Intake Ocean Site will send you a detailed message within the eReferral to inform you of where/who the referral was forwarded to and the relevant contact information that you can use to obtain future 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.

I received an eReferral and marked it as 'Externally Managed'. What do I do now?

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.

Can referrals be removed from the 'Externally Managed' status folder?

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:

Option 1: Central Intake Electronically Forwards the Ocean eReferral

Locate and open the referral from the 'Externally Managed' folder.

Click the 'Forward' button.

Search for and select the desired Directory Listing that is accepting Ocean eReferrals that you would like to forward the referral to.

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.

Option 2: Manually Adding/Removing the Ocean eReferral to/from the 'Externally Managed' 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.

This button allows users to manually add or remove the referral from the 'Externally Managed' status folder for further actioning in Ocean.
When a referral is manually removed from the Externally Managed folder using this option, it is automatically re-categorized into the status folder that it was in prior to being marked as Externally Managed at all Ocean Sites.

Do 'Externally Managed' eReferrals trigger Deletion Warnings?

No, eReferrals that have been marked as 'Externally Managed' do not trigger Deletion Warnings.

Are 'Externally Managed' eReferrals included in referral analytic exports?

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'.

How long are eConsults/eReferrals stored when they have been 'Saved for Later'?

If you have initiated an eConsult/eReferral but you require additional information before it can be sent (e.g. physician is waiting on a prior imaging report, or lab result to include in the referral), you can use the the 'Save for Later' functionality to temporarily save the incomplete eConsult/eReferral in Ocean, and then complete and send it later on.
Once it has been 'Saved for Later', the eConsult/eReferral will be stored in your Ocean Site's 'Incomplete' status folder for 30 days before it is deleted.

Note: eConsults/eReferrals in the 'Incomplete' folder do not trigger deletion warnings.

What do the different Health Service Offering settings mean?

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.

Tip: To learn about the difference between a Health Service Category and a Health Service Offering, refer to: What is the difference between a Health Service Category and a Health Service Offering?

Within the 'Service Details' section of the Directory Listing, click on the Offering that you would like to configure.
The offering-specific configuration window will open.

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.

Which User Roles require a Professional ID prior to sending an eReferral/eConsult?

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

How do I determine the 'Number of Clinicians' for my Directory Listing?

Background

When applying to a Regional Authority within your Directory Listing settings, users are prompted to enter the number of clinicians authorized to receive eReferrals and/or eConsults at the Directory Listing before submitting their application.

Similarly, users who are modifying Directory Listings which have already been approved by a Regional Authority are also prompted to enter the number of clinicians authorized to receive eReferrals and/or eConsults at the Directory Listing before saving any new changes.

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.

Note

Administrative staff should not be included in the count.
Clinicians do not need an Ocean user account to be counted.
Users may enter '0' if appropriate.

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:

Scenario A: One clinician with one dedicated Directory Listing

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.

Scenario B: More than one clinician sharing one Directory Listing

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.

Scenario C: One Directory Listing with no associated clinicians

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.

Scenario D: One clinician associated with more than one Directory Listing

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.

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.

What languages are included in eReferral/eConsult email notifications?

Patient Notification Emails

If the patient’s email address and consent to receive eReferral notifications via email was provided at the time the eReferral/eConsult was sent, the patient will receive email notifications when status updates are made to the request.
Patient email notifications contain both English and French versions of the status update message.

Provider Notification Emails

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

Can I filter the eConsults/eReferrals in my Ocean Site?

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.

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.

'Patient with surname' filters all your referrals to only include patients with the matching surname.
'Referring clinician with the name containing' filters all your referrals to only include referrals sent by a specific clinician.
'Provider with name containing' filters all your referrals to only include referrals sent to the Directory Listing with the chosen search term included in it's name.

'EMR / MRN #' filters all your referrals to only include referrals for patients with the matching EMR ID/MRN value.
'HN' filters all your referrals to only include referrals for the patient with the matching health card number.

'Sent on' filters all your referrals to only include referrals that were sent on the chosen day.
'Received on' filters all your referrals to only include referrals that were received on the chosen day.
'Booked on' filters all your referrals to only include referrals that had appointment information added on the chosen day.
'Noted on' filters all your referrals to only include referrals that were noted on the chosen day.

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 always appear on the left, while folder-specific filters always appear on the right.
The 'Save Filters' button can be used to save your currently-applied filters, and the 'Clear Filters' button can be used to remove all currently-applied filters.

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.

Where do I find a Referral Reference value?

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.

Locate and open the relevant referral in the eReferrals & eConsults area of the Ocean Portal.

Open the 'Action' menu in the top right corner, and select 'View Event Log'.

The unique Referral Reference value can be found at the top of the Event Log window.

How does Ocean integrate with Health Report Manager (HRM®)?

Ontario Pilot Phase

Please note that the Ocean-HRM integration is curently in a closed pilot phase and not yet widely available.

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

Clinicians who are sending HRM messages must ensure they have entered their 'Professional ID' within their Ocean user account settings under the 'Clinical Contact Information' section.

Clinicians who are sending HRM messages should also enable the 'Authentication - Requesting providers must sign in' setting in their own Directory Listing settings. This ensures that all referrers are signed in to an Ocean user account while sending the eReferral, allowing for HRM messaging as described below when possible.

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

Once approved in the Ocean backend, referring clinicians must update the 'Clinician Information' setting in their Directory Listing settings with their First Name, Surname, and Professional ID at a minimum.
Clinicians that have been properly approved by both OntarioMD and OceanMD will see an approval message stating 'This clinician uses HRM' in the Clinician Information window.

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.

Note:

HRM messages can only be sent within an eReferral if:

The original referrer was signed in to an Ocean user account when sending the eReferral.
There is at least one referral stakeholder that is live on HRM.
- 'Stakeholders' include the original referrer and any other referral targets that previously 'owned' the eReferral.
- Stakeholders are only considered to be 'live' if they meet the 'Ocean-HRM Message Receiver Configuration' requirements outlined above.

Locate and open the relevant eReferral in Ocean.

Using the 'Messaging' area, include your consultation report/letter as an attachment and optionally enter a message in the text field, and then press 'Send'.

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.

Clicking on the icon provides more detailed information regarding the HRM status, along with the ability to re-send the HRM message if necessary.

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.

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:

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

What do the different request colours mean in the eReferrals & eConsults area?

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

The default text colour for eReferrals is black.

The text colour for eConsults is blue.

The text for cancelled eConsults is stricken through and blue.

Requests that are declined are underlined and red.

Requests that are cancelled are stricken through and red.

Requests that have marked as 'Awaiting Reply' are denoted using purple text.

What is the difference between a Health Service Category and a Health Service Offering?

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.

What if I can't find the exact Health Service Category for my Directory Listing?

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:

Navigate to your Directory Listing settings, and locate the 'Service Details' section.

In the 'Offers' field, search for and select the most applicable Health Service Category to add it as a Health Service Offering on your Directory Listing.

After adding your Health Service Offering, click on it to open it's customization options.

Specify your customize name in the 'Program Name' field, and press 'OK'.

Your customized Health Service Offering name will appear in the 'Offers' section, with the true Health Service Category shown in parentheses.
Press 'Save Changes' in the bottom right corner to save your Directory Listing.

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.

How do I set a Clinical Delegate user for my Ocean user account?

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

Log into the Ocean Portal.
Click your name in the top right hand corner and select My Account from the menu.

Click the "Edit Delegates" button.

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.

A Clinical Delegate can be removed by pressing the 'Remove' button on the right.

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.

Can I include handout files for patients on my listing in the Ocean Healthmap?

Yes, you can include patient handout files for each of the Health Service Offerings shown on your Directory Listing in the Ocean Healthmap.
The handouts are made available for download when the Health Service Offering is selected on the listing.

Additionally, when a patient is referred under a specific Health Service Offering, the email notification they receive (if applicable) will include the handout files.

How do I add handout files?

Log in to the Ocean Portal, open the 'Menu' and select 'Admin'. From the Admin Settings page, select 'Directory Listings'.

Within the appropriate Directory Listing, locate the 'Service Details' section and select the appropriate service offering.

Locate the 'Patient Handout' file uploader, and press 'Choose File'. 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, press 'OK'. The handout file(s) can now be found in your listing in the Ocean Healthmap, and will be included in the patient's email notification if they are referred for that health service.

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.

How does my User Role impact my functionalities as a Clinical Delegate sending eReferrals in Ocean?

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.

When sending a new eReferral as a Clinical Delegate, the dropdown menu in the 'Referrer's Information' panel allows you to select the referring provider, if applicable. The menu displays all providers for which the sending user is designated as a Clinical Delegate.

After the eReferral has been sent, email notifications are sent to the 'Referral Notification Email' email address listed in referring provider's account settings. If there is no email listed, email notifications will be sent to the 'Clinical Delegate Email(s)' listed in the referring provider's account settings.
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.

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

When sending an eReferral on behalf of a physician as a Physician Assistant or Resident, the Referrer's Information panel is modified to clearly indicate that the eReferral is being sent by a Physician Assistant or Resident, on behalf of the referring provider.

This is recorded in the General pane of the eReferral, so the recipient can clearly see that it was sent on behalf of the referring physician.

After the eReferral has been sent, email notifications are sent to the 'Referral Notification Email' email address listed in referring provider's (i.e., the physician's) account settings. If there is no email listed, email notifications will be sent to the 'Clinical Delegate Email(s)' listed in the referring provider's account settings.

Nurse Practitioners

In the case that a Nurse Practitioner initiates an eReferral for a medical test/procedure which requires authorization from a physician, an 'Authorizing Physician' field is added to the Referrer's Information panel to select the authorizing MD.
Typing into the field searches the Ocean Healthmap directory for convenient selection of the authorizing physician.

Once the Authorizing Physician is selected and the eReferral is sent, it is recorded in the General pane of the eReferral, so the recipient can clearly see the physician who provided authorization.

After the eReferral has been sent, email notifications are sent to the 'Referral Notification Email' email address listed in Nurse Practitioner's account settings. If there is no email listed, email notifications will be sent to the 'Clinical Delegate Email(s)'.

Directory Listings Enforcing Referrer Restrictions

Directory Listings may be configured to enforce that the referring provider have a User Role of 'Family Physician', 'Specialist', or 'Nurse Practitioner'.
If the user sending the eReferral is not configured with one of these User Roles, they will be unable to send the eReferral and an orange warning message will appear.
However, if the user sending the eReferral is configured as a Clinical Delegate for a 'Family Physician', 'Specialist', or 'Nurse Practitioner' user, the Clinic Delegate will be permitted to send the referral on their behalf.

How does Ocean's health service directory (oceanhealthmap.ca) find and prioritize search results?

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.

Can I send eReferrals from the Ocean Portal with pre-populated patient demographics?

For non-integrated Ocean sites, users can go directly to the Ocean Healthmap to send eReferrals. As the patient demographic information is not pulled in from an integrated-EMR, referring providers will need to manually complete this portion of the referral at the time of sending.

If these sites would like to have their patient information pre-populated, they can bulk upload a set of patients in to their Ocean site under the Patients View.

See the following support article for the various importer types and their sample templates that can be uploaded into Ocean. The General Importer is the sample containing all of the patient demographic fields on a referral form. Use this sample file to generate a list of your patients you would like to upload into your Ocean site.

Once your patient list is generated, go to the Action menu in the bottom left of Patients page and select "Upload Patients from File".

Select the file containing your list of patients, choose the General Importer from the dropdown, and provide a Cohort Id (a name to identify the patient set being uploaded).

Select "Upload". You will receive a confirmation prompt when the patients have been successfully uploaded into your Ocean site.

From there, referring providers can select the patient they would like to send a referral for, and then choose "Find Health Service". This will launch the provider into the Healthmap, pulling in the patient demographic information and prepopulating it on the referral form.

Note: Uploaded patients will be maintained in Ocean for 14 days before they are purged automatically from the site.

What File Types and Sizes can be Added as Attachments to eConsults and/or eReferrals?

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

For example, Ocean will only accept attachments with a size limit of 10MB per attachment, and up to 50MB total for all attachments included on the eConsult/eReferral. If an attachment that exceeds this file size limit is added, an error message will appear.

Ocean also has filetype restrictions. Only attachments of the following types can be included: "jpg", "jpeg", "png", "tiff", "tif", "mp3", "mp4", "txt", and "pdf". If an unsupported file type is added the user will be prompted with an error message.

What do the different folders mean in the eReferrals & eConsults page?

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.

What do the icons and buttons mean?

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.

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.

What do the different Action Menu Items mean?

The Action menu within an eConsult/eReferral is used to action and manage your site's consults and/or referrals. Each action menu item is described here to help you process and manage incoming and outgoing eConsults and/or eReferrals.

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.

Add to Externally Managed/Remove from Externally Managed

Used to indicate whether or not this referral is being managed externally (i.e., outside of Ocean) or not. For more information, please refer to What are 'Externally Managed' eReferrals?

How long are eConsults/eReferrals stored after they are sent through Ocean?

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.

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.

Viewing a Patient's Referral History

If you ever need to inquire about any Ocean eReferral(s) that have been received and processed for a certain patient in the past, you can easily look this up in the patient's eReferral history in Ocean.

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.

The "Referral History" captures the following referral information: Description, Status, Referring Site, Booked Date, Referral Date, Referrer, Provider, Protocol, and Priority.

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.

When viewing referrals under the eReferrals & eConsults View in the Ocean Portal, there may be an "Open File" icon displayed on the far right hand side of the referral.

This is a quick flag to indicate that there was at least one previous referral for the patient at your site. Simply click this icon to open and view the patient's referral history.

If you already have a specific patient's referral open, the referral history can be accessed from the Action menu at the top right corner of the referral.

Simply open this Action menu and then select "Referral History" to see if there were any previous referrals at your site for that patient.

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.

To search for a patient's referral history, go into the eReferrals & eConsults View in the Ocean Portal. From the Actions menu at the bottom left, select "Referral History".

Enter the patient’s birth date and health card number, then select "Search".

If no previous referrals are found, you will see a pop-up window, informing you as such.

Otherwise, the "Referral History" window will appear.

Where do eConsult and/or eReferral notification emails get sent to?

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.

An example of the notification email provided to patients can be seen by expanding the image on the right.

Notification Email Rules

Email Notifications for Senders

Notification emails are sent to the sender/referrer when:

An appointment date is booked, changed, or removed within the eReferral
An Anticipated Time to Appointment is provided within the eReferral
Booking comments are added or changed within the eReferral
The eConsult or eReferral is forwarded
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.
A secure message (or an eConsult response) is sent to the sender/referrer (patients do not receive this message)

Notifications will be sent based on the following conditions:

An Ocean user is associated with the referral

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"):
- Referral Notification Email
- Clinical Delegate Email
- The user's Email Address

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:

Default Incoming Referral Notification Email for the Ocean Site
Clinical Administrator / Ocean Support Contact for the Ocean Site
The email address associated with the Ocean Site Payer's user account

Email Notifications for Referral Delegates

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:

The delegate's Referral Notification Email
The delegate user's Email Address

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:

Default Incoming Referral Notification Email for the Ocean Site
Clinical Administrator / Ocean Support Contact for the Ocean Site
The email address associated with the Ocean Site Payer's user account

Email Notifications for Receivers

Notification emails are sent to the receiver when:

Any new eConsults or eReferrals are received
A secure message is sent to the receiver
An eConsult or eReferral is canceled
An eConsult or eReferral is forwarded to the receiver and then revoked
A sender converts an in-progress eConsult to an eReferral using the 'Change to eReferral' button
A sender requests that an in-progress eConsult be converted to an eReferral using the 'Proceed with eReferral' button
An eConsult is marked as completed by the sender

Notification emails will be sent either at the offering level, the listing level, or the site level, depending on how notifications are configured for the site.

Notifications regarding a specific consult/referral will be sent to the first email address that is set, based on the following order of email addresses in the site's Admin View (of the Ocean Portal):

Offering Notification Email

Set by the site in the specific Health Service Offering tagged in the "Service Details" section of a site's "Directory Listing"

Listing Notification Email

Set by the site in the "Advanced" section of the "Directory Listing"

Default Incoming Referral Notification Emails

Set by the site in the "Referrals Configuration" section

Clinical Administrator/Ocean Support Contact

Set by the site in the "Site Account" section

Site Payer's email address

Set by the site in the "Billing" section
Note: You can list multiple emails under each section by listing them out, separating each email address with commas (,) or semicolons (;).

Email Notifications for Patients
- For an email notification to be sent to the patient, the patient's email address must be included in the referral (which is only permitted after an acknowledgment of the patient's email consent).
- You can enter, update, or remove a patient's email address at any time by editing the patient demographics within the consult/referral window.
Notification emails are sent to the patient when:
- - The eReferral is successfully sent
  - An Anticipated Time to Appointment is provided within the eReferral
  - An appointment date is booked, removed, or changed within the eReferral
  - Booking comments are added or changed within the eReferral
  - The eReferral is forwarded
  - The eReferral is cancelled
  - 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.
  - The eReferral is redirected (following an initial cancellation or declination)
- For more details about eReferral-related email notifications that are sent to patients, please refer to "What email notifications will patients receive regarding their eReferrals?".
Disabling Email Notifications
- If you are a receiving site and would like to disable automatic email notifications to patients, you can do so in your Ocean Site's Referrals Configuration area.

Can I change the File Format for Downloaded Records and Notes?

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

Open the Menu and select the eReferrals option.

Click Settings button in the top right hand corner of the page.

Within the Referrals Settings, click to Configure Referrals.

Select the dropdown for Referral Records/Notes Filetype and choose between the default PDF files option or the TIFF files format.

Save changes.

Selecting the Download option in the Import window (which appears after the eConsult and/or eReferral is accepted), will now trigger the file to download in the format specified.

The Action Menu items for Download Referral Record and Download Referral Note will also download the consult and/or referral files in the format specified.

What email notifications will patients receive regarding their eReferrals?

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.

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).

Can Ocean Automatically Mark Booked Referrals as Closed at my 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.

Open the Menu and select the eReferrals option.

Click Settings button in the top right hand corner of the page.

Within the Referrals Settings, click to Configure Referrals.

Within the Receiving Referrals settings list, select "Yes" under the "Automatically Close Referrals" setting. This will trigger Ocean to run a scheduled job every night to look at ALL referrals sitting in the Booked Confirmed and Booked Unconfirmed folder of your site, and close them.

When the above setting is enabled, Ocean defaults to closing referrals 7 days after the latest appointment. You can change the number of days for when you would like Ocean to close the referral, based on how long ago the latest appointment on the referral was.

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.

Save changes.

Once the scheduled job is run, closed eReferrals will be moved to the Completed folder of your Ocean site. An automated message will be added to the messaging pane to inform all stakeholders that the referral was closed automatically.

An "Automatically closed" event will be added to the Event log with the date and time that the scheduled job was run.

If any referrals were closed incorrectly, the "Mark Incomplete" button can be used to move them back to the Booked folders.

Can I Configure the Booking Time Options that Appear in the eReferral Scheduling Pane?

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.

Open the Menu and select the eReferrals option.

Click Settings button in the top right hand corner of the page.

Within the Referrals Settings, click to Configure Referrals.

View the Appointment Time Options section on the right hand side of the page.

Select the Time System to configure whether the times display as a 12 hour clock, 24 hour clock, or both.

Select the Time Interval dropdown and choose the number of minutes you would like the appointment times to be spaced out by.

Select the Time Range options to drill the list down to a range of appointment times that match your clinic's hours.

Preview the changes in the View Dropdown Values item to ensure the options reflect the desired update for the referral's scheduling pane.

Save changes.

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.

Backing Up Your eReferrals

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:

Expand the Actions menu at the bottom left. Then select "Export".

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.

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".

Batch Printing eReferrals/eConsults

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.

Log in to the Ocean Portal and navigate to the 'eReferrals & eConsults' area.
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.

Apply any filters you would like to the list. This includes filtering by booking date, listing, health service offering, referring provider etc.

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.

What Health Service Categories are available for eConsults and/or eReferrals?

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").

Health Service Name	Health Service ID
Abnormal Pregnancy Screening Support	ABNORMAL_PREGNANCY_SCREENING_SUPPORT
Acupuncture	ACUPUNCTURE
Acquired Brain Injury	ACQUIRED_BRAIN_INJURY
Addictions Assessment & Referral	ADDICTIONS_ASSESSMENT_AND_REFERRAL
Adolescent Medicine	ADOLESCENT_MEDICINE
Adoption Support	ADOPTION_SUPPORT
Adult Day Program	ADULT_DAY_PROGRAM
Adult Intensive Services	ADULT_INTENSIVE_SERVICES
Adverse Event Following Immunization	AEFI
Alcoholic Support Groups	ALCOHOLIC_SUPPORT_GROUPS
Allergy and Immunology	ALLERGY_AND_IMMUNOLOGY
Ambulatory Blood Pressure Monitoring	AMBULATORY_BP
Amputee Services	AMPUTEE_SERVICES
Anger Disorders	ANGER_DISORDERS
Arthritis Services	ARTHRITIS_SERVICES
ADHD Services	ADHD_SERVICES
Anaesthesia	ANAESTHESIA
Aquafit Programs	AQUAFIT_PROGRAMS
Arterial Blood Gases	ARTERIAL_BLOOD_GASES
Assistive Equipment	ASSISTIVE_EQUIPMENT
Asthma Education	ASTHMA_EDUCATION
Augmentative Communication	AUGMENTATIVE_COMMUNICATION
Autism Spectrum Disorder Services	AUTISM_SPECTRUM_DISORDER_SERVICES
Arterial Segmental Pressures	ABI
Assisted Dying Inquiry Support	ASSISTED_DYING_INQUIRY_SUPPORT
Audiology	AUDIOLOGY
Back Pain	BACK_PAIN
Back - Epidural Steroid Injection	BACK_EPIDURAL_STEROID
Back - Prolotherapy	BACK_PROLOTHERAPY
Bariatric Surgery	BARIATRIC_SURGERY
Bereavement Support	BEREAVEMENT_SUPPORT
Biophysical Profile	BIOPHYSICAL_PROFILE
Family Planning	BIRTH_CONTROL
Blindness or Low Vision Rehabilitation	BLIND_OR_LOW_VISION_REHABILITATION
Blood Donor Clinic	BLOOD_DONOR_CLINIC
Bone Mineral Density	BONE_MINERAL_DENSITY
Bone Scan	BONE_SCAN
Bone Marrow Aspiration	BONE_MARROW_ASPIRATION
Botox Injections	BOTOX
Botox Injections - Cervical Dystonia	BOTOX_CERVICAL_DYSTONIA
Bracing	BRACING
Breastfeeding Support Services	BREASTFEEDING
Breast Clinic	BREAST_CLINIC
Breast Ultrasound	BREAST_ULTRASOUND
Bronchial Challenge	BRONCHIAL_CHALLENGE
Bronchoscopy	BRONCHOSCOPY
Supervised Exercise Rehabilitation - Cardiovascular	CARDIAC_REHAB
Cardiac Stress Testing	CARDIAC_STRESS_TESTING
Cardiology	CARDIOLOGY
Cardiology Services	CARDIOLOGY_SERVICES
Cardiovascular Surgery	CARDIOVASCULAR_SURGERY
Care Coordination	CARE_COORDINATION
Cataract Care	CATARACT_CARE
Cataract Surgery	CATARACT_SURGERY
Central Venous Catheter Insertion	CENTRAL_VENOUS_CATHETER_INSERTION
Children's Aid	CHILDRENS_AID
Circumcision	CIRCUMCISION
Community Health Centre	COMMUNITY_HEALTH_CENTRE
Concussion Management	CONCUSSION_MANAGEMENT
Core Needle Biopsy	CORE_NEEDLE_BIOPSY
Child Development Service Navigation	CHILD_DEVELOPMENT_SERVICE_NAVIGATION
Chiropractic	CHIROPRACTIC
Chronic Disease Self-Management	CHRONIC_DISEASE_SELF_MANAGEMENT
Chronic Pain Self-Management	CHRONIC_PAIN_SELF_MANAGEMENT
Colonoscopy	COLONOSCOPY
Colorectal Screening	COLORECTAL_SCREENING
Compounding Pharmacy	COMPOUNDING_PHARMACY
Community Support Services	COMMUNITY_SUPPORT_SERVICES
Convalescent Care	CONVALESCENT_CARE
Cord Blood Services	CORD_BLOOD_SERVICES
Cosmetics	COSMETICS
Cosmetic Surgery	COSMETIC_SURGERY
Counseling	COUNSELING
Colposcopy	COLPOSCOPY
CSSP	CENTRALIZED_SURGICAL_SERVICES_PROGRAM
CT	CT
Cystoscopy	CYSTOSCOPY
Dementia Support Services	DEMENTIA_SUPPORT
Dental Hygiene	DENTAL_HYGIENE
Dentistry	DENTISTRY
Dentistry (Subsidized or Free)	DENTISTRY_LOW_COST
Dental Surgery	DENTAL_SURGERY
Dermatology	DERMATOLOGY
Developmental and Disability Services	DEVELOPMENTAL_AND_DISABILITY
Diabetes Education	DIABETES_EDUCATION
Diabetes Specialist Management	DIABETES_SPECIALIST_MANAGEMENT
Diabetes Self-Management	DIABETES_SELF_MANAGEMENT
Diagnostic Imaging	DIAGNOSTIC_IMAGING
Dietitian / Nutrition	DIETITIAN
Driving Services	DRIVING_SERVICES
Drug Safety Testing	DRUG_SAFETY_TESTING
Early Pregnancy Loss	EARLY_PREGNANCY_LOSS
Early Psychosis Intervention	EARLY_PSYCHOSIS_INTERVENTION
Eating Disorders	EATING_DISORDERS_PROGRAM
ECG	ECG
Echocardiogram	ECHOCARDIOGRAM
EEG	EEG
EMG	EMG
Emergency Department	EMERGENCY_DEPARTMENT
Emergency Medicine	EMERGENCY_MEDICINE
Emergency Shelter	EMERGENCY_SHELTER
Endocrinology	ENDOCRINOLOGY
End-of-life care	END_OF_LIFE_CARE
Endometrial Biopsy	ENDOMETRIAL_BIOPSY
Endoscopy	ENDOSCOPY
Endoscopic retrograde cholangiopancreatography (ERCP)	ERCP
Exercise Oximetry	EXERCISE_OXIMETRY
Falls Prevention	FALLS_PREVENTION
Family Medicine	FAMILY_MEDICINE
Family Services	FAMILY_SERVICES
FASD Services	FASD_SERVICES
Feeding Services	FEEDING_SERVICES
Fertility	FERTILITY
Fibromyalgia	FIBROMYALGIA
Fine Needle Aspiration	FINE_NEEDLE_ASPIRATION
FIT-Positive Testing	FIT_POSITIVE_TESTING
Flexible Sigmoidoscopy	FLEXIBLE_SIGMOIDOSCOPY
Fluoroscopy	FLUOROSCOPY
Foot Care Self-Management	FOOTCARE_SELF_MANAGEMENT
Foot Care Nursing	FOOTCARE_NURSING
Forensics	FORENSICS
Forensic Psychiatry	FORENSIC_PSYCHIATRY
Fracture Clinic	FRACTURE_CLINIC
Friendly Visiting	FRIENDLY_VISITING
Gastroenterology	GASTROENTEROLOGY
Gastric Emptying Study	GASTRIC_EMPTYING_STUDY
Gambling Addiction Assistance	GAMBLING_ADDICTION_ASSISTANCE
Gender Services	GENDER_SERVICES
Genetics	GENETICS
Genitourinary Surgery	GENITOURINARY_SURGERY
Geriatrics	GERIATRICS
Geriatric Behaviour	GERIATRIC_BEHAVIOUR
Geriatric Medicine	GERIATRIC_MEDICINE
Geriatric Medicine Risk Consultation	GERIATRIC_MEDICINE_RISK_CONSULTATION
Geriatric Psychiatry	GERIATRIC_PSYCHIATRY
Geriatric Mental Health	GERIATRIC_MENTAL_HEALTH
Government Service Office	GOVERNMENT_SERVICE_OFFICE
Group Dining	GROUP_DINING
Group Exercise/Fitness	GROUP_EXERCISE_AND_FITNESS
Gynecology	GYNECOLOGY
Gynecologic Oncology	GYNECOLOGIC_ONCOLOGY
Hair Removal	HAIR_REMOVAL
Headache Medicine	HEADACHE_MEDICINE
Healthcare Navigation Service	HEALTHCARE_NAVIGATION_SERVICE
Health Education Class	HEALTH_EDUCATION_CLASSES
Health Education Class - Stroke	HEALTH_EDUCATION_CLASSES_STROKE
Health Education Class - Posture	HEALTH_EDUCATION_CLASSES_POSTURE
Hearing Loss/Deaf Support	HEARING_LOSS_OR_DEAF_SUPPORT
Hematology	HEMATOLOGY
Hepatology	HEPATOLOGY
Hernia Repair	HERNIA_REPAIR
HIV Medicine	HIV_MEDICINE
Ambulatory ECG Monitoring	HOLTER_MONITORING
Home Healthcare Products	HOME_HEALTHCARE
Home Maintenance & Repair	HOME_MAINTENANCE_AND_REPAIR
Homecare Services	HOMECARE_SERVICES
Home and Community Care	HOME_AND_COMMUNITY_CARE
Hospice	HOSPICE
Hospital	HOSPITAL
Hospital Medicine	HOSPITALIST
Housekeeping	HOUSEKEEPING
Housing and Homelessness Services	HOUSING_AND_HOMELESSNESS_SERVICES
Hydrotherapy	HYDROTHERAPY
Hyperbaric Therapy	HYPERBARIC_THERAPY
Imaging-Guided Needle Biopsy	IMAGING_GUIDED_NEEDLE_BIOPSY
Immunization Clinic	IMMUNIZATION_CLINIC
Independent Living Skills Training	INDEPENDENT_LIVING_SKILLS_TRAINING
Infectious Disease	INFECTIOUS_DISEASE
Internal Medicine	INTERNAL_MEDICINE
Intensive Care Medicine	INTENSIVE_CARE_MEDICINE
Intensive Geriatric Service Worker	INTENSIVE_GERIATRIC_SERVICE_WORKER
Intramuscular Stimulation	INTRAMUSCULAR_STIMULATION
Intravenous Iron Therapy	INTRAVENOUS_IRON_THERAPY
Intrauterine Device Insertion (IUD)	IUD
Laboratory	LABORATORY
Lactation Consultant	LACTATION_CONSULTANT
Laser Eye Surgery	LASER_EYE_SURGERY
Laser Services	LASER_SERVICES
Laser Hair Removal	LASER_HAIR_REMOVAL
Laser Tattoo Removal	LASER_TATTOO_REMOVAL
Laser Wart Removal	LASER_WART_REMOVAL
Long Term Care Assessment	LONG_TERM_CARE_ASSESSMENT
Lumbar Puncture	LUMBAR_PUNCTURE
Legal Services	LEGAL_SERVICES
Liquid Nitrogen	LIQUID_NITROGEN
Lower Limb Services, Chiropody or Podiatry	LLS_CHIROPODY_PODIATRY
Long-Term Care Home	LONG_TERM_CARE
Low Back Pain	LOW_BACK_PAIN
Mammography	MAMMOGRAPHY
Massage Therapy	MASSAGE_THERAPY
Maternal Fetal Medicine	MATERNAL_FETAL_MEDICINE
Meal Services	MEAL_SERVICES
Medical Marijuana	MEDICAL_MARIJUANA
Medical Microbiology	MEDICAL_MICROBIOLOGY
Medical Biochemistry	MEDICAL_BIOCHEMISTRY
Memory Clinic	MEMORY_CLINIC
Men's Health	MENS_HEALTH
Mental Health Assessment & Referral	MENTAL_HEALTH_ASSESSMENT_AND_REFERRAL
Midwifery	MIDWIFERY
Miscellaneous	MISCELLANEOUS
Minor Surgical Procedures	MINOR_SURGICAL_PROCEDURES
Mobility Services	MOBILITY_SERVICES
Mood Disorder and Anxiety	MOOD_DISORDER_AND_ANXIETY_SUPPORT_GROUP
MRI	MRI
MUGA Scan	MUGA
Multi-Disciplinary Assessment and Management - Adult	MULTI_DISCIPLINARY_ASSESSMENT_AND_MANAGEMENT_ADULT
Multi-Disciplinary Assessment and Management - Pediatric	MULTI_DISCIPLINARY_ASSESSMENT_AND_MANAGEMENT_PEDIATRIC
Multi-Use Recreation Centre	MULTI_USE_RECREATION_CENTRE
Multiple Sclerosis	MULTIPLE_SCLEROSIS
Musculoskeletal Rehabilitation	MUSCULOSKELETAL_REHAB
Myocardial Perfusion Study	MYOCARDIAL_PERFUSION_STUDY
Naturopathy	NATUROPATHY
Neonatology	NEONATOLOGY
Nephrology	NEPHROLOGY
Neurology	NEUROLOGY
Neurology Services	NEUROLOGY_SERVICES
Neuropsychology	NEUROPSYCHOLOGY
Neuroradiology	NEURORADIOLOGY
Neurorehabilitation	NEUROREHABILITATION
Neurosurgery	NEUROSURGERY
Nerve Block	NERVE_BLOCK
Nuclear Medicine	NUCLEAR_MEDICINE
Nurse Practitioner	NURSE_PRACTITIONER
Nursing	NURSING
Nutritional Counseling Workshop	NUTRITIONAL_COUNSELING_WORKSHOP
Ontario Breast Screening Program (OBSP)	OBSP
Obstetrics	OBSTETRICS
Obstetrical 3D Ultrasound	OBSTETRICAL_3D_ULTRASOUND
Obstetrical Ultrasound	OBSTETRICAL_ULTRASOUND
Occupational Health Clinic	OCCUPATIONAL_HEALTH
Occupational Medicine	OCCUPATIONAL_MEDICINE
Occupational Therapy	OCCUPATIONAL_THERAPY
OMF Surgery	OMF_SURGERY
Medical Oncology	ONCOLOGY
Ontario eConsult	ONTARIO_ECONSULT
Ophthalmology	OPHTHALMOLOGY
Optometry	OPTOMETRY
Orofacial Medicine	OROFACIAL_MEDICINE
Orthopedics	ORTHOPEDICS
Orthopedics: Elbow	ORTHOPEDIC_SURGEON_ELBOW
Orthopedics: Foot & Ankle	ORTHOPEDIC_SURGEON_FOOT_AND_ANKLE
Orthopedics: Hand	ORTHOPEDIC_SURGEON_HAND
Orthopedics: Hip	ORTHOPEDIC_SURGEON_HIP
Orthopedics: Knee	ORTHOPEDIC_SURGEON_KNEE
Orthopedics: Shoulder	ORTHOPEDIC_SURGEON_SHOULDER
Orthopedics: Spine	ORTHOPEDIC_SURGEON_SPINE
Orthopedics: Wrist	ORTHOPEDIC_SURGEON_WRIST
Orthotics	ORTHOTICS
Orthodontics	ORTHODONTICS
Osteopathy	OSTEOPATHY
Otolaryngology	OTOLARYNGOLOGY
Pain Management	PAIN_MANAGEMENT
Paracentesis	PARACENTESIS
Palliative Care Specialist	PALLIATIVE_CARE
Palliative Care Services	PALLIATIVE_CARE_SERVICES
Palliative Community Physician	PALLIATIVE_COMMUNITY_PHYSICIAN
Palliative Homecare	PALLIATIVE_HOMECARE
Pap Testing	PAP_TESTING
Pathology	PATHOLOGY
Patient Self-Advocacy Counseling	PATIENT_SELF_ADVOCACY_COUNSELING
Pediatric Allergy	PEDIATRIC_ALLERGY
Pediatric Cardiology	PEDIATRIC_CARDIOLOGY
Pediatric Cleft Lip and Palate	PEDIATRIC_CLEFT_LIP_PALATE
Pediatric Dentistry	PEDIATRIC_DENTISTRY
Pediatric Dermatology	PEDIATRIC_DERMATOLOGY
Pediatric Developmental	PEDIATRIC_DEVELOPMENTAL
Pediatric Emergency Medicine	PEDIATRIC_EMERGENCY
Pediatric Endocrinology	PEDIATRIC_ENDOCRINOLOGY
Pediatric Gastroenterology	PEDIATRIC_GASTROENTEROLOGY
Pediatric Hematology	PEDIATRIC_HEMATOLOGY
Pediatric Infectious Disease	PEDIATRIC_INFECTIOUS_DISEASE
Pediatric Laboratory	PEDIATRIC_LABORATORY
Pediatric Nephrology	PEDIATRIC_NEPHROLOGY
Pediatric Neurology	PEDIATRIC_NEUROLOGY
Pediatric Neurosurgery	PEDIATRIC_NEUROSURGERY
Pediatric OMF	PEDIATRIC_OMF
Pediatric Oncology	PEDIATRIC_ONCOLOGY
Pediatric Ophthalmology	PEDIATRIC_OPHTHALMOLOGY
Pediatric Orthopedics	PEDIATRIC_ORTHOPEDICS
Pediatric Otolaryngology	PEDIATRIC_OTOLARYNGOLOGY
Pediatric Plastic Surgery	PEDIATRIC_PLASTIC_SURGERY
Pediatric Primary Care	PEDIATRIC_PRIMARY_CARE
Pediatric Psychiatry	PEDIATRIC_PSYCHIATRY
Pediatric Psychology	PEDIATRIC_PSYCHOLOGY
Pediatric Radiology	PEDIATRIC_RADIOLOGY
Pediatric Respirology	PEDIATRIC_RESPIROLOGY
Pediatric Rheumatology	PEDIATRIC_RHEUMATOLOGY
Pediatric General Surgery / Thoracic	PEDIATRIC_SURGERY
Pediatric Urology	PEDIATRIC_UROLOGY
Pediatrics	PEDIATRICS
Pelvic Floor Physiotherapy	PELVIC_FLOOR_PHYSIOTHERAPY
Periocular Lesions	PERIOCULAR_LESIONS
Periodontistry	PERIODONTIST
Personal Care	PERSONAL_CARE
PET Scan	PET_SCAN
Pharmacy	PHARMACY
Pharmacist	PHARMACIST
Physiotherapy	PHYSIOTHERAPY
Physiatry	PHYSIATRY
Plastic Surgery	PLASTIC_SURGERY
Postnatal Care	POSTNATAL_CARE
Pregnancy Counseling	PREGNANCY_COUNSELING
Prenatal Care	PRENATAL_CARE
Prenatal Screening	PRENATAL_SCREENING
Preoperative Clinic	PREOPERATIVE_CLINIC
Psychiatry	PSYCHIATRY
Psychology	PSYCHOLOGY
Psychotic Disorders	PSYCHOTIC_DISORDERS
Public Health	PUBLIC_HEALTH
Pulmonary Function Testing	PULMONARY_FUNCTION_TESTING
Radiation Oncology	RADIATION_ONCOLOGY
Radiology	RADIOLOGY
Radiofrequency Ablation	RADIOFREQUENCY_ABLATION
Refugee Care	REFUGEE_CARE
Registered Psychotherapy	REGISTERED_PSYCHOTHERAPY
Remote Patient Monitoring	REMOTE_PATIENT_MONITORING
Respiratory Therapy	RESPIRATORY_THERAPY
Respirology	RESPIROLOGY
Respirology Services	RESPIROLOGY_SERVICES
Respite Care	RESPITE_CARE
Retina Care	RETINA_CARE
Rheumatology	RHEUMATOLOGY
Rides & Transportation	RIDES_AND_TRANSPORTATION
rTMS	RTMS
School Psychology	SCHOOL_PSYCHOLOGY
Senior Community Centre	SENIOR_COMMUNITY_CENTRE
Seniors Gentle Exercise Class	SENIOR_EXERCISE
Seniors Gentle Exercise (In-Home)	SENIOR_EXERCISE_IN_HOME
Sex/Love Addiction Counseling	SEX_AND_LOVE_ADDICTION_ASSISTANCE
Sexual Health	SEXUAL_HEALTH_THERAPY
Sexual Abuse Treatment	SEXUAL_ABUSE_TREATMENT
Sexual Behaviours	SEXUAL_BEHAVIOURS
Shopping Assistance	SHOPPING_ASSISTANCE
Specialty Drug Patient Support Program	SPECIALTY_DRUG_PATIENT_SUPPORT_PROGRAM
Spinal Cord Injury Support	SPINAL_CORD_INJURY
Spine Assessment Clinic	SPINE_ASSESSMENT_CLINIC
Spirometry	SPIROMETRY
Supervised Rehabilitation Exercise	SUPERVISED_REHABILITATION_EXERCISE
Supervised Rehabilitation Exercise - Diabetes	SUPERVISED_REHABILITATION_EXERCISE_DIABETES
Supervised Rehabilitation Exercise - Neurological	SUPERVISED_REHABILITATION_EXERCISE_NEUROLOGICAL
Supervised Rehabilitation Exercise - General Fitness	SUPERVISED_REHABILITATION_EXERCISE_GENERAL_FITNESS
Supervised Rehabilitation Exercise - Chronic Disease	SUPERVISED_REHABILITATION_EXERCISE_CHRONIC_DISEASE
STI Clinic	STI_CLINIC
Sleep Medicine	SLEEP_MEDICINE
Small Bowel Follow-Through	SMALL_BOWEL_FOLLOW_THROUGH
Smoking Cessation Therapy	SMOKING_CESSATION
Social Work	SOCIAL_WORK
Sonohysterogram	SONOHYSTEROGRAM
Spasticity Management	SPASTICITY_MANAGEMENT
Speech Therapy / Speech Language Pathology	SPEECH_THERAPY
Spiritual Care	SPIRITUAL_CARE
Sport Therapy	SPORT_THERAPY
Sports Medicine Specialist	SPORTS_MEDICINE_SPECIALIST
Stroke Care	STROKE_CARE
Substance Use Disorders	ADDICTIONS
Supplies Delivery	SUPPLIES_DELIVERY
Support Group	SUPPORT_GROUP
Supportive Housing	SUPPORTIVE_HOUSING
General Surgery	SURGERY
Surgery: Biopsy	SURGICAL_BIOPSY
Surgery: Brachial Plexus	SURGERY_BRACHIAL_PLEXUS
Surgery: Cervical Spine	SURGERY_CERVICAL_SPINE
Surgery: Brain	SURGERY_BRAIN
Surgery: Colorectal	SURGERY_COLORECTAL
Surgery: Lumbosacral Spine	SURGERY_LUMBAR_SPINE
Surgery: Thoracic Outlet Syndrome	SURGERY_THORACIC_OUTLET_SYNDROME
Surgery: Thoracic Spine	SURGERY_THORACIC_SPINE
Surgery: Ankle	SURGERY_ANKLE
Surgery: Ankle - Total Arthroplasty	SURGERY_ANKLE_TOTAL_ARTHROPLASTY
Surgery: Ankle - LCL	SURGERY_ANKLE_LCL
Surgery: Elbow	SURGERY_ELBOW
Surgery: Wrist	SURGERY_WRIST
Surgery: Wrist - Osteotomy	SURGERY_WRIST_OSTEOTOMY
Surgery: Wrist - De Quervain's Tenosynovitis Repair	SURGERY_WRIST_DE_QUERVAINS
Surgery: Elbow - Total Arthroplasty	SURGERY_ELBOW_TOTAL_ARTHROPLASTY
Surgery: Tennis Elbow	SURGERY_TENNIS_ELBOW
Surgery: Foot	SURGERY_FOOT
Surgery: Foot - Bunion	SURGERY_FOOT_BUNION
Surgery: Foot - Hammertoe	SURGERY_FOOT_HAMMERTOE
Surgery: Foot - Metatarsophalangeal Arthroplasty	SURGERY_FOOT_MTP_ARTHROPLASTY
Surgery: Hand	SURGERY_HAND
Surgery: Hand - Dupuytren's Contracture	SURGERY_HAND_DUPUYTRENS
Surgery: Hand - Carpal Tunnel Syndrome	SURGERY_HAND_CARPAL_TUNNEL
Surgery: Hand - Trigger Finger Release	SURGERY_HAND_TRIGGER_FINGER_RELEASE
Surgery: Hand - Small Joint Arthroplasty	SURGERY_HAND_SMALL_JOINT_ARTHROPLASTY
Surgery: Hip - Total Arthroplasty	SURGERY_HIP_ARTHROPLASTY
Surgery: Knee - ACL Reconstruction	SURGERY_KNEE_ACL
Surgery: Knee - LCL Reconstruction	SURGERY_KNEE_LCL
Surgery: Knee - Arthroscopy	SURGERY_KNEE_ARTHROSCOPY
Surgery: Knee - Total Arthroplasty	SURGERY_KNEE_TOTAL_ARTHROPLASTY
Surgery: Shoulder - Arthroscopy	SURGERY_SHOULDER_ARTHROSCOPY
Surgery: Shoulder - Open Repair Rotator Cuff	SURGERY_SHOULDER_OPEN_REPAIR_ROTATOR_CUFF
Surgery: Shoulder - Total Arthroplasty	SURGERY_SHOULDER_TOTAL_ARTHROPLASTY
Surgery: Shoulder - Total Reverse Arthroplasty	SURGERY_TOTAL_REVERSE_ARTHROPLASTY
Surgical Oncology	SURGICAL_ONCOLOGY
Telephone Reassurance & Safety Checks	TELEPHONE_REASSURANCE_AND_SAFETY_CHECKS
Therapeutic/Interventional Radiology	THERAPEUTIC_RADIOLOGY
Thoracic Surgery	THORACIC_SURGERY
Thoracentesis	THORACENTESIS
Thrombosis / DVT / VTE Care	THROMBOSIS_DVT_VTE_CARE
Thyroid Biopsy	THYROID_BIOPSY
Tilt Table Testing	TILT_TABLE_TESTING
Tongue Tie Release	TONGUE_TIE_RELEASE
Traditional Chinese Medicine	TRADITIONAL_CHINESE_MEDICINE
Transfusion Medicine	TRANSFUSION_MEDICINE
Transgender Services	TRANSGENDER_SERVICES
Travel Medicine	TRAVEL_MEDICINE
Ultrasound	ULTRASOUND
Unplanned Pregnancy Support	UNPLANNED_PREGNANCY_SUPPORT
Upper GI Series	UPPER_GI_SERIES
Urgent Care Clinic	URGENT_CARE_CLINIC
Urology	UROLOGY
Urodynamic Testing	URODYNAMICS
Varicose Vein Treatment	VARICOSE_VEIN_TREATMENT
Vasectomy	VASECTOMY
Vascular Studies	VASCULAR_STUDIES
Vascular Surgery	VASCULAR_SURGERY
Vocational Services	VOCATIONAL_SERVICES
Walk-In Clinic	WALK_IN_CLINIC
Weight Loss Clinic	WEIGHT_LOSS_CLINIC
Women's Health	WOMENS_HEALTH
Wound Care	WOUND_CARE
X-Ray / Radiography	X_RAY
Youth Shelter	YOUTH_SHELTER

Provider Network FAQ

Who can access the 'Receive and Manage Externally' button?

Is there an indication when a Directory Listing is configured in this way?

Central Intakes Externally Managing eReferrals

An eReferral I sent has been marked as 'Externally Managed'. What do I do now?

I received an eReferral and marked it as 'Externally Managed'. What do I do now?

Can referrals be removed from the 'Externally Managed' status folder?

Option 1: Central Intake Electronically Forwards the Ocean eReferral

Option 2: Manually Adding/Removing the Ocean eReferral to/from the 'Externally Managed' Folder

Do 'Externally Managed' eReferrals trigger Deletion Warnings?

Are 'Externally Managed' eReferrals included in referral analytic exports?

How do I access the settings?

What do the settings mean?

Details

Options

Background

Note

Determining your Number

Updating your Number

Patient Notification Emails

Provider Notification Emails

Filtering using the Search Bar

Filtering Status Folders

Group-Level Filters

Folder-Specific Filters

Ontario Pilot Phase

What is HRM®?

Ocean-HRM Message Sender Configuration

Sender Approval

Sender Configuration

Ocean-HRM Message Receiver Configuration

Receiver Approval

Receiver Configuration

Sending Messages via HRM

Receiving Messages via HRM

Troubleshooting & Support

Colour Coding

Definitions

What are Health Service Categories?

What is a Health Service Offering?

Why do they both exist?

What if I can't find the exact Health Service Category for my Directory Listing?

How do I customize the name?

Can I request additional Health Services Categories?

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

How do I add handout files?

Special Considerations

Physician Assistants and Residents

Nurse Practitioners

Directory Listings Enforcing Referrer Restrictions

General Folder Group

Received Folder Group

Sent Folder Group

Other Folders

Icons within the eReferrals & eConsults page

Icons within the eConsult and/or eReferral

Buttons within the eConsult and/or eReferral

Sender and Receiver Actions

Sender Specific Actions

Receiver Specific Actions

Actions That Extend the Purge Deadline

Checking the Purge Deadline for an eConsult/eReferral

Notification Email Rules

Email Notifications for Senders

Notifications will be sent based on the following conditions:

An Ocean user is associated with the referral

Email Notifications for Referral Delegates

Email Notifications for Receivers

Email Notifications for Patients

Disabling Email Notifications

Sent Referrals

Forwarded Referrals

Referrals with Estimated Wait Times

Booked Referrals

Rescheduled Referrals

Appointment Reminders

Declined Referrals

Cancelled Referrals

Redirected Referrals

Final Comments