How can I set up a Website Form to allow patients to securely send attachments?

Ocean supports the use of a dedicated Website Form to allow patients to securely send a message with an attachment(s) to the clinic. This feature is only available to clinics that integrate with Ocean using Cloud Connect. Patients must have an existing patient record in the EMR to use this form.

You must Create a Directory Listing for your Clinic prior to configuring any Website Form.

  1. Create a new Website Form configuration.

    • Login to the Ocean Portal and navigate to the Admin tab.
    • Enter the "eRequest Links" section (from the menu along the left.)
    • Click the "New eRequest Configuration" button at the bottom righthand corner of the screen.
  2. Configure your Website form settings.

    • Name
      The name of your Website form (for tracking purposes.)
      Directory Listing
      Clinical location that you listed and/or claimed (a.k.a. your clinic/site name).
      Website Forms Type
      Select "Authenticated Form" as your Website Form Type.
      Redirect URL (optional)
      This will take the patient to a specific URL once they have completed and sent the inbound message. You can use this to redirect patients back to your own website.
      Subsite Reference (optional)
      This will only apply if you have Website Form fees covered by different payers. More information about subsites can be found in "Creating Separate Bills for Different Ocean Services".
    • Once the “Active” button is enabled, billing will begin for the Website Form link. If you are not ready to activate the form yet, simply disable this option.
    • Click "Create" to finish configuring your Website Form.
  3. Activate your Website Form.

    • Once you've finished creating and configuring your Website Form Link, you can change the "Active" status at any time. Through the "eRequest Links: section, you can also access and manage your existing links, configure your settings, or create new Website Forms at any time.

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How do I download an attachment submitted through a Website Form?

Please note: Telus PS Suite and Med Access cannot directly attach files to patient charts/notes. Files must first been downloaded to your computer. Please refer to the instructions in this guide for steps on uploading downloaded attachments into the EMR chart. 

1. How to access and review your attachment

Once you have received a new inbound message via an Ocean Website Form Link, it will appear in the Ocean portal as a new request.

PS Suite, Med Access Accuro
    • To review your new requests and download your file attachments and note, open the "eRequest" tab in the portal and select the "New" option from the sidebar. Select the appropriate request to view its details.

    • The patient's file attachment will be displayed under the "Messaging" panel on the righthand side of the request. You can click the attachment to download it directly to your computer.

    • After downloading your attachment, ensure you click the "Completed" option at the bottom of the screen. This will initiate an EMR import and download the corresponding note from the request into the patient's chart.

      Note: The file attachment itself will not be downloaded with the note. See Step 2 of this guide for more information.

If you need to re-download the attachment, you can locate the request in the "Completed" folder on the lefthand sidebar.

For more detailed information on the full eRequest workflow, please refer to this guide: Basic Website Forms Management Workflow

2. How to import your attachment into the EMR

PS Suite Med Access Accuro

Caution: As patient attachments are being downloaded directly to your computer, and may contain PHI, please exercise appropriate security measures to ensure files are removed from the computer after being uploaded into the EMR.

    • Open the corresponding patient chart in PS Suite.
    • Select the file attachment from your computer's Downloads folder (or location where downloaded files are saved from your web browser.)
    • Drag the file attachment to the corresponding Ocean note. (You will see the note contains the term "Attachment Included.")
    • In the attachment preview window, click the "Save" button
    • The attachment will now be associated with the note via a paperclip icon next to the date. Clicking the paperclip icon will allow you to review the attachment.

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How do I delete a Website form?
  1. Sign into the Ocean Portal and navigate to the Admin Tab and click the eRequests Tab.
  2. Click "Delete" on the Website form you would like to remove and confirm by clicking "Delete" on the pop-up.

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What do I do if I see "Warning from Ocean: Notes Require Download"?

Every Monday morning, Ocean sends out automatic notifications to site clinic administrators if it finds any patient notes or submissions from Website Forms that may require a manual export or download to the EMR.

Website Forms

If there are any submissions from Website Forms that have not been exported, the email will tell you how many are pending removal and how to review them. Even if you are processing the submission as part of the initial "acceptance" workflow, it's a good idea to heed these warnings and export them for audit purposes (i.e. a spreadsheet saved in a secure place).

Patient Notes

For clinics using Ocean Tablets or Ocean Online, the email contains the EMR ID and the Ocean reference number of patients that have not been marked "downloaded to the EMR". We call these "orphaned notes" since the EMR has not claimed them promptly.

These notifications can be confusing. See below for a few quick FAQs.

What circumstances would lead to an orphaned note?

The PS Suite and OSCAR EMR integrations (as of 2017) are only able to download notes when the chart for a particular patient is open and connected to Ocean. If the patient's chart isn't open or the chart doesn't know about the Ocean note, the note can remained orphaned.

Notes can be orphaned for three common reasons:
  1. A web questionnaire was sent and the patient's chart hasn't been opened for months. Ocean has a configurable expiry date (default of 100 days), after which it will remove the patient, note and all. If you send out web questionnaires months in advance (e.g. a pediatrician sending an intake package to newly pregnant women), then this time period may expire before the chart is opened to download the note.
  2. The Ocean custom form was removed from a chart in PS Suite before a tablet session or web questionnaire is complete.
  3. A tablet session was completed and the initial note was downloaded, then the same ref was used to load the tablet again for the same patient. In this case, the Ocean custom form would be deleted after the first tablet session completed -- the notes associated with subsequent completions will be orphaned since the link to the EMR chart is broken.

Note: If you are only using tablets (and not web questionnaires), most likely any "real" missing notes would be noticed at the time of the appointment and you can ignore the notifications.

Why does Ocean bother me about it?
Since Ocean is not an EMR, it is unable to retain private patient health information for prolonged periods. Consequently for privacy reasons, it removes patient data as soon as it's not strictly required. Notes that are orphaned for months must eventually be removed, even if they contain important clinical notes. Hence we notify you with a warning email and ask you to manually review the notes before they are deleted.
What should you do about these orphaned notes?
  1. Log in to the Ocean Portal and navigate to the Patients tab.
  2. Review the outstanding notes by searching for your patients using their Ocean reference number. If this is the first time you are logging in to Ocean on your computer, you will need to enter your shared encryption key to see the encrypted data.
  3. A quick scan of the notes will usually give you some indication whether they are real or not. If appropriate, copy & paste the note into your EMR patient chart and remove the Ocean patient and patient record from Ocean.

Hint: If you want to pull a note back into PS Suite, simply insert the Ocean custom form as you would normally for that patient, click the generated 3 or 4 digit number and update it to the Ocean reference you want to import -- within a few seconds the note and any demographic changes will be downloaded and applied automatically.

How do I reduce the number of times this happens?

It depends on why you are getting orphaned notes.

  • If the leading cause is early-sending of web questionnaires, you can either act on the completion notification and download the note then, or extend the expiry date on the invitation to more than 100 days.
  • If the leading cause is testing, the warnings ought to settle down after a while.
  • Finally, if the leading cause is staff miskeys (i.e. removing the custom form or re-entering the Ocean patient reference number on the tablet after the patient has completed their forms), a recap on training might be appropriate.

However, the root cause of these issues may be something else specific to your workflow or process. If you think that you are getting too many orphaned notes, let us know at ocean.tips/support to see whether we can help.

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How do I change the name/description of an incoming Website form submission based on the eForm's answers?

A link to your Website Forms will set the "Description" value for a Website form to match the description of the associated service. For example, a "Physiotherapy" Website form will set the "Description" column value of a form submission to "Physiotherapy". However, this may not be very helpful for browsing incoming submissions if they are all of the same type(s).

You can customize this description by changing the associated eForm for the Website Forms. All you need to do is add an invisible formula item with the following values:

  • Item Reference should be "referralDescription".
  • Item Type should be "Formula"
  • "Show this field if:" should be "false"
  • The formula should be a Javascript expression that returns the value of the description, based on the form answers.

Examples of possible formulas include:

renewalRequest.p != 0 ? "Renewal Request" : "General eRequest"
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(function() { if (myItem1.p != 0) { return "myItem1Description"; } if (myItem2.p != 0) { return "myItem2Description"; })()
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Here is the XML for the Diagnostic Imaging eRequisition form:

item ref="referralDescription" type="FORMULA" showIf="false" formula="(function() {
	var descs = [];
	if (ctBrainHeadNeck.p) { descs.push('CT Brain/Head/Neck'); }
	if (ctSpine.p) { descs.push('CT Spine and Neck'); }
	if (ctMsk.p) { descs.push('CT MSK'); }
	if (ctChest.p) { descs.push('CT Chest'); }
	if (ctChestAbdoPelvis.p) { descs.push('CT Abdomen/Pelvis'); }
	if (ct_angiography.p) { descs.push('CT Angiography'); }
	if (mammo.p) { descs.push('Mammogram'); }
	if (bmd.p) { descs.push('Bone Densitometry'); }
	if (xray.p) { descs.push('X-Ray'); }
	if (nm.p) { descs.push('Nuclear Medicine'); }
	if (us.p) { descs.push('Ultrasound'); }
	if (fluoroscopy.p) { descs.push('Fluoroscopy'); }
	if (descs.length == 0) { descs.push('Diagnostic Imaging'); }
	return descs.join('; ');
})()
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