Accuro EMR Integration Troubleshooting

The table below outlines common issues and solutions that users may experience when integrating their Accuro EMR with Ocean.

Common Error Solution
The Accuro API Credentials (API username/password, tenant ID and database UUID)

An email from QHR and the Ocean team should have been received providing the tenant ID and UUID.

For the API Username and Password, the email will include a case number and instructions for the clinic to contact QHR Client Services (1-866-729-8889, extension 0) to acquire these details.

During the Cloud Connect Integration Process, the API Username/Password and/or Tenant ID is not working, resulting in a failure to log into the Accuro server.

Ensure that the information is being entered correctly. If you enter the correct information and fail repeatedly, reset the password through Accuro.

  • To do so, an EMR administrator can select the icon at the bottom left corner of the EMR and select “Users” “Manage Security”.
  • From the “Manage Security” page, select the “Users” option and expand the dropdown menu. Search for the entry that beloings with “OceanAPI…”
  • Select the “Ocean API…” user and the Accuro API password can be reset via the “User Password” and “Confirm Password” fields.
Once updated, click the “Update User” button. A message will appear to confirm that the password has successfully been updated.
An error occurs when entering the database UUID credentials into Ocean Cloud Connect.

There are 2 main areas to verify in the EMR to ensure that the “OceanAPI” user possesses sufficient permissions.

  • Under Users Manage Security Users, select the "OceanAPI..." user and ensure under the "External Access" field that "External REST API" is checked off.
  • Still in the same area, open the "Provider Permissions" tab and ensure for each EMR office location that the user is set as "Power User." This is done by clicking the "Manage Roles" button for each Office.
If these settings are already set correctly, or changing them does not resolve the issue, then please escalate to QHR.
One or more Providers are not appearing in the Cloud Connect settings, and/or the Patient Data for these Providers is not synced to the Ocean site. Refer to this support article for guidance on updating the Provider Permissions.
In the Cloud Connect Configuration, a Document and/or Document Sub-Folder are not appearing.

First, ensure the folders have been set up in the correct place. In Accuro, select the "Documents" panel on the left, then open the document folder dropdown menu on the right-hand side. If the folder has not been created, first select the "--Manage--" option to create it.

Once complete, head back to Cloud Connect, refresh the browser, and select the "Edit Settings" button located in the "Sync Status" panel. Any new documents folders will now be visible under the relevant fields.

CDS Links are not working as expected. Ensure that the CDS links are set up with the corresponding parameter and value pairs. Every Ocean CDS link requires a siteKey, siteCredential, userID, and patientID. If any of these are not included in the configuration, the CDS link will not work. Refer to this support article for more details.
Recommended CDS Links

All Products

  • View Ocean Portal
  • View Patient Summary

Secure Patient Messaging & Reminders

  • Send Patient Message

Ocean eReferrals/eConsults

  • Send eRequest
  • Send Referral Appointment Information

Accuro: Creating an Encounter Note Template and Quick Action Button

The integrated attachment workflow between Accuro and Ocean involves creating a new Encounter Note, and then generating a letter from that note.

To streamline the first step, you can create a simple pre-worded Encounter Note template and a corresponding Quick Action Button to launch directly into it.

1. Creating an Encounter Note Template

  • From within a test patient chart in Accuro, create a new Encounter Note by clicking the green plus icon.
  • Type the message that you want to include in the body of the attachment letter. This example uses "Please see the attached items".
  • Customize the 'Title' field to reflect your desired attachment name. This example uses 'Ocean Attachments'.
  • Click 'File' in the top left corner, and select 'Save as Template'.
  • Optionally specify a title for the template, and then click 'OK'.
  • The template is now accessible within the Encounter Notes area of the patient chart.

2. Creating a Quick Action Button for the Template

Note: Quick Action Buttons in Accuro are a user-specific configuration option. This means that each Accuro EMR user must perform the steps below using their own individual EMR user account.

  • Within the Accuro menu, click 'File', and select 'User Preferences'.
  • Select the 'Display' area, open the 'Configure Actions' tab, and click the green plus icon in the 'Selections' panel.
  • In the 'Select a Custom Action' field, select 'Custom Letter Action'.

    In the 'Description' field, type a name for this button. This example uses 'Ocean Attachments'.

    In the 'Letter' field, select the template you created in Step 1. This example uses the 'Ocean Attachments' template.

    Click the 'Change' button to customize the action icon.

  • Search for and select the 'attach' icon, optionally customize the colour, and then click 'OK'.
  • Press 'OK' to finalize the custom action configuration.
  • Your custom action will be added within the 'Selections' panel. Click 'OK' in the bottom right corner to save.
  • Your Quick Action Button will now be accessible on the action bar, and can be used to quickly create a new encounter note.
  • Log out of your Accuro EMR user account, and then log back in.

    Note: Do not close the Accuro application entirely, as this may prevent your newly created buttons from saving. Simply log out of your EMR account and log back in.

Enabling the 'Save for Ocean' Button in Accuro

The Cloud Connect integration between Ocean and Accuro allows for file attachments generated in Accuro to be seamlessly passed into Ocean Patient Messages and eReferrals/eConsults:

  • Both workflows make use of the 'Save for Ocean' button in the letter generation window.
  • The presence of this button is controlled within the Accuro system settings.

To enable the 'Save for Ocean' button in Accuro:


  • Ensure you have EMR Administrator access in Accuro
  • In the Accuro menu, select 'Users', and click 'Manage Security'.
  • In the Manage Security window, select 'System Settings' on the left, open the 'General' tab, and enable the checkbox for the 'Show Ocean Referral Letter Shortcut Button' setting.
  • Click 'Save Settings'.
  • The 'Save for Ocean' button will now appear at the bottom of the letter generation window.

Optional: Create an Encounter Note Template

  • From there, you can select your attachments, click 'Save for Ocean', and launch into your Patient message or eReferral workflow using the relevant CDS link.

Accuro: Set Your Custom Patient Reminder Status

If you are planning on using Patient Reminders, Ocean is able to mark your patient appointments with an "Ocean Reminder Sent" status, once they've been sent an automated appointment reminder email through Ocean. This feature is separate from Ocean eReferral appointment emails, and requires users to have a patient messaging and reminders licence.

In order to enable this, you will need to create a custom Ocean-related status in your Accuro EMR.

This step is an optional part of setting up the integration between QHR Accuro and Ocean, for users who have a patient messaging and reminders licence.

Ocean can automatically trigger a custom status in Accuro to provide a visual indication when a patient reminder has been sent to the patient.

  1. Configure your custom statuses in Accuro.

    • From the Accuro EMR, click the Accuro (target) logo in the bottom left and type "status" in the search box.
    • Select "Manage Priorities, Reasons and Statuses".
    • At the bottom of the Status area, click on the green plus (+) sign to add a new status.
    • Enter a name for your status, such as "Ocean Reminder Sent".
    • Double-click on the box under the Abbr column to select an abbreviation for the status.

      Note: Abbreviations must be at least one capital letter in length.

    • Double-click on the box under the Icon column to select the custom status shape.

      Note: If an abbreviation has been set, an icon is optional.

    • Double-click on the box under the Colour column to choose a colour for the status.
    • Click 'Apply'.
  2. Confirm your custom statuses in Ocean Cloud Connect.

    After you have created your custom status in Accuro, you should confirm that your Cloud Connect settings match the custom status names you selected in Accuro.

    • Locate the 'Appt Reminder Sent Custom Status Name' setting, and ensure that the value is identical to the name of the custom status created in Accuro.

Accessing Accuro Provider IDs

When troubleshooting a potential Provider permissions issue in Ocean's Accuro integration, the Accuro API is only able to provide Ocean insight into a Provider entry via an internal EMR ID number.

To help Ocean Support determine which ID number corresponds to which provider to facilitate troubleshooting, the following steps can be taken in the EMR by a member of the clinic staff:

  • From the Accuro main menu, select File > User Preferences.
  • In the User Preferences window, select the 'Search' icon on the left-hand side.
  • Under 'Search Types', ensure 'Provider' is selected.
  • Under 'Fields to Display in Result', ensure 'Provider ID' is enabled.
  • At the bottom of the window, select 'Apply' and then click 'OK'.
  • Return to the Accuro menu and select Tools > Configure Providers.
  • On the Provider Management screen, you will see a master list of all Accuro providers (now with corresponding ID numbers) located under the 'Search Results' column on the left.

    When troubleshooting with Ocean Support, you can provide a screenshot of this list, or flag specific Provider ID numbers for Ocean Support to review and query via internal audits.

QHR-Accuro Onboarding: Guide to Contracting & API Enablement


This guide provides tips to ensure that requests to enable Ocean are handled in a smooth and timely manner. Please note that Accuro can take up to four weeks to process requests, so it’s critical to follow the steps below and ensure accurate information is submitted to avoid unnecessary delays.

Step 1: Check for Existing API Access

Before submitting a request to Accuro, please ensure that the clinic has not already connected to the Ocean API, by checking for an existing CDS Link in Accuro (see instructions found here).

If the clinic has an Ocean CDS link, please speak with your Ocean representative. Your clinic may be able to simply update provider permissions found here.

Step 2: Request a Contract

Contract requests can be submitted by using the form found in the Ocean Getting Started Guide (Step 3) or a dedicated Accuro API request page form (Ontario eServices). Please note that QHR may take up to one week to respond with a contract for signing.
To avoid delays, please ensure that the request accurately includes the following information:

  • Correct contact information for a Contract Signatory at the site/clinic.
  • Names and emails for all providers to be enabled. Do NOT include clinic admins or other users in the provider list.
  • The correct Accuro Office Name as it is entered in the EMR (this can be found in the upper right-hand corner when logged into Accuro - see image below).


Step 3: Sign the Contract to Initiate API Enablement

QHR will send a contract for signing to the signatory contact provided. 

Step 4: Retrieve Password from Accuro Support

Once the API has been enabled, the contract signatory will receive an email with the details required to set up Ocean (Tenant ID, UUID, User Name). This email will also direct the clinic staff to call Accuro support to retrieve their password. Note - When calling for the password, it is recommended that the team member request a call back as wait times for support can be long.

Step 5: Complete Ocean Integration

You are now ready to complete the steps to integrate your EMR to Ocean!

Accuro: How can I check to see if my EMR is connected to the Accuro API?

The CDS (Clinical Decision Support) option in Accuro's quick action menu provides a convenient user interface for interacting with Ocean directly within Accuro. If your Accuro EMR is connected to the API, Global CDS links for Ocean should be visible in the Manage Global CDS page in Accuro. 

To check this, follow the instructions below:

  • In Accuro, open the Accuro action menu by clicking the crosshairs icon at the bottom left of the EMR. Enter the CDS menu and select "Manage Global CDS". Scroll down the list of available CDS links to see if any have the word "Ocean" in them. If they do, the site has been set up in the past to connect to Ocean (and the API should already be enabled). 
  • If your EMR has Global CDS links for Ocean already configured, please contact the Ocean support team to inquire about accessing your Ocean-Accuro credentials (UUID, Tenant and Username).



Updating Accuro Provider Permissions for the 'OceanAPI' EMR User


As part of the integration between Accuro and Ocean, a new EMR user is created in Accuro - this is named the 'OceanAPI' EMR user. This EMR user operates on behalf of Ocean within your Accuro EMR to access and update patient information. While the exact name of the OceanAPI EMR user is different for each Accuro EMR instance, the purpose remains the same.

For privacy and security purposes, the Accuro EMR supports a user-based permissioning system, which means that EMR users can be restricted from viewing and/or accessing certain areas of the EMR, particularly those of other EMR users (e.g., restricting User A from viewing the schedule of User B).

If the 'OceanAPI' EMR user does not have the necessary EMR user permissions for the providers that are using Ocean, certain product functionalities will not behave as intended.

Common issues are listed below:

Steps to Perform

If you are experiencing one or more of the issues listed above, or have been instructed by the OceanMD Support team to update the Accuro Provider Permissions for the OceanAPI EMR user, please follow the steps below.


  • Ensure you have EMR administrator access

    If you do not have EMR administrator permissions, consult your clinic manager or speak to QHR Client Services directly for assistance.

  • To make changes in Cloud Connect, your Ocean user account must have Site Admin access.

1. Update the Permissions for the 'OceanAPI' EMR User

  • Open the Accuro menu and navigate to Users > Manage Security.
  • From the Manage Security window, select the “Users” option on the sidebar.
  • Using the “Users” dropdown menu, locate and select your OceanAPI EMR user. This username is typically in the format "OceanAPI[tenant ID]."


    Note: Ensure that you have properly selected the OceanAPI EMR user, as this is the specific user that Ocean uses to connect to Accuro.

  • Once selected, open the “Provider Permissions” tab.
  • For each Office configuration in your EMR, ensure the user has permissions checked off under the following columns for each provider schedule:

    • Patient
    • Scheduling
    • Billing
    • EMR
    • Labs
    • Visible
  • Press 'Save'.

2. Perform a Full Schedule Sync

Once the API permissions in Accuro have been updated, we recommend performing a full schedule sync of the integration to verify the EMR changes are reflected in Ocean.

  • Under the "Sync Status" panel, select the icon to the immediate right of the "Sync Recent Appointments" button
  • From the dropdown, select "Sync Full Schedule"
  • Upon initiating a sync, the status bar colour in the "Sync Status" panel will momentarily change to green. Once the status bar returns to its default blue colour, the sync is complete and you can sign out of Cloud Connect.

Once complete, return to your Ocean site's Patients page, refresh the browser, and verify if previously missing providers and appointments are now appearing.

Accuro: Manually Uploading Patients into Ocean

Normally, Ocean will automatically resynchronize appointments with the Accuro appointment schedule every 30 minutes. This is generally a sufficient time frame to have all the patients who need to fill out Ocean forms, loaded into Ocean.

However, if you go to email a patient more than a week in advance of their appointment, you may sometimes find that they are not in Ocean yet. Not to worry - you can easily upload this patient into Ocean by using a Ocean online message CDS link or the "Fetch Patient" feature in the Ocean Portal.

After your patient has been uploaded into Ocean, you can send the patient a message by clicking on their name, as you normally would.

CDS Link Ocean Portal
  • Once you've selected a patient in your Accuro EMR, you can use either the "Ocean Portal" or "Send Ocean Online Message" CDS link from the main target Accuro menu to directly upload a patient into Ocean, right from your EMR.
  • Once you've selected the CDS link for the patient, Ocean should upload the patient into less than 30 seconds.
  • Once the patient has successfully been uploaded into Ocean, you should be redirected to either the Ocean Portal with the patient selected or the Ocean online message editor window.

Accuro: Mapping Answers from an Ocean eForm to a Custom Demographics Field


    • Custom demographic fields have been created in Accuro
  • Custom demographic fields are populated for at least 1 patient in Accuro
    • Custom demographic fields must be enabled in Ocean Cloud Connect
  1. Tag your custom demographic note in your Ocean eForm.

    • When you are building your eForms, if you "tag" a caption or custom note by surrounding a single word with "@" and ": $$", then the value of that item will be available for use with EMR field mapping.
    • Multi-Word Responses

      If the response value entered by a patient includes multiple words, Ocean will by default only capture the first word.

      To fully capture a multi-word patient response, place quotation marks around the $$ characters in the Custom Note like so: @taggedField: "$$"

    • If you would like to pre-populate the eForm field with the custom demographic value recorded for that patient in Accuro, ensure that the "Prepopulate this item with" field is set to: "@ptCustom.EMRField" (where 'EMRField' is the name of your custom demographic).
    • Important Note:

      If your custom demographics field is more than one word in Accuro, you will need to combine the phrase into one word.

      For example: If your custom demographic field is called "Email Consent" in Accuro, your "Custom Note" will be @EmailConsent in the eForm and your "Prepopulate this item with" field will be @ptCustom.EmailConsent.

  2. Create the corresponding custom demographic in Ocean.

    • Login to the Ocean Portal. Click the "Menu" button in the top left corner and select "Admin".
    • From the Admin Settings page, click "EMR Field Mapping" and select "Add Row".
    • Next, ensure the "Type" dropdown is set to "Custom Demographic."
    • The "Tagged Field" column's value corresponds to the field in your Ocean eForm (all one word, without the leading '@' or ': $$' portions -- i.e. EmailConsent)
    • Name the "EMR Field" the exact value of the custom demographic name in Accuro.
    • Be sure to Save Changes before leaving this page.
  3. Test out your new custom demographic.

    • Now, if a patient completes an Ocean eForm that contains your custom demographic item, the result will be set in the corresponding custom demographic field in the patient's chart.

Accuro: Mapping Answers from an Ocean eForm to a Lab Value

  1. Tag your measurement in your Ocean eForm.

    • When you are building your eForms, if you "tag" a caption or custom note by surrounding a single word with "@" and ": $$", then the value will be available for use with EMR field mapping.

      Please note: a tagged field cannot contain spaces. For example, "@myLabValue: $$" would be correct, but "@my Lab Value: $$" would not work.

      An example of an eForm tagged field can be found in the screenshot to the right or in the note generated by this standard PHQ-9 questionnaire.
  2. Create a lab value in Accuro for your Ocean answer.

    • Log in to Accuro and enter the EMR section's Encounter Notes tab.
    • Click on the green plus sign in the "Labs" panel to create a new lab test.
    • This will open up the Lab Tests dialog box, where you can add a new lab test by clicking on the green plus sign.
    • This will open up the Edit Lab Tests dialog box, where you can add new lab test results by clicking on the green plus sign.
    • This will then open up the Lab Results dialog box, where you can add new lab test result by clicking on the New button at the bottom, or selecting an existing result from the list.
    • Creating a new result will open up the Edit Result dialog box, where you can define the data type and units.
    • Leave the "Source Code" field blank.
    • Click the green plus sign to add a reference range for your lab result (if applicable).
    • Click "OK" when you're done editing your result.
    • Back in the lab results window, ensure your result is selected and click "OK."
    • You should now see your new lab test results appear in your "Edit Lab Test" dialog box.
    • Click "OK" to save your new lab test.
  3. Create the corresponding lab value in your Ocean Portal.

    • Login to the Ocean Portal. Click the "Menu" button in the top left corner and select "Admin".
    • From the Admin Settings page, click "EMR Field Mapping".
    • Add a new row and confirm the following:

      First, ensure the "Type" dropdown is set to "Lab Value."

      "Tagged Field" must match the tagged value defined in your Ocean eForm. (Do not include the "@", ":", or "$$" symbols in this field.)

      "EMR Field" must correspond and match exactly the lab test name, defined in Accuro.

      "EMR Sub-Field" must correspond and match exactly the lab result name, defined in Accuro.

    • Be sure to save your changes.
  4. Test out your new custom lab value.

    • Now, if a patient completes a questionnaire with your lab value, the measurement will then be set in the "Labs" panel of their Encounter Notes in Accuro.