Documentation for Ocean Audit Log Entries

This article provides a description for the various types of audit log entries listed in Ocean audit logs.

Note that, since the list of audit types in Ocean continues to grow, the following list will be updated periodically and may not be comprehensive.

Exporting the User Activity Log 

User Activity logs provide insight on all Ocean user activities on your Ocean site. 

To download a user activity log, you must be an administrative user on your Ocean site. Login to the Ocean Portal and click "Menu" in the top left corner. Select "Admin" and in the left side bar, select "Reports". Under the Export User Activities heading, select a date range and Ocean user for your logs. Click the Export button to download a .csv file onto your computer. 

For more information on reviewing your site's audit logs for privacy reasons, please refer to this article.

Audit Types

Each audit record contains:

  • siteNum: The Ocean site number under which the action was performed
  • userName: The Ocean username of the user who directly or indirectly triggered the audit action.
  • creationDate: The date/time that the action was recorded in Ocean (which should be within a few milliseconds at most of the actual event)
Audit Type

Audit Record Properties

Description
REGISTER_TABLET macAddr, "tabletName", "ipAddress" The Ocean Tablet app was registered (includes Kiosk registrations).
UPDATE_TABLET_TOKEN macAddr, "ipAddress"
The Ocean Tablet authentication token has been regenerated. This can be done manually via the app's Admin menu, and may be done automatically in future.
DEREGISTER_TABLET siteNum,"macAddr","tabletName", "reason"
The Ocean Tablet app was deregistered. This can be done via the Ocean web portal, the admin menu on the Tablet app, or automatically for a security related reason (e.g. unauthorized app install, too many attempts to unlock, etc.)
ASSIGN_TABLET_TO_TABLET_SETTINGS macAddr, "key" Within the web portal in Tablets tab, a tablet was moved (dragged-and-dropped) from one settings group to another.
RENAME_TABLET_SETTINGS_KEY old, "new" A tablet settings group was renamed in Ocean web portal.
DELETE_TABLET_SETTINGS_KEY key A tablet settings group was deleted in Ocean web portal.
UPDATE_SUBSITE_REF_ON_TABLET macAddr,"newSubsiteRef" The subsite reference (for billing purposes) for a tablet was changed.
UPLOAD_PATIENT ref,"externalPatientRef","client","v"
A patient was uploaded from the EMR to create an Ocean patient record. The ref is the Ocean assigned reference ID, the externalPatientRef is the EMR's patient ID, the client describes what uploaded the patient record, and the version describes the version of the client (only applies where client-side code is used for uploads).
REUSE_PATIENT ref,"externalPatientRef","client","v"
A patient was to be uploaded, but an existing patient record was found in Ocean based on the externalPatientRef (the EMR's patient ID), so the patient record in Ocean was reused instead of a new one created.
UPDATE_OR_ADD_PATIENT ref,"externalPatientRef" A patient record in Ocean was updated or created (sometimes redundant with other audit actions).
GET_PATIENT ref,"client","v", "reqType"
A patient record was retrieved from the database by Ocean reference number ("ref") and returned to a client (either to show in the web browser or for an Ocean Tablet/Kiosk).
GET_PATIENT_BY_ACCESS_TOKEN ptAccessToken,"ref"
A patient record was retrieved from the database by access token, which is used by Ocean Online to send to patients via email.
ADD_ON_DEMAND_FORM ref,"formRef" A form (idenfied by "formRef") was added to the queue for a patient (identified by "ref").
REMOVE_EFORM_FROM_QUEUE ref,"formRef" A form (idenfied by "formRef") was removed from the queue for a patient (identified by "ref").
UPDATE_PATIENT_NOTE ref,"oceanSessionId"
A patient note payload was updated. The "ref" property identifies the patient, and the "oceanSessionId" identifies the session in which the note was generated, either via Ocean Online or on a Tablet.
RETRIEVE_PATIENT_UPDATE ref A patient note payload was downloaded, e.g. to update the EMR record.
FINALIZE_PATIENT_UPDATE ref
A patient note payload was finalized, i.e. it is now safe for the EMR to download the note. In contrast, a note that is generated by a tablet might be updated multiple times (once for each completed form) before the tablet session is complete and the note is "finalized", and safe to download to the patient chart.
MARK_NOTES_AS_DOWNLOADED ref  
MARK_NOTES_FINALIZED ref
A user clicked "Mark Notes Finalized" in the patients tab to complete an interrupted patient session and trigger a download to the EMR.
RESET_NOTES_DOWNLOADED ref
The patient notes were reset manually to trigger the EMR download again, often because of a problem downloading the notes (e.g. an EMR-side error).
DELETE_PATIENT ref,"externalPatientRef", "ptSiteNum" A patient record was deleted in Ocean. Note that this has no impact on the patient record in the EMR.
DELETE_ALL_PATIENTS   All patient records in a given Ocean site were deleted. This is currently only possible in demo sites.
LOCK_PATIENT ref
A patient record was "locked" manually, meaning the Ocean system will not automatically delete it as per standard rentention/purge rules.
VIEW_PATIENTS   A user viewed the patients tab and may have seen patient names and other information in summary view.
FORM_COMPLETED ref,"formRef","src", "lang"
An Ocean eForm with reference "formRef" was completed for a patient indicated by the "ref" property. The languge and device used to complete the form (tb = tablet, ol = online) are also captured as parameters.
SECURE_MESSAGE_SENT ref, "hasAttachment", "expiryDate" A secure message was sent to a patient indicated by the "ref" property.
SECURE_MESSAGE_CONFIRMED ref, "finishedViewing", "ptReplied"
A patient (with Ocean reference ref) viewed a secure message and confirmed receipt. If "finishedViewing" is true, it means the patient indicated that the secure message was no longer needed. If "ptRelied" is true, it means the patient typed in a reply.
VIEW_FORM_MEMORY ref, "externalPtRef", "viewed" A user clicked to view the form memory for the patient with reference ref and the EMR ID externalPtRef.
CLEAR_FORM_MEMORY ref, "externalPtRef", "deleted" A user chose to "Clear Form Memory" after viewing the form memory for a patient.
CREATE_STUB_PATIENT ref, "externalPatientRef"
A temporary placeholder record in Ocean has been created in anticipation of an upload of the patient record from the EMR (with patient record ID "externalPtRef")
PATIENT_DOWNLOADED_TO_EMR ref
The EMR sent a message to Ocean indicating that the Ocean notes were successfully downloaded for a patient record with Ocean reference "ref".
OVERDUE_NOTIFICATION_SENT externalPatientRef, "emailUsed", "ptSiteNum"
An email indicating that a secure message or form for patient with EMR ID externalPatientRef has been flagged as overdue (awaiting the patient's response).
PATIENT_APPOINTMENT_UPDATED ref, "newAppt", "oldAppt" The appointments held in Ocean for a patient with reference "ref" have been updated by an external system (the EMR).
CREATE_EMAIL_INVITE oceanRef, "overdueDate", "expiryDate", "hasSecureMsg", "formCount"
A user has created a "secure email link" for an Ocean email that will be subsequently emailed to the patient with reference "oceanRef". The link has an "expiryDate" after which it can no longer be used and an optional earlier "dueDate" after which it will be flagged as "overdue". If a free-text secure message is included, "hasSecureMsg" is "true". The number of Ocean eForms included in the link is included as "formCount"
FORM_SENT oceanRef, "formRef"
A specific Ocean eForm with form reference "formRef" has been sent via a secure email link to a patient with reference "oceanRef"
MARK_PATIENT_ARRIVED ref
A patient with Ocean reference "ref" has been marked as "Arrived" within Ocean, which will subsequently request the EMR to mark the patient as arrived in the appointment schedule.
OCEAN_REMINDER_SENT ref, "apptDateTime", "templateName", "providerName", "reasonForVisit"
An Ocean reminder was sent to a patient with reference "ref" for an EMR appointment at "apptDateTime" for a provider with name "providerName" tagged with an appointment reason "reasonForVisit", using the message template "templateName"
OCEAN_REMINDER_CONFIGURATION_SAVED cfg A configuration for an Ocean reminder has been saved in the Ocean Reminder configuration screen in Ocean.
OCEAN_REMINDER_SUBSCRIPTION_CANCELLED   A user has canceled a site's Ocean Reminder subscription.
OCEAN_REMINDER_SCHEDULED_SEND   The Ocean Reminders engine executed at this time for a specific site.
OCEAN_REMINDER_FORCE_SEND   A user has clicked "Force Send" to force the Ocean Reminders to execute at a specific site.
REMINDER_APPOINTMENT_CONFIRMED ref, "apptId", "scheduleId" A patient has confirmed an appointment using a reminder link.
REFERRAL_TARGET_ADD_NEW ref A new directory listing was created.
REFERRAL_TARGET_UPDATE ref A directory listing was updated. 
REFERRAL_TARGET_KEY_PAIR_UPDATE siteNum A new set of public/private encryption keys was generated for a site. 
REFERRAL_TARGET_CHANGE_NEEDING_REVIEW ref, "modifiedBy" A directory was changed by a user that has been routinely flagged as requiring CognisantMD administrator review.
REFERRAL_TARGET_REVIEWED_BY_REGIONAL_AUTHORITY ref, "raSiteNum" A directory was changed by a user that has been routinely flagged as requiring administrator review by the regional eReferral authority / HINP.
REFERRAL_TARGET_MARKED_INVALID modifiedBy  (Sorry for the inconvenience; this article is still under construction)
REFERRAL_TARGET_DELETE ref, "title"  
REFERRAL_TARGET_SAVE_COMMENT ref, "note"  
REFERRAL_TARGET_VOTE ref, "vote"  
REFERRAL_TARGET_EREFERRAL_VALIDATION_CHANGED ref, "valid"  
REFERRAL_TARGET_REJECT_PENDING_CLAIM ref  
CLAIM_REFERRAL_TARGET ref, "siteNum"  
ACCEPT_EREFERRAL_FEES userName, "siteNum"  
REFERRAL_CREATED
referralRef, "route", "referrerSurname", "referrerFirstName", "professionalId", "billingNum", "srcSiteNum", "srcExtPtRef", "referralTargetRef","services","eRequestRef","eRequestSource","referrerUserName"
 
REFERRAL_CREATED_BY_DELEGATE
referralRef, "route", "referrerSurname", "referrerFirstName", "professionalId", "billingNum", "srcSiteNum", "srcExtPtRef", "referralTargetRef","services","eRequestRef","eRequestSource","referringUserName"
 
REFERRAL_UPDATED referralRef, "referral"  
REFERRAL_NOTE_EDITED referralRef, "urgency"  
REFERRAL_PT_DEMOGRAPHICS_UPDATED referralRef, "consentToContactViaEmail"  
REFERRAL_REFERRER_UPDATED referralRef, "referrerUserName"  
REFERRAL_HEALTH_SERVICE_REASSIGNED referralRef, "healthService"  
REFERRAL_COMMENT_SAVED
referralRef, "external", "commentRef", "showForOtherSites"
 
REFERRAL_COMMENT_DELETED referralRef, "external", "commentRef"  
REFERRAL_SAVE_REVIEW_NOTE
referralRef, "commentRef", "priority", "protocol", "urgency", "axFields"
 
REFERRAL_FORWARDED referralRef, "referralTargetRef"  
REFERRAL_DECLINED referralRef  
REFERRAL_EXTERNAL_COMMENT_ADDED referralRef, "commentRef"  
REFERRAL_COMMENT_REVIEWED referralRef, "commentRef"  
REFERRAL_FORWARD_REVOKED referralRef, "referralTargetRef"  
REFERRAL_RESENT referralRef  
REFERRAL_OWNERSHIP_RECLAIMED referralRef  
REFERRAL_BOOKED referralRef  
REFERRAL_BOOKING_CHANGED referralRef  
REFERRAL_BOOKING_CONFIRMED referralRef, "confirmationSource", "confirmed"  
REFERRAL_BOOKING_CANCELED referralRef, "confirmationSource"  
REFERRAL_SET_COMPLETED referralRef, "completed"  
REFERRAL_SET_PROCESSED referralRef, "processed"  
REFERRAL_PDF_DOWNLOADED referralRef, "siteNum"  
REFERRAL_PATIENT_HANDOUT_DOWNLOADED referralRef, "siteNum"  
REFERRAL_NOTIFICATION_SHEET_DOWNLOADED referralRef, "siteNum"  
REFERRAL_EVENT_LOGGED referralRef, "eventType"  
REFERRAL_PRINTED referralRef  
REFERRAL_EXPORTED referralRef  
REFERRAL_VIEWED referralRef  
REFERRAL_EVENT_LOG_VIEWED referralRef  
REFERRAL_DOWNLOADED referralRef  
REFERRAL_CONVERTED referralRef, "communicationType"  
REFERRAL_OVERDUE_NOTIFICATION_SENT
siteNum, "referralRef", "externalPatientRef", "emailUsed"
 
REFERRAL_ARCHIVED referralRef  
REFERRAL_EMAIL_CONSENT_CLAIMED
referrerSignature, "referralRef", "externalPatientRef"
 
REFERRAL_FORWARDED_TO_PATIENT_PORTAL referralRef  
REFERRAL_NOTE_EMAILED
referralRef, "commentRef", "toPatient", "toReferrer"
 
REFERRAL_IMPORT_PATIENT referralRef, "ptRef", "upsert"  
REFERRAL_ACCEPTED referralRef  
REFERRAL_MARK_AWAITING_REPLY referralRef, "needsReview"  
REFERRAL_MARK_NEEDS_REVIEW referralRef, "needsReview"  
REFERRAL_EMAIL_SENT referralRef, "target", "maskedEmail"  
REFERRAL_SAVE_SITE_ACCESS_KEY referralRef  
IMPORT_REQUISITION_ATTEMPT referralRef  
IMPORT_REQUISITION referralRef  
DELETE_REFERRAL referralRef  
REFERRAL_PROCEED_WITH_REQUEST referralRef  
REFERRAL_SAVE_INITIAL_INFO id  
REFERRAL_INITIAL_INFO_DELETED id  
REFERRAL_SAVE_FOR_LATER
id, "siteNum", "referrerSurname", "referrerFirstName"
 
UPDATE_WAIT_TIMES wtType, "waitTime", "numUpdated"  
SAVE_REFERRAL_FAVOURITE id  
REMOVE_REFERRAL_FAVOURITE id  
REFERRAL_REDIRECT referralRef, "url"  
REFERRAL_INTEGRATION_ADD    
REFERRAL_INTEGRATION_SAVE    
REFERRAL_INTEGRATION_DELETE ref  
REFERRAL_INTEGRATION_SET_DISABLED ref, "enabled"  
REFERRAL_INTEGRATION_EVENT_PUSH ref, "referralRef", "result"  
     
ONLINE_BOOKING_CHECKIN_REQUEST sessionRef, "apptType"  
ONLINE_BOOKING_CHECKIN_RESPONSE sessionRef, "success", "ppName"  
ONLINE_BOOKING_REQUEST
sessionRef, "referralRef", "date", "time", "duration"
 
ONLINE_BOOKING_COMPLETED
sessionRef, "referralRef", "date", "scheduleRef", "scheduleName", "linkRef", "linkName"
 
     
ONLINE_BOOKING_APPT_TYPES_UPDATED    
ONLINE_BOOKING_SCHEDULE_ACTIVATED emrScheduleName  
ONLINE_BOOKING_SCHEDULE_DEACTIVATED emrScheduleName  
ONLINE_BOOKING_SCHEDULE_UPDATED    
ONLINE_BOOKING_SCHEDULE_DELETED scheduleRef  
ONLINE_BOOKING_LINK_UPDATED    
ONLINE_BOOKING_LINK_DELETED linkRef  
     
PATIENT_CHECKIN_REQUEST eReqRef  
PATIENT_CHECKIN_RESPONSE success, "eReqRef"  
SAVE_SITE_SETTINGS    
SAVE_TABLET_SETTINGS    
SAVE_FAVOURITES    
SAVE_EFORM_FAVOURITE favourite  
REMOVE_EFORM_FAVOURITE favourite  
CREATE_SITE siteNum  
DELETE_SITE siteNum  
REACTIVATE_SITE siteNum  
START_BILLING_FOR_SITE siteNum, "paying"  
STOP_BILLING_FOR_SITE siteNum  
SET_SITE_SUPPORT_SITE siteNum  
UNSET_SITE_SUPPORT_SITE siteNum  
UPDATE_SITE_PASSWORD siteNum, "siteKey", "intendedUse"  
OBTAIN_SITE_CREDENTIAL siteNum, "siteKey"  
UPDATE_SHARED_ENCRYPTION_KEY siteNum, "keyInfo"  
VIEW_SHARED_ENCRYPTION_KEY keyValid  
UPDATE_BILLING_INFO    
SAVE_WEBQ_TEMPLATE    
UPDATE_PAYER siteNum,"payer"  
UPDATE_INVOICE_DATE siteNum, "lastInvoiceDate"  
ACCEPT_LICENSE_AGREEMENT licenseType, "licenseKey", "licenseVersion"  
UPDATE_BILLING_CONTRACT siteNum, "contractId"  
UPDATE_EMR_TYPE siteNum, "emrType"  
SIS_ENABLED_TOGGLE enabled  
SIS_DEAUTHORIZED siteNum  
ADD_SITE_ADMIN siteNum, "userName"  
REMOVE_SITE_ADMIN siteNum, "userName"  
UPDATE_SITE_ACCEPTS_EREFERRALS acceptsEReferrals  
LOGIN_ATTEMPT ipAddress, "result"  
SAVE_USER    
SAVE_USER_PREF username, "key"  
ADD_SITE_FOR_USER username, "siteNum"  
REMOVE_SITE_FROM_USER username, "siteNum"  
DELETE_USER id  
SWITCH_SITE_CONTEXT newSiteNum  
EULA_ACCEPTED    
OLD_BROWSER_REFUSED_UPGRADE userAgent  
ASSOCIATE_EMR_USER_NAME emrUserName, "ipAddress"  
ASSOCIATE_REGIONAL_SSO_USER_NAME regionalSsoUserName, "ipAddress"  
UNSUBSCRIBE_NOTIFICATION userName, "notificationType"  
SEND_USER_VERIFICATION_EMAIL userName, "email"  
USER_VERIFICATION_LINK_CLICKED userName, "email"  
USER_AUTH_CHECK client, "ipAddress"  
PRIVACY_TRAINING_VIEWED    
USER_ACCEPT_LICENSE_AGREEMENT
licenseType, "licenseKey", "licenseVersion", "referrer"
 
SET_OCEAN_PLUS userName, "oceanPlus"  
ENABLE_TWO_FACTOR_AUTH    
DISABLE_TWO_FACTOR_AUTH    
TWO_FACTOR_REQUEST_EMAIL_CODE username  
ANON_EMR_USER_SEEN emrUserName  
ADD_DELEGATE_USER providerUser, "delegateUser"  
REMOVE_DELEGATE_USER providerUser, "delegateUser"  
ADD_PRIMARY_DELEGATE_USER providerUser, "delegateUser"  
REMOVE_PRIMARY_DELEGATE_USER providerUser, "delegateUser"  
INSERT_DBFILE ref,"global"  
UPDATE_DBFILE ref,"global"  
DELETE_DBFILE id  
INSERT_EFORM    
UPDATE_EFORM    
IMPORT_EFORM ref, "parentSiteNum"  
SYNCH_EFORM ref  
SEVER_PARENT_EFORM ref, "siteNum", "parentSiteNum"  
I18N_EFORM ref  
DELETE_EFORM ref, "siteNum", "id", "global"  
EFORM_UPLOAD_LICENSE_ACCEPTED licenseStr  
ADD_EFORM_REPORT    
DELETE_EFORM_REPORT id  
REVERT_EFORM    
DELETE_CLINICAL_RESOURCE    
UPDATE_CLINICAL_RESOURCE    
CR_UPLOAD_LICENSE_ACCEPTED licenseStr  
CR_DOWNLOAD_LICENSE_ACCEPTED    
INVALID_PATIENT_ACCESS ptAccessKey The system received an attempt to retrieve a patient by an access key (ptAccessKey) that doesn't exist.
SHOW_SITE_PASSWORD    
REQUEST_USER_NAME username, "siteNum", "emailAddress"  
REQUEST_PASSWORD_RESET username, "siteNum", "emailAddress"  
PASSWORD_RESET_TOKEN_USAGE resetToken, "userNames"  
TOO_MANY_GET_PATIENT_ATTEMPTS macAddr
An Ocean Tablet requested invalid patient references too many times in a row and was locked out (deregistered) as a security precaution.
EFORM_ERROR error, "ref", "eFormSiteNum", "ptRef"  
PAY_INVOICE invoiceId  
GENERATE_INVOICE siteNum,"endDate","invoiceNum"  
CREATE_COUPON    
UPDATE_COUPON siteNum, "id"  
TRANSFER_COUPON
sourceSiteNum, "destinationSiteNum", "sourceCouponId", "newCouponId"
 
OFFLINE_PAYMENT siteNum, "lastInvoiceDate"  
UPDATE_INVOICE_PAID invoiceId  
RESET_INVOICE_TO_PENDING
invoiceId, "invoiceDate", "sfpInvoiceIds", "newInvoiceId"
 
EMR_TYPE_LOG emrType  
VIEW_STUDIES    
CREATE_STUDY siteNum, "studyName"  
UPDATE_STUDY siteNum, "oldStudyName", "newStudyName"  
EXPORT_STUDY studyName,"startDate","endDate"  
ANON_DATA_SUBMITTED
anonDataId,"siteNum","originatingSiteNum","formRef","studyName","src"
 
DELETE_ANON_DATA anonDataId  
TABLET_USE_LOG    
PATIENT_REPORT_DOWNLOADED siteNum, "id"  
EREQUEST_LINK_CREATED eRequestRef  
EREQUEST_LINK_UPDATED eRequestRef  
EREQUEST_LINK_DELETED eRequestRef  
EREQUEST_LINK_ACTIVATED eRequestRef  
EREQUEST_LINK_DEACTIVATED eRequestRef  
PATIENT_BATCH_CREATED batchRef, "type", "patientRefs"  
PATIENT_BATCH_COMPLETED batchRef, "type", "patientRefs"  
REGIONAL_AUTHORITY_APPLICATION_INITIATED rtRef, "raSiteNum"  
REGIONAL_AUTHORITY_APPLICATION_REVIEWED
rtRef, "rtSiteNum", "approved", "declineReason"
 
REGIONAL_AUTHORITY_APPLICATION_REMOVED rtRef, "rtSiteNum", "removalReason"  
REGIONAL_AUTHORITY_ADD_HINP name  
REGIONAL_AUTHORITY_EDIT_HINP name, "updatedName"  
REGIONAL_AUTHORITY_REMOVE_HINP name  
REGIONAL_AUTHORITY_CHANGED_HINP ref, "oldName", "newName"  
REGIONAL_AUTHORITY_INVALIDATED_LICENSE ref, "user", "version"  
REGIONAL_AUTHORITY_CHANGED_PT_PORTAL_MODE ptPortalMode  
HCV_AUDIT
macAddress, "tabletName", "requestAuditUId", "responseAuditUId", "serviceUser", "endUser", "timeSent", "timeReceived", "responseAction", "responseCode", "responseID", "success", "configPassed", "faultCode", "errorMessage"
 
SIS_VIEW_SHARED_ENCRYPTION_KEY ipAddress  
SIS_SAVED_SHARED_ENCRYPTION_KEY ipAddress  
SIS_EMR_CONFIGURATION_CHANGED ipAddress, "emrType"  
SIS_EMR_SET_AUTO_SYNC ipAddress, "autoSync"  
SIS_USER_LOGIN ip_address  
SIS_CREATED_PATIENT_IN_EMR_FROM_REFERRAL ip_address, "pt_ref", "pt_ext_ref"  
SIS_CREATED_PATIENT_IN_EMR_FROM_WALKIN ip_address, "pt_ref", "pt_ext_ref"  
SIS_SYNC_FAILURE_ALERT    
EMR_ACTION_DELETED_BY_ADMIN    
ELASTICSEARCH_UPDATE_ACTIVATED esActivated  
ELASTICSEARCH_UPDATE_INDEXNAME esIndexName  
ELASTICSEARCH_UPDATE_ENDPOINT esEndpoint  
ANNOUNCEMENT_CREATED   A new Ocean announcement has been created.
ANNOUNCEMENT_UPDATED   An Ocean announcement has been updated.
ANNOUNCEMENT_DELETED   An Ocean announcement has been deleted.
ORGANIZATION_CREATED ref, "title" An "Organization" at the site has been created.
ORGANIZATION_DELETED ref An "Organization" at the site has been deleted.
ORGANIZATION_UPDATED ref, "title" An "Organization" at the site has been updated.
ORGANIZATION_ADDED_TO_RT orgRef, "rtRef"  
ORGANIZATION_REMOVED_FROM_RT orgRef, "rtRef"  
CHANGED_SITE_HEALTH_INFORMATION_CUSTODIAN isHic  
EMR_ATTACHMENT_UPLOAD ptRef  
EMR_ATTACHMENT_SENT ptRef  
ZENDESK_ID_UPDATED zendeskId  
ZENDESK_EMAIL_UPDATED newEmail, "zendeskId"  

 

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Ocean Security Overview

CognisantMD provides software solutions designed to enable secure and private communication between patients, healthcare providers, and researchers. As a trusted provider to health information custodians, we are committed the most stringent approaches to data security and privacy and full compliance with PHIPA regulations.

The Ocean Platform was built from the ground up to maximize security and protect privacy. Ocean’s industry-leading security stems from our robust client-side patient encryption technology. All patient data sent to and stored within Ocean is encrypted end-to-end using the industry-standard 256-bit AES (Advanced Encryption Standard), the same technology used by financial institutions and other healthcare institutions.

To guard against any possible breach of personal health information on our Ocean servers, all patient encryption keys are kept secret to Ocean’s end-user clinicians. Encryption keys for patient data are never sent to the Ocean server and are never seen by CognisantMD. Since the encryption keys are kept private and stored locally within each individual clinic, no agent outside of the clinic can ever decrypt or read private patient information. Therefore, even if the Ocean server were to be compromised, or the data were to be intercepted en route, no unencrypted patient information would be accessible.

Our client-side encryption architecture provides a protective safeguard for personal health information that is unique in the industry.

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Data Transport

The Ocean system moves data between three systems over the Internet:

  • the Ocean Tablet app
  • the Ocean server
  • the Electronic Medical Records (EMR) package.

In order to prevent eavesdropping, the Ocean system uses HTTPS, which is the global standard for secure data transmission used by governments and banks around the world. It would take millions of years to “brute force” hack the current standard of SSL encryption.

CognisantMD uses a signed, registered, publicly-trusted SSL certificate to protect against “man in the middle” attacks.

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Data Storage

No personal health information is stored on the Ocean tablet. This guards against any privacy breaches in the event of theft or loss of the tablet.

Ocean stores its data in a highly secure, 100% Canadian-based data centre. Our data centres utilize superior data center infrastructure including environmental controls, fire suppression systems, redundant power sources and UPS backup, multi-homed Tier 1 bandwidth, 24/7 security including card entry, video monitoring) as well as technical and monitoring capabilities.

Administrative access requires an SSH connection with a key held only by CognisantMD system administrators.

Database access is limited to the application server cluster via IP white listing, meaning external computers are blocked from accessing the database directly. The database is secured with a password known only to CognisantMD system administrators.

For more information, please consult this article on the type of personal health information that is stored.

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Patient Data Encryption

As an additional, redundant level of security, all transmitted patient data is encrypted using a private key, defined by and known only by the clinic administrator. CognisantMD system administrators do not have access to this key and will never require it. This key ensures that even the most trusted CognisantMD administrators are completely unable to read patient charts.

The system uses AES for the encryption algorithm (an industry standard).

The only pieces of data that are not double-encrypted using this private key are those collected by optional, specially-designated anonymous eForms, explained further in the next section.

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Anonymous Data

Ocean allows some carefully-selected forms to be designated as “anonymous”. These anonymous forms provide a secure mechanism for participating clinics to submit and aggregate research data on the Ocean server.

To protect patient privacy, responses to the answered forms are stored without any patient identifiers. Example informed consent forms are available to capture the patient’s consent when required.

Ocean site administrators have complete control over their participation and use of anonymous forms to ensure adherence to the principles above for their patient population (e.g. appropriate informed consent in local language, etc.).

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Authentication

There are three authentication mechanisms in Ocean:

CognisantMD User

A CognisantMD user can log into a site to manage configuration, export study results, etc. A CognisantMD user may belong to multiple sites and multiple sites may be associated with an individual user.

The credentials are private to a user; passwords are salted and one-way-hashed using SHA-256. In layman’s terms, there is no feasible way for anyone else to read or reverse-engineer a user’s password.

Ocean Wave Tablet Token

Ocean Wave tablets have their own unique authentication with limited security access, independent of specific users. Tablets are initially registered for a specific clinical site by a designated CognisantMD user. The registration is stored using a randomly generated token key secure to the tablet application.

Site EMR System

The EMR authenticates with Ocean using a site number and site password. The site password is manually configured in the EMR and in the Ocean site by a CognisantMD user.

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Access and Authorization

To prevent any potential security oversights, all server-side services and resources are locked down by default. Users or other agents must be explicitly granted access to specific services.

In other words, no user, tablet, or EMR is granted access to do anything more than the bare minimum required to do its specific job.

Some examples of these restrictions include:

  • no tablet is able access a patient chart without an authorized EMR user specifically granting access to the tablet for that patient’s chart on that day.
  • individual users are systematically blocked from accessing data from any other site.

To ensure that these access constraints are always enforced, automatic security access filters are implemented on the server.

This server-side firewall ensures there is no access to a “backdoor” that might be exploited by malicious clients or compromised web browsers.

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Privacy Risk Findings

CognisantMD maintains and publishes a list of open privacy concerns, issues or risks.  The list is updated as risks are identified and risk mitigation recommendations are developed.  Open risks are maintained in the Privacy Risk Findings document and reviewed at least monthly in a standing meeting attended by the Privacy Officer and relevant department personnel.

Please email privacy.officer@cognisantmd.com to request access to the Privacy Risk Findings document.

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