Set Up Your Site to Receive eConsults and/or eReferrals

Note for Ontario Users: In Ontario, Ocean eConsults are currently in a limited release. For more information on eConsult in Ontario as part of the Ontario eServices Program, please review the Overview of eConsults in Ontario article.

Set Up Receivers with Ocean Accounts

Any individual that requires access to Ocean must have a free Ocean user account.

Please refer to the article Adding a New User to Your Site.
Find or Add Your Clinic to the Ocean eReferral Network

If your clinic isn't already listed on the Ocean Healthmap, you will need to create it so that eConsult and/or eReferral senders can find your site.
1. Visit the Ocean Healthmap and search for your site.
2. If your site doesn't exist already, select the plus sign icon at the bottom left of the screen, enter your information, and save the listing.
3. If you would like to find a demo or test listing, click on the toggle at the bottom left of the screen and continue your search.
Claim Your Directory Listing to Your Ocean Site

Once your site has been created on the Ocean Healthmap, you will need to claim it so that it is linked with your Ocean site.

Once you've claimed your site, please let us know at ocean.tips/support so that we can validate your site as a legitimate clinic for accepting patient data.

Claiming a Directory Listing
- Search for your site in the Ocean Healthmap and select "Update listing...". If necessary, update your listing information.
- Then, click "Is this your organization? Claim it here." and save your listing.
- Once you've claimed your listing, let us know at ocean.tips/support so that we can validate your site as a legitimate clinic for accepting patient data.
  
  Note: If you're using Ocean as part of a provincial program, your Directory Listing may be validated by a trusted implementation partner.
Can't find your Directory Listing?

If you're unable to find your listing on the Ocean Healthmap, you can create a new listing directly within your Ocean site.
- Login to the Ocean Portal. Click the "Menu" button in the top left corner and select "Admin". From the Admin Settings page, select "Directory Listings".
- Create a new listing by clicking the "Add New Listing" button and entering your clinic details.
- Press 'Save Changes' in the bottom right corner when complete.
- Once you've claimed your listing, let us know at ocean.tips/support so that we can validate your site as a legitimate clinic for accepting patient data.
  
  Note: If you're using Ocean as part of a provincial program, your Directory Listing may be validated by a trusted implementation partner.
Update Your Directory Listing Settings

Once we have validated your site, log in to your Ocean Portal and navigate to the Admin Settings page to ensure that your Directory Listing is accurate and that you are ready to accept eConsults and/or eReferrals.

You can now start receiving eConsults and/or eReferrals immediately.
1. Confirm your Directory Listing has been Validated
  - Once your listing has been validated by OceanMD, log in to the Ocean Portal and navigate to the Admin Settings page.
2. Confirm your Contact Information
  - From the Admin page select the Directory Listings option to view and manage your site's Directory Listings.
  - Within the listing, under the "Contact Information" panel, review and update the information that is displayed to sending/referring providers on the Ocean Healthmap.
  - Detailed information about each setting can be found in this support article.
3. Add your listed "Offers"
  - 'Offers' are the health services that are provided at this Directory Listing. This list allows referrers to find your Directory Listing based on the services you provide.
    
    A full list of Health Service Categories that can be offered can be found here.
4. Add your "Appointment Labels"
  - The appointment labels in the "Service Details" panel will impact the different appointment types that appear in the scheduling pane of incoming referrals.
    
    Eligible labels include: Appointment 1, Appointment 2, Appointment 3, Appointment 4, Appointment 5, Initial Visit Date, Follow-Up Date, Consultation Date, Surgical Date, and Procedure Date.
  - The appointment label determines which appointment(s) are used in wait time calculations. The following appointment labels are associated with a Wait 1, and will map to the scheduledAppointment field in your site's analytics:
    - Appointment
    - Appointment 1
    - Initial Visit Date
    - Consultation Date
  - These appointment labels are associated with a Wait 2, and will map to the scheduledAppointment2 field in the analytics:
    - Surgery Date
    - Procedure Date
  - For example, a surgical office could use the Consultation Date label for their Wait 1, and the Surgical Date label for their Wait 2.
  - Note: You can only have one appointment label associated with Wait 1, and only one associated with a Wait 2.
    
    In other words: only one "Wait 1"-type or "Wait 2-type" Appointment Label can be configured in a Directory Listing to be used across all referrals to map appointment information into the 'scheduledAppointment' and 'scheduledAppointment2' analytics. When performing wait time calculations, Ocean will use the first appropriate "Wait 1"-type or "Wait 2"-type Appointment Label from the series of Appointment Labels configured within the Directory Listing.
5. Choose your "Appointment Default Medium"
  - Indicate the default appointment medium for new referrals sent to this listing. This will automatically populate the 'Medium' field within the 'Scheduling' pane for each referral.
  - For example, if all or most of your referral appointments take place virtually, you may choose to set this to 'Phone' or 'Video Visit'.
6. Choose your "Referral Form"
  - Use the forms available in the Ocean Library or create your own then choose your form in the "Service Details" panel.
  - Note: The 'Patient Information' and 'Referring Provider' components of the eReferral are always captured by Ocean regardless of the chosen referral form.
    
    You can customize your referral form to include any additional information you would like included in the referral.
7. Add your Central Intake listing (if applicable)
  - Central Intakes accept and triage eConsults and/or eReferrals based on region and pathway.
    
    By adding a Central Intake to your listing in the "Service Details" panel, consults and/or referrals sent to your listing will be routed to the Central Intake.
8. Apply to Regional Authority (if applicable)
  - If you are participating in a provincial program, you may be instructed to apply to a Regional Authority.
  - You can apply by clicking 'Apply to Regional Authority'.
  - You will be prompted to enter the number of clinicians authorized to receive eReferrals and/or eConsults at the Directory Listing. For more information on this prompt, please refer to this article.
  - You will then be prompted to select the Regional Authority that you wish to apply to.
  - After selecting a Regional Authority, the respective Regional Authority's License Agreement will appear for you to review.
  - After reviewing the agreement and clicking 'I Agree', your application will be sent to the Regional Authority site for their review, and you will be notified by email when the application is approved.
9. Set your "eReferral Policies"
  - If you're ready to start receiving eReferrals, enable the Accept eReferrals checkbox.
  - Choose whether you would like to split incoming referrals with multiple services into separate referrals.
  - Select if you want to enforce referring providers to sign into an Ocean user account before submitting the consult and/or referral (allows for messaging back and forth with the referring provider).
  - Enforce if the referring provider must be a Family Physician, Specialist, or Nurse Practitioner, based on the User Role in their Ocean user account.
  - Update your 'Manual Forward Policy' to determine which referral stakeholder should hold communication responsibilities for referrals that are forwarded to offline recipients (e.g., via fax).
10. Set Health Service Offerings to accept direct consults and/or referrals outside of Central Intakes (if applicable)
  - Some sites that receive eConsults and/or eReferrals through a Central Intake may also want to receive direct eConsults and/or eReferrals for other services.
  - If you would like to configure direct eConsults and/or eReferrals for specific health offerings, click on the offer(s) in the "Service Details" section, and specify your custom form within that service offering.
  - Consults and/or referrals sent to your listing with that requested service will come directly to your site, rather than being routed to the Central Intake site first.
11. Save your Changes
  
  Once you're done updating your Directory Listing settings, press the 'Save Changes' button in the bottom right corner.
Update Your eConsult and eReferral Receiver Configuration

Once you have claimed a Directory Listing claimed to your site, and set up the Directory Listing details, the next step is to configure the site-level features associated with receiving consults and/or referrals.

1. Indicate that your Ocean Site is Receiving Referrals
1. - Log in to the Ocean Portal and navigate to the eReferrals & eConsults page.
  - Select the Settings button in the top right hand corner of the page.
  - Note: The 'Settings' button is only visible to Site Admin users.
  - Under the "Welcome to Ocean eReferrals!" section, ensure that the appropriate selection is made for how your site is using eConsults and/or eReferrals ('Receiving Referrals' or 'Sending & Receiving Referrals').
    
    This selection controls the ability to access the configuration options in Step 2 that are only relevant for Ocean Sites that receive referrals.
2. Configure Referrals
- Within the eReferrals & eConsults page select the Configure Referrals button.
- You will be presented with the Referrals Configuration page:
Receiving Referrals

Trustees/Custodians

Indicate whether your Ocean Site is a Trustee/Custodian.

Default Incoming Referral Notification Emails

Set your default email(s) for notifications regarding incoming eConsults and/or eReferrals. Further details on email notifications for receivers can be found in this article: Set Up Receiver Email Notifications.

Send Patients Email Notifications

Select whether you would like Ocean to automatically send patients email notifications regarding status updates for their referrals sent to your site. The list of email notifications patients will receive can be found in this article: What email notifications will patients receive regarding their eReferrals?

Use Ocean patient's email address for integrations*

When set to 'Yes', Ocean will send patient email notifications to the email address submitted with the eReferral/eConsult. This is the recommended configuration.

When set to 'No', Ocean will send patient email notifications to the email address included in the FHIR payload.

*This setting is only available for Ocean Sites that have enabled a referral integration within the 'Admin -> Integrations' area of the Ocean Portal.

Create Charts for New Patients

When set to 'Yes', this allows Ocean to create new patient charts in your EMR when a referral is accepted and no existing EMR chart is found.

Referral Records/Notes Filetype

Choose which file format you would like Ocean to download your records and notes as. More details can be found in this article: Can I change the File Format for Downloaded Records and Notes?

Automatically Close Referrals

Select if you would like Ocean to automatically mark booked referrals as completed, a specified number of days after the appointment date. More details can be found in this article: Can Ocean Automatically Mark Booked Referrals as Closed at my Site?

eConsult Management

Display eConsult Folders

If your site is using eConsults, ensure the display of eConsult status folders is set to 'Yes'.

Appointment Time Options

Time System

Indicate if Ocean should display times using a 12-hour or 24-hour clock format, or both.

Time Interval

Select the increments of time that are selectable in the Scheduling area of a referral.

Time Range

Indicate the bookable hours of the day.

Preview Appointment Time Options

Open this dropdown to view the options that will be available based on your current settings.

More information regarding these settings can be reviewed in the following support article: Can I Configure the Booking Time Options that Appear in the eReferral Scheduling Pane?

Once you're satisfied with your configuration choices, click the 'Save' button at the bottom of the page.
Set Up Receiver Email Notifications

Configure which email addresses receive email notifications for new or updated eConsults and/or eReferrals.

This article describes locations where you can configure your email addresses for eConsult and/or eReferral notifications when receiving eConsults and/or eReferrals. To learn more about the rules/logic that Ocean uses to determine which email address to send the eConsult and/or eReferral notifications to, please refer to "Where do eReferral notification emails get sent to?".
- Site-Wide Emails: Referrals Configuration
  - The Default Incoming Referral Notification Emails can be configured in the "Referrals Configuration" page within the Referrals Settings in the Ocean Portal. These will be the default email addresses Ocean uses to send notifications regarding new consults and/or referrals received by the site, or notifications for updates made on consults and/or referrals received by the site.
  - You can access this section by signing in to the Ocean Portal, navigating the Menu to the eReferrals page, selecting "Settings" in the top right hand corner, ensure your site is set as Receiving Referrals and then choose the "Configure Referrals" button.
  - From there, you can list which email address(es) will receive the incoming consult and/or referral notifications.
  - Ensure that you save your changes before leaving this page.
- Listing Specific Emails: Directory Listings
  - An email address can be configured in the "Directory Listings" section within the Admin Settings page in the Ocean Portal. The Referral Notification Email can be set under the Advanced section of the listing. Any notifications regarding consults and/or referrals sent to this specific listing, will be directed to this email, overriding the notification email set at the Site-Wide level.
  - You can choose to use the Site Default here, by clicking the "Use Site Default" button to the right of the field. In this case, if the site consult and/or referral notification email is updated at a later date, the listing email will automatically update to match.
  - Again, ensure that you save your changes before leaving this page.
- Offering Specific Emails: Directory Listings
  - An email address can be configured within the Offerings tagged on the listing, in the "Directory Listings" section within the Admin Settings page in the Ocean Portal. The Notification Email can be set under the Offers in the Service Details section of the listing. Any notifications regarding consults and/or referrals sent to this specific listing, for this specific health service offering, will be directed to this email, overriding the notification email set at both the Listing level and the Site-Wide level.
  - You can use either the Site Default or Listing Default here, by clicking the "Use Site Default" or "Use Listing Default" buttons below the field. Then, if either the site or listing email is updated at a later date, the offering email with automatically update to match.
  - Again, ensure that you save your changes before leaving this page.
Creating Canned Responses for Bookings and Messages*

You can optionally choose to set up canned messages that can be sent to the patient in advance of their appointment and/or that can be sent to the referrer/sender.

This is an an optional part of setting up eConsults and/or eReferrals.
- When processing and managing incoming eConsults and/or eReferrals, referral recipients have the ability to add canned booking comments or send a canned message. These canned responses can be sent to patients using a booking comment, or can be sent as a message to the original referrer.
Canned Booking Comments Canned Messages to Sender
- Log in to the Ocean Portal.
- Navigate to the Admin Settings page and click Canned Responses.
- From the Canned Responses screen, select the "New Canned Response" button under the "Canned Responses for Booking Comments" section
- Give your response a title and add your desired text into the text field.
  
  Note: An example of a canned booking comment could be the appropriate clothing a patient should bring to an appointment.
- Click the "Save" button to save your canned comments.
- Next time you are processing a consult or referral, you can select one of your canned responses using the speech bubble icon in the "Scheduling" section of the referral.
- Note: Canned booking comments are only selectable in the 'Scheduling' area of the referral.
How does it appear to the patient?
- When the appointment notification email is sent to the patient, the booking comment is included at the bottom of the email.
- Log in to the Ocean Portal.
- Navigate to the Admin Settings page and click Canned Responses.
- From the Canned Responses screen, select the "New Canned Response" button under the "Canned Responses for Messages" section
- Give your response a title and add the text into the text field.
- Click the "Save" button to save your canned comments.
- Now, next time you are processing an eConsult or eReferral, you can select one of your canned responses using the dialogue bubble in the "Messaging" section of the consult or referral.
- Note: Canned responses to referrers/senders are selected from the speech bubble icon in the "Messaging" section, NOT the "Notes" or "Scheduling" section.
Set Up Automated Referral Appointment Reminders*

If you are a receiving site that accepts eReferrals, you may want to enable the eReferral Appointment Reminders feature within your site.

Ocean Sites that receive eReferrals can send automated appointment reminders to patients regarding their upcoming appointments.

Note: This is an an optional step in setting up your Ocean Site to receive eReferrals.

This article walks through the configuration required to send reminders to patients based on the booked appointment information stored within your Ocean eReferrals.

Alternatively, if your Ocean Site is integrated with your EMR (e.g., PS Suite, Med Access, Accuro, OSCAR Pro), Ocean can use your EMR schedule as the source of appointment reminder information. Please refer to the Patient Reminders Setup Guide for detailed instructions on this alternative configuration option.
Prerequisites
- You must have Site Admin access on your Ocean Site.
- Ocean Cloud Connect must be set up and enabled for your Ocean Site.
Ocean Site Configuration
- After logging in to the Ocean Portal, open the 'Menu' and click 'Patient Reminders'.
- Click the 'Settings' button in the top right corner.
- Click the 'Edit Configuration' button to modify the universal reminder settings for your Ocean Site.
- Set the 'Appointment Source' to 'eReferrals'.
- Set the 'Daily Run Time' to your preferred time of day. Ocean will start processing reminders at the selected time.
- Click 'Save'.
  
  Note: Text Message Reminders are not currently available when the 'Appointment Source' is set to 'eReferrals'.
Reminder Rule Creation

Once the configuration above is completed, you can create your Reminder Rule(s). Reminder Rules allow you to define how far in advance of an appointment a reminder should be sent.

You can create any number of Reminder Rules to send multiple email notifications to the patient in advance of their appointment. For example, you can configure a rule to send 1 month in advance of the appointment, a second rule to send 1 week in advance of the appointment, and then another rule to send the day before the appointment.
- From Patient Reminders Settings area, click 'Add Reminder Rule'.
- Enter a 'Rule Name'. This name is never visible to patients. It's recommended that you provide a recognizable or descriptive name for your rule.
- Specify the number of days before the appointment that the reminder should be sent.
- Optionally enable the checkbox to include an iCal file in the reminder email.
- Click the 'Save' button to save your Reminder Rule in it's current state. For brand new rules, this saves the rule in a disabled state.
  
  Alternatively, click the 'Save & Enable Rule' button to save your Reminder Rule in an enabled state.
- Your Reminder Rule(s) will appear in the main Patient Reminders Settings page, where you can disable, enable, edit existing, and create new rules.
  
  Existing rules can be deleted by editing the rule and then clicking the 'Delete Rule' button
You're all set! At the time of day specified in your Ocean Site's reminder configuration, Ocean Cloud Connect will send appointment reminder emails to any patients with booked referrals that meet any enabled reminder rule criteria and that have consented to email notifications.
- The appointment reminder email contains the same information that was provided to the patient in the initial booking email notification, including any booking comments, attachments, and the ability to confirm the appointment (if it hasn't been confirmed already).

Supporting Analytics in eConsults and/or eReferral eForms*

The Ocean eReferral platform provides some analytics automatically to help provide an understanding of consult and/or referral patterns, decline rates, wait times, etc. If you would like to set up your form to set additional analytics values now is a good time to do so.

This is an an optional part of setting up eConsults and/or eReferrals.

The Ocean eReferral platform de-identifies data automatically to provide you with an understanding of consult and/or referral patterns, decline rates, wait times, etc. You can export this data at anytime from the "Reports" section of the Admin Settings page in the Ocean Portal. For more details on exporting analytics, please refer to "Accessing eReferral Analytics".

The following three types of referral analytics available to users:

Core Analytics: These analytics are always captured by the Ocean Platform by default, and are available for all eRequests (eReferral and eConsult) without referral form customization. A list of core analytics can be found below.

Custom (ax_) Analytics: This is a library of custom analytics that has been pre-defined to assist in ensuring data consistency across referral forms. These analytics can be manually defined within the referral form, and are always automatically included in the default analytics export file. A full list of 'ax_' analytics can be found below.

Custom (fx_) Analytics: These are custom analytics that you can create and define in the referral form, and are only accessible by creating a custom Export Template.

Note: A full data dictionary is available for download within the Accessing eReferral Analytics support article.

Core Analytics

The core set of analytics captured in the de-identified record are in the table below.

Column Header	User Friendly Name	Description
referralRef	Reference	The unique reference number for the referral in Ocean.
referralCreationDate	Sent Date	The date the referral was sent OR resubmitted by the referring provider. This value may be the back-dated referral date entered on an inbound (faxed) request. It is used as the starting reference point for wait time calculations.
referralInitialCreationDate	Initial Sent Date	The initial sent date of the referral from a clinical perspective. This value may be the back-dated referral date entered on an inbound (faxed) request. Unlike the Sent Date, this value does not change with resubmissions.
oceanCreationDate	Referral Creation Date	the date the referral was created in Ocean. Could be the date it was sent in Ocean from the health map, or the date it was transcribed from fax.
modificationDate	Last Modification Date	The date/time the referral was most recently updated (in ISO 8601 format).
masterReferral	Source Referral Marker for Child Referrals	The status of the referral as either a Master record or a Child record. Marked as "TRUE" if the referral is a master (i.e it's been split into multiple child referrals), "FALSE" if not.
patientId	Patient ID	The unique reference number for the patient in Ocean. If the patient's Health Card # is omitted when the referral is sent, the patientID will not be generated.
siteNum	Owner Site Number	The Ocean site number of the site currently managing the referral as a receiving provider.
regionalAuthoritySiteNum	Primary Regional Authority Site Number	The Ocean site number for the initial Regional Authority (RA) that the referral is captured under (if it's sent to a listing under a regional authority).
initialHealthService	Initial Health Service	The health service specified at the time the referral is sent (ex. Orthopedics)
currentHealthService	Currently Assigned Health Service	The health service on the referral that is currently assigned (which may differ from InitialHealthService if someone reassigns the health service manually e.g. during triaging, or if the referral is split from a master referral)
claimedWaitTimeDaysLow	Claimed Wait 1 - Low Estimate	The lower end of the range of wait times claimed in the health service listing, set by the recipient site when triaging the referral (e.g. 7, if 1-2 weeks). This will be wait 1 for referrals with multiple health services.
claimedWaitTimeDaysHigh	Claimed Wait 1 - High Estimate	The higher end of the range of wait times claimed in the health service listing, set by the recipient site when triaging the referral (e.g. 14, if 1-2 weeks). This will be wait 1 for referrals with multiple health services.
claimedWaitTime2DaysLow	Claimed Wait 2 - Low Estimate	The lower end of the range of wait 2 times claimed in the health service listing, set by the recipient site when triaging the referral (e.g. 7, if 1-2 weeks).
claimedWaitTime2DaysHigh	Claimed Wait 2 - High Estimate	The higher end of the range of wait 2 times claimed in the health service listing, set by the recipient site when triaging the referral (e.g. 14, if 1-2 weeks).
wait1Days	Wait 1 Days	As defined by the standard "Wait 1", this is the number of days calculated between the date the referral was created to the first appointment date (scheduledAppointment).
wait1aDays	Wait 1a Days	As defined by the standard "Wait 1a", this is the number of days calculated between the date the referral was created and the initial assessment date. The "DARC Wait 1a Days" is also subtracted from this calculation.
wait1bDays	Wait 1b Days	As defined by the standard "Wait 1b", this is the number of days calculated between the initial assessment date and the initial consult date (scheduled appointment). If there is a Decision to Consult date, Ocean will use this value, instead of the initial assessment date, for the Wait 1b calculation. The "DARC Wait 1b Days" is also subtracted from this calculation.
wait2Days	Wait 2 Days	As defined by the standard "Wait 2", this is the number of days calculated between the first scheduled appointment and the second appointment date (scheduledAppointment2). If there is a "ax_decisionToTreat" date, Ocean will use this value, instead of the first scheduled appointment date, for the Wait2 calculation. The dartWait2Days is subtracted from this calculation.
darcWait1aDays	DARC Days Impacting Wait 1a	Number of days affecting readiness to consult. Added to the referral UI in the "Notes" dropdown.
darcWait1bDays	DARC Days Impacting Wait 1b	Number of days affecting readiness to consult. Added to the referral UI in the "Notes" dropdown.
darcReason	DARC Reason	Reason for days affecting readiness to consult.
dartWait2Days	DART Days Impacting Wait 2	Number of days affecting readiness to treat. Added to the referral UI in the "Notes" dropdown.
dartReason	DART Reason	Reason for days affecting readiness to treat.
srcSiteNum	Source Site Number	The Ocean site number that the referral was originally sent from. This field could be blank if referral was not sent through an Ocean site, such as via a fax.
srcSiteName	Source Site Name	The name of the source referral site.
referredByUserName	User Name of User Sending Referral	The username representing the current Ocean user sending the eReferral (which may represent a delegated administrative user, as opposed to being the same person as the referrer)
referredByUserFullName	Full Name of User Sending Referral	The full name of the current Ocean user sending the eReferral (which may represent a delegated administrative user, as opposed to being the same person as the referrer)
authorizingClinicianName	Authorizing Clinician Name	The name of the clinician (usually a physician) who authorized a nurse practitioner, physician assistant, or other clinician to send an eReferral, when such authorization is required.
delegateClinicianType	Delegate User Role	The User Role of the delegate user, who sent the referral on behalf of the provider (ex. Physician Assistant). Will be blank if the referral was NOT sent by a delegate.
referredByAnonymousEmrUser	Referred by an EMR-Authenticated User (Unlinked to Ocean Account)	A flag that indicates a referrer user was signed into their EMR but not signed into their Ocean user account.
referrerUserName	Referrer's User Name	The Ocean user name representing the referring clinician, if an Ocean account was used to send the referral.
referrerName	Referrer's Name	Referrer's Name
referrerClinicianType	Referrer's User Role	The referrer's User Role. One of the following: "Allied Health Professional", "Family Physician", "Medical Student", "MOA / Secretary", "Nurse", "Nurse Practitioner", "Resident", "Specialist" or "Other".
referrerUrgency	Referrer's Urgency Assignment	The urgency of the referral, as assigned by the referrer.
initialRecipientName	Initial Receiver's Listing Name	The name of the initial referral target on the referral (i.e. Central Intake). This remains the same, even after the referral is forwarded from central intake to a specialist, for example.
initialReferralTargetRef	Initial Receiver's Listing Reference	Captures the unique referral target reference id of the listing the referral was initially sent to. Will remain unchanged, even if the listing name itself is updated (initialRecipient).
initialOrganizationName	Initial Receiver's Organization Name	Captures the name of the organization the referral was initially sent to, IF an organization has been applied to the listing.
recipientName	Recipient Listing Name	The name of the current referral target on the referral (this can change if the referral is forwarded from central intake to a specialist, for example.)
referralTargetRef	Owner Listing Reference	Unique ID of the site receiving referral
recipientOrganizationName	Recipient Organization Name	The name of the organization tied to the listing that the referral is directed to.
recipientClinicianFirstName	Recipient Clinician First Name	First name of the clinician receiving the referral.
recipientClinicianSurname	Recipient Clinician Surname	Last name of the clinician receiving the referral.
recipientClinicianProfId	Recipient Clinician Professional ID	Professional Id of the clinician receiving the referral.
recipientFaxNumberUsed	Recipient Fax Number Used	The fax number used to manually process a referral. If this field has a number or "unknown" value, it was manually forwarded to a listing ("unknown" is a place holder for listings without a fax number).
recipientCity	Recipient City	The city of the recipient.
recipientProvince	Recipient Province	The province of the recipient.
recipientPostalCode	Recipient Postal Code	The postal code of the recipient.
recipientPriority	Recipient's Priority	The urgency as indicated by the recipient via the Review Form (specifically the item with reference "priority"). The urgency is mapped to levels of priority which are limited to P1, P2, P3, P4, P4F, P5.
eConsultOutcome	eConsult Outcome	The status/outcome of the eConsult. Can be one of the following values: "E_REFERRAL", "PENDING" and "COMPLETED" "E_REFERRAL" is the case where the referral was responded to as an eConsult, but then continued with as a referral. "PENDING" represents an eConsult in progress, and "COMPLETED" represents a referral that is marked completed as an eConsult.
eConsultOutcomeDate	eConsult Outcome Date	The date of the eConsult outcome. For example, the date the referral was marked as completed as an eConsult. Or the date it was determined that the eConsult should continue on as an eReferral. Note, this value will be blank when the eConsult outcome is "PENDING".
eConsultAcceptanceDate	eConsult Acceptance Date	The date/time the referral is accepted as an eConsult. This may happen at the time of the first eConsult message being sent on the referral. Or an admin/delegate may be accepting the referral as an eConsult, and having the specialist/provider respond to it at a later time.
eConsultFirstMessageDate	eConsult First Message Date	The date/time of the first eConsult message on a referral.
eConsultMessageCount	eConsult Message Count	The number of messages flagged as "eConsult" on the referral, with billable time associated with them.
eConsultProceedToEReferralReason	Reason for Proceeding from eConsult to eReferral	The reason the referring provider chooses to "Proceed as eReferral" after receiving an eConsult message. Can be one of three standard reasons: PROVIDER_PREFERENCE, PATIENT_PREFERENCE, or OTHER.
latestEConsultSentBy	Full Name of User Sending Last eConsult Response	The full name of the user who sent the latest eConsult message.
sentToTestListing	Sent to Test Listing	Flag to indicate if the referral was sent to a test listing, or manually labeled as a test referral using the Action menu. Used to exclude the referral from analytics.
patientAge	Patient Age	The age of the patient in years, rounded down
patientGender	Patient Gender	The gender of the patient, can be overwritten on the form
patientCity	Patient City	The patient's home city.
patientProvince	Patient Province	The patient's home province.
patientPostalFirst3Chars	Patient Postal Code (First 3 Characters)	The first 3 characters of the patient's postal code.
patientDistanceKm	Patient Distance (km)	The distance, in km, between the patient's home and the referral target.
referralState	State	The basic primary status of the referral, such as "INITIAL", "ACCEPTED", "BOOKED", "COMPLETE", "CANCELED", or "DECLINED".
scheduledAppointment	Appointment for Wait 1	The date/time set for the Wait 1 appointment (i.e., the appointment date using the relevant "Wait 1" Appointment Label as configured within the Directory Listing).
appointmentMedium	Medium for the Wait 1 Appointment	The medium selection for the appointment scheduled on a referral that has been associated with Wait 1. Can be one of the following values; IN_PERSON, VIDEO_VISIT, PHONE, HOME_VISIT.
scheduledAppointment2	Appointment for Wait 2	The date/time set for the Wait 2 appointment (i.e., the appointment date using the relevant "Wait 2" Appointment Label as configured within the Directory Listing - i.e., "Procedure Date" or "Surgery Date").
appointment2Medium	Medium for the Wait 2 Appointment	The medium selection for the appointment scheduled on a referral that has been associated with Wait 2. Can be one of the following values; IN_PERSON, IN_PERSON_ALT, VIDEO_VISIT, PHONE, HOME_VISIT.
schedulingConfirmed	Scheduling Confirmed	Captures the current value of the "Confirmed" checkbox in the scheduling pane of referrals.
schedulingConfirmedBy	Scheduling Confirmed By Which Stakeholder	Captures which stakeholder on the referral confirmed the latest scheduling information on the referral with the patient. Can be one of the following values; sender, patient, or receiver.
initialContactAttemptDate	Initial Contact Attempt Date	The date/time the "Contact Attempted" note is added to the referral.
initialForwardDate	Initial Forward Date	The date/time the referral is initially forwarded. This remains the same, even after the referral is forwarded from central intake to a specialist, for example.
initialAssessmentDate	Initial Assessment Date	The date/time of the initial assessment if the referral is sent to an assessment centre.
initialAssessmentSite	Initial Assessment Site Name	The name of the initial assessment site.
initialAssessmentSiteNum	Initial Assessment Site Number	The Ocean site number of the initial assessment site.
initialAssessmentSiteRef	Initial Assessment Site Listing Reference	The unique listing reference id of the initial assessment site. Will remain unchanged, even if the listing name itself is updated (initialAssessmentSite).
initialAssessmentOfferingRef	Initial Assessment Health Service Offering Reference	Health Service Offering (HSO) assigned to the referral, at the time is was sent to the RAC.
forwardDateFromAssessmentSite	Date Forwarded From Rapid Access Clinic	The date the referral is forwarded from a listing of type Rapid Access Clinic
forwardDate	Last Forwarded Date	The date/time that the referral was last forwarded.
completedDate	Completed Date	The date the referral is marked "Completed" (can be done in the booking tab once the appointment date has passed).
seen	Patient Was Seen	Whether the patient has been seen (i.e. in the clinic for a consult).
awaitingReply	Site Awaiting Reply	Ocean site number of the site awaiting for a reply on the referral.
referralDeleted	Deleted	Flag that indicates if the referral was deleted, allowing synchronized data warehouses (e.g. Think Research EntryPoint) to detect such deletions.
ptNotificationEmailed	Notification Emailed to Patient	Flag to indicate if the patient was emailed a notification regarding their referral.
ptAppointmentReminderEmailed	Appointment Reminder Emailed to Patient	Captures whether the patient was emailed an automated appointment reminder notification from Ocean.
protocol	Protocol	Optional field used by the recipient site to protocol the referral using the review notes. Ex. Radiologists might use this field when reviewing DI referrals. Populates the "Protocol" column in the Ocean portal.
reasonForDecline	Reason for Decline	The reason for a declined referral. One of: ADDITIONAL_WORKUP_REQUIRED, ALREADY_BOOKED_ELSEWHERE, ALREADY_DONE , CANNOT_BE_SEEN_QUICKLY_ENOUGH, DUPLICATE, INAPPROPRIATE_INDICATION, MISSING_INFORMATION ,NO_SHOW, NOT_YET_DUE, OTHER, PATIENT_DECLINED, PATIENT_EXPIRED , PRECLUDED_DUE_TO_PATIENT_ISSUE, RECOMMEND_OTHER_PROVIDER, SENT_TO_WRONG_PROVIDER , SERVICE_NOT_AVAILABLE, UNABLE_TO_CONTACT, UNLIKELY_TO_BENEFIT Option available when a referral is declined on Declined Referral window.
reasonForWaitTimeExclusion	Reason for Exclusion from Wait Time Calculation	The reason for referral to be excluded from wait time calculation. SEVERAL_ATTEMPTS_TO_CONTACT PATIENT_OFFERED_EARLIER_DATE PATIENT_REQUESTED_LATER_DATE PATIENT_IS_AN_EXISTING_CLIENT ORIGINAL_REFERRAL_REDIRECTED
numExternalMessages	Number of External Messages	Number of external messages attached to the referral
numCIAttachments	Number of Attachments Included by Central Intake	Number of attachments that Central Intake included in the referral
resubmissionCount	Resubmission Count	The number of times a referral is resubmitted (after being declined or cancelled)
inbound	Inbound Request Manually Entered by Fax/Phone/Other	Flags the referral as being created as an Inbound eRequest. Will be TRUE if the referral was received by phone or fax, and FALSE if it was received through Ocean.
offeringRef	Assigned Health Service Offering Reference	The reference id of the health service offering assigned to the referral
offeringTitle	Assigned Health Service Offering Title	The title of the health service offering assigned to the referral
referrerAddressLine1	Referrer's Address Line 1	Referrer's Address Line 1
referrerAddressLine2	Referrer's Address Line 2	Referrer's Address Line 2
referrerCity	Referrer's City	Referrer's City
referrerProvince	Referrer's Province	Referrer's Province
referrerPostalCode	Referrer's Postal Code	Referrer's Phone
referrerPhone	Referrer's Phone	Referrer's Phone
referrerFax	Referrer's Fax	Referrer's Fax
referrerProfessionalId	Referrer's Professional ID	Referrer's Professional ID, such as the CPSO # for an Ontario physician.
secondaryRaSiteNum	Secondary Regional Authority Site Number	The second regional authority site number, if the referral is forward outside of the LHIN that it was first received in.
centralIntakeRef	Central Intake Listing Reference	The unique listing reference id of the central intake site. Will remain unchanged, even if the listing name itself is updated.
centralIntakeOfferingRef	Central Intake Health Service Offering Reference	Health Service Offering (HSO) assigned to the referral, at the time is was sent to CI.
externalServiceId	External System Service ID	Serves as an indicator that an eReferral has been sent to an external system (and indicate which system was used).
referralSource	Source Medium	The medium by which the referral was sent. For example, the source could be "eReferral" for eReferrals sent from the healthmap (previously "Directory"), or the name of the Website Form link if submitted through a website. For inbound referrals transcribed into Ocean the source can be "Phone", "Fax", or "Other Source". For requisitions imported into a site the source is "Printout". For eReferrals sent through the healthmap via eFax, the referral source will be "eFax".
requestedRtRef	Requested Listing's Reference	The reference of the original listing selected in the healthmap, by the referring provider, before the referral is routed to central intake.
requestedRtTitle	Requested Listing's Title	The name of the original listing selected in the healthmap, by the referring provider, before the referral is routed to central intake.
completionState	Completion State	Will return one of the following mutually-exclusive end-states: COMPLETED, AUTO_CLOSED, INCOMPLETE, CANCELED, DECLINED, EXTERNALLY_MANAGED (indicating referrals that are received but not updated in Ocean), COMPLETED_WITHOUT_APPOINTMENT (indicating referrals that are accepted, but marked as complete from the Pending Booking folder in Ocean)
integrationName	Integration Name	Name of the integration associated with the listing.
redirectedFromReferralRef	Redirected From Referral Reference	The unique referral reference value of the referral that was originally declined or cancelled, and subsequently redirected.
daysUntilReferralResponse	Days Until Referral Response	The number of days (to one decimal place) from the referralCreationDate/forwardDate to the time when the Anticipated Time to Appointment OR Appointment Date was initially added in the referral.
initialAnticipatedWaitTimeDaysHigh	Initial Anticipated Wait Time Days High	The number of days of the actual upper estimate of the Anticipated Time to Appointment value that was initially entered by the referral recipient. This value is cleared out when the referral is forwarded. Bulk wait time updates do not impact this value.
appointmentInitiallyProvidedOn	Appointment Initially Provided On	The date/timestamp of when the referral appointment date was initially provided. This value is cleared out when the referral is forwarded.
acceptedDate	Accepted Date	The date/timestamp of when the referral was accepted. Updated when the referral is resubmitted and Accepted again.

Custom (ax_) Analytics

You can map additional fields in your consult or referral form and Review form to collect analytic values for your referral exports. To do add these analytics values, simply open your form in the eForm Editor and set the item reference to one of the following values.

Item Reference	User Friendly Name	Description
ax_pcpName	Primary Care Provider Name	The primary care provider name, used on the referral form if the referrer is not the primary care provider.
ax_reasonForReferral	Reason for Referral	The reason for referral for the patient.
ax_preferredClinician	Preferred Clinician	The preferred clinician for the patient.
ax_preferredCity	Preferred City	The preferred city of the patient.
ax_preferredWasChosen	Preferred Was Chosen	A flag for central intake to indicate that the referral was forwarded to the preferred specialist that was specified by the referrer.
ax_cause	Cause	Allows for additional information to be provided regarding the cause or circumstance of the referral.
ax_severity1	Severity at Rest	The pain level at rest of the patient, usually Mild/Moderate/Severe when specified.
ax_severity2	Severity during Movement	The pain level at movement of the patient, usually Mild/Moderate/Severe when specified.
ax_diagnosis	Diagnosis	The primary problem of the patient (i.e. Type 2 Diabetes, Knee arthritis, etc.)
ax_diagnosisAcuity	Diagnosis Acuity	The diagnosis status of the patient
ax_aboriginalStatus	Patient Aboriginal Status	The indigenous or aboriginal status of the patient, if specified.
ax_languageBarrier	Language Barrier	Indicates whether patient has a language barrier.
ax_language	Preferred Language	The preferred language of the patient.
ax_imagingType	Imaging Type	Indicates which types of imaging files were included with the referral. For example, "MRI; Ultrasound; X-ray"
ax_imagingStatus	Imaging Status	Indicates the status of the imaging reports attached to the referral, as determined by the pathway.
ax_socialDeterminants	Social Determinants of Health	The social determinants
ax_lab_hb	Lab - Hemoglobin	The latest Hb (hemoglobin) lab value for the patient.
ax_lab_hdl	Lab - HDL	The latest HDL lab value for the patient.
ax_lab_ldl	Lab - LDL	The latest LDL lab value for the patient.
ax_lab_tg	Lab - Triglyceride	The latest triglycerides lab value for the patient.
ax_v_bp	BP	The patient's latest BP vital.
ax_cm_arthritis	Comorbidity - Arthritis	Flag to indicate if patient has a health history/co-morbidity of arthritis.
ax_cm_asthma	Comorbidity - Asthma	Flag to indicate if patient has a health history/co-morbidity of asthma
ax_cm_cvd	Comorbidity - CVD	Flag to indicate if patient has a health history/co-morbidity of cardiovascular disease
ax_cm_dm	Comorbidity - Diabetes	Flag to indicate if patient has a health history/co-morbidity of diabetes
ax_cm_osteoporosis	Comorbidity - Osteoporosis	Flag to indicate if patient has a health history/co-morbidity of osteoporosis
ax_cm_tiaStroke	Comorbidity - TIA/Stroke	Flag to indicate if patient has a health history/co-morbidity of TIA/Stroke
ax_cm_htn	Comorbidity - Hypertension	Flag to indicate if patient has a health history/co-morbidity of hypertension
ax_request_mentalHealth	Mental Health Request	A flag to indicate mental health services are requested on the referral.
ax_examType	Exam Type	The specific exam that is being ordered on the referral.
ax_surgicalCandidate	Surgical Candidate	Yes/No question for whether the patient is a candidate for surgical consult. Completed on the assessment centre's review form.
ax_assessmentOutcome	Outcome of the Assessment	Outcome of the assessment. For example, with rapid-access clinics, this outcome indicates whether the patient is being referred on to a surgical consult or not.
ax_assessmentOutcomeMedicalSpecialist	Outcome of the Assessment for Medical Specialist	Outcome of the assessment - if patient is being referred on to Medical Specialist, will return the specific medical specialist(s) selected.
ax_assessmentOutcomeCommunityProgram	Outcome of the Assessment for Community Program	Outcome of the assessment - if patient is being referred on to a Community Program, will return the specific program(s) selected.
ax_assessmentOutcomeSelfManagement	Assessment Outcome Self Management	The patient-self-management aspect of the assessment outcome.
ax_patientPreference	Patient Preference for Specific Care	If the patient is a candidate, and outcome is to referral to surgery consult, what is their preference: next available surgeon; specific surgeon; specific hospital; etc.
ax_consultOutcome	Consult Outcome	Indicates the outcome for the consultation, often recorded as a Yes/No answer for whether the patient is going on to surgery.
ax_decisionToTreat	Decision to Treat	Date field to capture when decision is made to schedule surgery. Used to calculate Wait2.
ax_decisionToConsult	Decision to Consult	Date field to capture when decision is made to forward referral on to surgical consult. Used to calculate Wait1b.
ax_bodySite	Body Site	The body site the referral is for (e.g., Hip/Knee/Shoulder etc)
ax_secondaryOutcome	Secondary Outcome	Records a secondary (non-primary) clinical outcome as defined by the pathway. For example, for the MSK pathway, this records the re-entry outcome when a patient returns the RAC within the 6-12 month timeframe. A true value indicates that the patient is a returning patient that was previously assessed within the prior 6-12 months and a false value indicates that the patient has not been assessed within the prior 6-12 months.
ax_receivedReferralComplete	Received Referral Was Complete	Indicates whether the referral received had all of the required information or not when the referral was initially received, particularly at central intake sites.

Set Up eConsults and/or eReferrals on Your Website*

Once you're set up to receive eConsults and/or eReferrals, you can optionally choose to set up Website Forms on your website to accept Ocean eConsults and/or Ocean eReferrals from both your website and the Ocean Healthmap.

This step is an optional part of setting up your site to receive eConsults and/or eReferrals.
- Ocean lets you accept eConsults and/or eReferrals, not only from the Ocean Healthmap, but also from a secure page on your clinic’s website, called Website Forms.
- For example, Cambridge Memorial Hospital accepts Ocean eReferrals for diagnostic imaging and MRI on the "DI and MRI Request for Consultation" page of their website.
- All consults and referrals submitted through Website Forms will go to into your central eReferrals & eConsults View in the Ocean Portal.
To learn how to set up a submission page on your website, check out our Website Forms Creation Guide.

There are no Ocean license fees associated with setting up an eReferral Website Form link for referring providers to use.

If you would like to set up a self-referral link for patients to use, then Ocean's standard Website Form fees will apply. If your Ocean site has a listing under Regional Authority (RA), a single Website Form link, that is configured to be submitted as an eReferral, will be covered under the RA license.
Set Up Your Site to Receive Walk-Ins*

If you are a receiving site that accepts walk-in patients, you will want to enable the "Accept Walk-In" feature in your site.

This is an an optional part of setting up eReferrals.

If you are a receiving site that accepts walk-in patients (i.e. patients who can come in whenever they're available, without necessarily having a pre-booked appointment).

Follow the steps outlined below to enable this walk-in setup.
- Log in to the Ocean Portal.
- Navigate to the Admin Settings page and click "Directory Listings".
- In the "Service Details" panel, click on the health service offering for your listing that accepts walk-in patients.
- In the pop-up window, click on the blue text beside the "Wait Time 1" field to access the "Wait Time Information" dialog box.
- For the "Reported Wait Time" field, select "Walk-In".
- Be sure to save your changes.
- Now when you accept any new incoming eReferrals for this specific health service offering, the "Accept" option at the bottom of the referral will default to "Accept Walk-In".
- As usual, the "Import" window will appear, where you can obtain the patient's Ocean reference number. Accepting the eReferral will also move the patient directly into the "Walk-In" folder.
- From there, whenever the patient comes in to the office, you can simply search for them in this "Walk-In Folder" and then mark the referral as "Completed".
Review the Guides to Receiving eReferrals/eConsults

Review to the relevant guides to learn how to receive eReferrals and/or eConsults.

Now that you have finished setting up your Ocean Site to receive eConsults and/or eReferrals, check out the Guide to Receiving eReferrals and/or the Guide to Receiving eConsults.

Set Up Receivers with Ocean Accounts

Any individual that requires access to Ocean must have a free Ocean user account.

Please refer to the article Adding a New User to Your Site.

Find or Add Your Clinic to the Ocean eReferral Network

If your clinic isn't already listed on the Ocean Healthmap, you will need to create it so that eConsult and/or eReferral senders can find your site.

Visit the Ocean Healthmap and search for your site.
If your site doesn't exist already, select the plus sign icon at the bottom left of the screen, enter your information, and save the listing.
If you would like to find a demo or test listing, click on the toggle at the bottom left of the screen and continue your search.

Claim Your Directory Listing to Your Ocean Site

Once your site has been created on the Ocean Healthmap, you will need to claim it so that it is linked with your Ocean site.

Once you've claimed your site, please let us know at ocean.tips/support so that we can validate your site as a legitimate clinic for accepting patient data.

Claiming a Directory Listing

Search for your site in the Ocean Healthmap and select "Update listing...". If necessary, update your listing information.
Then, click "Is this your organization? Claim it here." and save your listing.
Once you've claimed your listing, let us know at ocean.tips/support so that we can validate your site as a legitimate clinic for accepting patient data.

Note: If you're using Ocean as part of a provincial program, your Directory Listing may be validated by a trusted implementation partner.

Can't find your Directory Listing?

If you're unable to find your listing on the Ocean Healthmap, you can create a new listing directly within your Ocean site.

Login to the Ocean Portal. Click the "Menu" button in the top left corner and select "Admin". From the Admin Settings page, select "Directory Listings".
Create a new listing by clicking the "Add New Listing" button and entering your clinic details.
Press 'Save Changes' in the bottom right corner when complete.
Once you've claimed your listing, let us know at ocean.tips/support so that we can validate your site as a legitimate clinic for accepting patient data.

Note: If you're using Ocean as part of a provincial program, your Directory Listing may be validated by a trusted implementation partner.

Update Your Directory Listing Settings

Once we have validated your site, log in to your Ocean Portal and navigate to the Admin Settings page to ensure that your Directory Listing is accurate and that you are ready to accept eConsults and/or eReferrals.

You can now start receiving eConsults and/or eReferrals immediately.

Confirm your Directory Listing has been Validated
- Once your listing has been validated by OceanMD, log in to the Ocean Portal and navigate to the Admin Settings page.
Confirm your Contact Information
- From the Admin page select the Directory Listings option to view and manage your site's Directory Listings.
- Within the listing, under the "Contact Information" panel, review and update the information that is displayed to sending/referring providers on the Ocean Healthmap.
- Detailed information about each setting can be found in this support article.
Add your listed "Offers"
- 'Offers' are the health services that are provided at this Directory Listing. This list allows referrers to find your Directory Listing based on the services you provide.
  
  A full list of Health Service Categories that can be offered can be found here.
Add your "Appointment Labels"
- The appointment labels in the "Service Details" panel will impact the different appointment types that appear in the scheduling pane of incoming referrals.
  
  Eligible labels include: Appointment 1, Appointment 2, Appointment 3, Appointment 4, Appointment 5, Initial Visit Date, Follow-Up Date, Consultation Date, Surgical Date, and Procedure Date.
- The appointment label determines which appointment(s) are used in wait time calculations. The following appointment labels are associated with a Wait 1, and will map to the scheduledAppointment field in your site's analytics:
  - Appointment
  - Appointment 1
  - Initial Visit Date
  - Consultation Date
- These appointment labels are associated with a Wait 2, and will map to the scheduledAppointment2 field in the analytics:
  - Surgery Date
  - Procedure Date
- For example, a surgical office could use the Consultation Date label for their Wait 1, and the Surgical Date label for their Wait 2.
- Note: You can only have one appointment label associated with Wait 1, and only one associated with a Wait 2.
  
  In other words: only one "Wait 1"-type or "Wait 2-type" Appointment Label can be configured in a Directory Listing to be used across all referrals to map appointment information into the 'scheduledAppointment' and 'scheduledAppointment2' analytics. When performing wait time calculations, Ocean will use the first appropriate "Wait 1"-type or "Wait 2"-type Appointment Label from the series of Appointment Labels configured within the Directory Listing.
Choose your "Appointment Default Medium"
- Indicate the default appointment medium for new referrals sent to this listing. This will automatically populate the 'Medium' field within the 'Scheduling' pane for each referral.
- For example, if all or most of your referral appointments take place virtually, you may choose to set this to 'Phone' or 'Video Visit'.
Choose your "Referral Form"
- Use the forms available in the Ocean Library or create your own then choose your form in the "Service Details" panel.
- Note: The 'Patient Information' and 'Referring Provider' components of the eReferral are always captured by Ocean regardless of the chosen referral form.
  
  You can customize your referral form to include any additional information you would like included in the referral.
Add your Central Intake listing (if applicable)
- Central Intakes accept and triage eConsults and/or eReferrals based on region and pathway.
  
  By adding a Central Intake to your listing in the "Service Details" panel, consults and/or referrals sent to your listing will be routed to the Central Intake.
Apply to Regional Authority (if applicable)
- If you are participating in a provincial program, you may be instructed to apply to a Regional Authority.
- You can apply by clicking 'Apply to Regional Authority'.
- You will be prompted to enter the number of clinicians authorized to receive eReferrals and/or eConsults at the Directory Listing. For more information on this prompt, please refer to this article.
- You will then be prompted to select the Regional Authority that you wish to apply to.
- After selecting a Regional Authority, the respective Regional Authority's License Agreement will appear for you to review.
- After reviewing the agreement and clicking 'I Agree', your application will be sent to the Regional Authority site for their review, and you will be notified by email when the application is approved.
Set your "eReferral Policies"
- If you're ready to start receiving eReferrals, enable the Accept eReferrals checkbox.
- Choose whether you would like to split incoming referrals with multiple services into separate referrals.
- Select if you want to enforce referring providers to sign into an Ocean user account before submitting the consult and/or referral (allows for messaging back and forth with the referring provider).
- Enforce if the referring provider must be a Family Physician, Specialist, or Nurse Practitioner, based on the User Role in their Ocean user account.
- Update your 'Manual Forward Policy' to determine which referral stakeholder should hold communication responsibilities for referrals that are forwarded to offline recipients (e.g., via fax).
Set Health Service Offerings to accept direct consults and/or referrals outside of Central Intakes (if applicable)
- Some sites that receive eConsults and/or eReferrals through a Central Intake may also want to receive direct eConsults and/or eReferrals for other services.
- If you would like to configure direct eConsults and/or eReferrals for specific health offerings, click on the offer(s) in the "Service Details" section, and specify your custom form within that service offering.
- Consults and/or referrals sent to your listing with that requested service will come directly to your site, rather than being routed to the Central Intake site first.
Save your Changes

Once you're done updating your Directory Listing settings, press the 'Save Changes' button in the bottom right corner.

Update Your eConsult and eReferral Receiver Configuration

Once you have claimed a Directory Listing claimed to your site, and set up the Directory Listing details, the next step is to configure the site-level features associated with receiving consults and/or referrals.

1. Indicate that your Ocean Site is Receiving Referrals

- Log in to the Ocean Portal and navigate to the eReferrals & eConsults page.
- Select the Settings button in the top right hand corner of the page.
- Note: The 'Settings' button is only visible to Site Admin users.
- Under the "Welcome to Ocean eReferrals!" section, ensure that the appropriate selection is made for how your site is using eConsults and/or eReferrals ('Receiving Referrals' or 'Sending & Receiving Referrals').
  
  This selection controls the ability to access the configuration options in Step 2 that are only relevant for Ocean Sites that receive referrals.

2. Configure Referrals

Within the eReferrals & eConsults page select the Configure Referrals button.
You will be presented with the Referrals Configuration page:

Receiving Referrals

Trustees/Custodians: Indicate whether your Ocean Site is a Trustee/Custodian.
Default Incoming Referral Notification Emails: Set your default email(s) for notifications regarding incoming eConsults and/or eReferrals. Further details on email notifications for receivers can be found in this article: Set Up Receiver Email Notifications.
Send Patients Email Notifications: Select whether you would like Ocean to automatically send patients email notifications regarding status updates for their referrals sent to your site. The list of email notifications patients will receive can be found in this article: What email notifications will patients receive regarding their eReferrals?
Use Ocean patient's email address for integrations*: When set to 'Yes', Ocean will send patient email notifications to the email address submitted with the eReferral/eConsult. This is the recommended configuration.; When set to 'No', Ocean will send patient email notifications to the email address included in the FHIR payload.; *This setting is only available for Ocean Sites that have enabled a referral integration within the 'Admin -> Integrations' area of the Ocean Portal.
Create Charts for New Patients: When set to 'Yes', this allows Ocean to create new patient charts in your EMR when a referral is accepted and no existing EMR chart is found.
Referral Records/Notes Filetype: Choose which file format you would like Ocean to download your records and notes as. More details can be found in this article: Can I change the File Format for Downloaded Records and Notes?
Automatically Close Referrals: Select if you would like Ocean to automatically mark booked referrals as completed, a specified number of days after the appointment date. More details can be found in this article: Can Ocean Automatically Mark Booked Referrals as Closed at my Site?

eConsult Management

Display eConsult Folders: If your site is using eConsults, ensure the display of eConsult status folders is set to 'Yes'.

Appointment Time Options

Time System: Indicate if Ocean should display times using a 12-hour or 24-hour clock format, or both.
Time Interval: Select the increments of time that are selectable in the Scheduling area of a referral.
Time Range: Indicate the bookable hours of the day.
Preview Appointment Time Options: Open this dropdown to view the options that will be available based on your current settings.; More information regarding these settings can be reviewed in the following support article: Can I Configure the Booking Time Options that Appear in the eReferral Scheduling Pane?

Once you're satisfied with your configuration choices, click the 'Save' button at the bottom of the page.

Set Up Receiver Email Notifications

Configure which email addresses receive email notifications for new or updated eConsults and/or eReferrals.

This article describes locations where you can configure your email addresses for eConsult and/or eReferral notifications when receiving eConsults and/or eReferrals. To learn more about the rules/logic that Ocean uses to determine which email address to send the eConsult and/or eReferral notifications to, please refer to "Where do eReferral notification emails get sent to?".

Site-Wide Emails: Referrals Configuration
- The Default Incoming Referral Notification Emails can be configured in the "Referrals Configuration" page within the Referrals Settings in the Ocean Portal. These will be the default email addresses Ocean uses to send notifications regarding new consults and/or referrals received by the site, or notifications for updates made on consults and/or referrals received by the site.
- You can access this section by signing in to the Ocean Portal, navigating the Menu to the eReferrals page, selecting "Settings" in the top right hand corner, ensure your site is set as Receiving Referrals and then choose the "Configure Referrals" button.
- From there, you can list which email address(es) will receive the incoming consult and/or referral notifications.
- Ensure that you save your changes before leaving this page.
Listing Specific Emails: Directory Listings
- An email address can be configured in the "Directory Listings" section within the Admin Settings page in the Ocean Portal. The Referral Notification Email can be set under the Advanced section of the listing. Any notifications regarding consults and/or referrals sent to this specific listing, will be directed to this email, overriding the notification email set at the Site-Wide level.
- You can choose to use the Site Default here, by clicking the "Use Site Default" button to the right of the field. In this case, if the site consult and/or referral notification email is updated at a later date, the listing email will automatically update to match.
- Again, ensure that you save your changes before leaving this page.
Offering Specific Emails: Directory Listings
- An email address can be configured within the Offerings tagged on the listing, in the "Directory Listings" section within the Admin Settings page in the Ocean Portal. The Notification Email can be set under the Offers in the Service Details section of the listing. Any notifications regarding consults and/or referrals sent to this specific listing, for this specific health service offering, will be directed to this email, overriding the notification email set at both the Listing level and the Site-Wide level.
- You can use either the Site Default or Listing Default here, by clicking the "Use Site Default" or "Use Listing Default" buttons below the field. Then, if either the site or listing email is updated at a later date, the offering email with automatically update to match.
- Again, ensure that you save your changes before leaving this page.

Creating Canned Responses for Bookings and Messages*

You can optionally choose to set up canned messages that can be sent to the patient in advance of their appointment and/or that can be sent to the referrer/sender.

This is an an optional part of setting up eConsults and/or eReferrals.

When processing and managing incoming eConsults and/or eReferrals, referral recipients have the ability to add canned booking comments or send a canned message. These canned responses can be sent to patients using a booking comment, or can be sent as a message to the original referrer.

Log in to the Ocean Portal.
Navigate to the Admin Settings page and click Canned Responses.
From the Canned Responses screen, select the "New Canned Response" button under the "Canned Responses for Booking Comments" section

Give your response a title and add your desired text into the text field.

Note: An example of a canned booking comment could be the appropriate clothing a patient should bring to an appointment.

Click the "Save" button to save your canned comments.
Next time you are processing a consult or referral, you can select one of your canned responses using the speech bubble icon in the "Scheduling" section of the referral.
Note: Canned booking comments are only selectable in the 'Scheduling' area of the referral.

How does it appear to the patient?

When the appointment notification email is sent to the patient, the booking comment is included at the bottom of the email.

Log in to the Ocean Portal.
Navigate to the Admin Settings page and click Canned Responses.
From the Canned Responses screen, select the "New Canned Response" button under the "Canned Responses for Messages" section

Give your response a title and add the text into the text field.

Click the "Save" button to save your canned comments.
Now, next time you are processing an eConsult or eReferral, you can select one of your canned responses using the dialogue bubble in the "Messaging" section of the consult or referral.
Note: Canned responses to referrers/senders are selected from the speech bubble icon in the "Messaging" section, NOT the "Notes" or "Scheduling" section.

Set Up Automated Referral Appointment Reminders*

If you are a receiving site that accepts eReferrals, you may want to enable the eReferral Appointment Reminders feature within your site.

Ocean Sites that receive eReferrals can send automated appointment reminders to patients regarding their upcoming appointments.

Note: This is an an optional step in setting up your Ocean Site to receive eReferrals.

This article walks through the configuration required to send reminders to patients based on the booked appointment information stored within your Ocean eReferrals.

Alternatively, if your Ocean Site is integrated with your EMR (e.g., PS Suite, Med Access, Accuro, OSCAR Pro), Ocean can use your EMR schedule as the source of appointment reminder information. Please refer to the Patient Reminders Setup Guide for detailed instructions on this alternative configuration option.

Prerequisites

You must have Site Admin access on your Ocean Site.
Ocean Cloud Connect must be set up and enabled for your Ocean Site.

Ocean Site Configuration

After logging in to the Ocean Portal, open the 'Menu' and click 'Patient Reminders'.

Click the 'Settings' button in the top right corner.

Click the 'Edit Configuration' button to modify the universal reminder settings for your Ocean Site.

Set the 'Appointment Source' to 'eReferrals'.
Set the 'Daily Run Time' to your preferred time of day. Ocean will start processing reminders at the selected time.
Click 'Save'.

Note: Text Message Reminders are not currently available when the 'Appointment Source' is set to 'eReferrals'.

Reminder Rule Creation

Once the configuration above is completed, you can create your Reminder Rule(s). Reminder Rules allow you to define how far in advance of an appointment a reminder should be sent.

You can create any number of Reminder Rules to send multiple email notifications to the patient in advance of their appointment. For example, you can configure a rule to send 1 month in advance of the appointment, a second rule to send 1 week in advance of the appointment, and then another rule to send the day before the appointment.

From Patient Reminders Settings area, click 'Add Reminder Rule'.

Enter a 'Rule Name'. This name is never visible to patients. It's recommended that you provide a recognizable or descriptive name for your rule.
Specify the number of days before the appointment that the reminder should be sent.
Optionally enable the checkbox to include an iCal file in the reminder email.
Click the 'Save' button to save your Reminder Rule in it's current state. For brand new rules, this saves the rule in a disabled state.

Alternatively, click the 'Save & Enable Rule' button to save your Reminder Rule in an enabled state.

Your Reminder Rule(s) will appear in the main Patient Reminders Settings page, where you can disable, enable, edit existing, and create new rules.

Existing rules can be deleted by editing the rule and then clicking the 'Delete Rule' button

You're all set! At the time of day specified in your Ocean Site's reminder configuration, Ocean Cloud Connect will send appointment reminder emails to any patients with booked referrals that meet any enabled reminder rule criteria and that have consented to email notifications.

The appointment reminder email contains the same information that was provided to the patient in the initial booking email notification, including any booking comments, attachments, and the ability to confirm the appointment (if it hasn't been confirmed already).