How do I use the "Await Reply" functionality?

In the case that you are a referral recipient waiting on additional information or a response from another stakeholder involved in the referral, you can use the 'Await Reply' functionality from within the Action Menu of the referral.

  • After locating and opening the relevant referral, open the 'Action' menu in the top right corner, and select 'Await Reply'.
  • The referral will be moved from its current status folder to the 'Awaiting Reply' status folder until you choose to accept the response. Referrals that are currently awaiting a reply are denoted using purple text for all referral stakeholders.
  • When the relevant stakeholder responds to your inquiry by using the 'Messaging' area within the referral, the referral will be flagged in your 'Needs Review' folder.

    Alternatively, you can locate the referral within the 'Awaiting Reply' folder.

  • After opening the referral from either the 'Needs Review' or 'Awaiting Reply' folder and reading the response to your inquiry, you can press either the 'Accept Reply' or 'Reviewed & Close' button.

Accept Reply

  • The 'Accept Reply' button both marks the referral as reviewed and accepts the response, which removes it from both the 'Needs Review' and 'Awaiting Reply' folders, and automatically categorizes the referral back into its appropriate status folder.

Reviewed & Close

  • The 'Reviewed & Close' button marks the referral as reviewed, which removes it from the 'Needs Review' folder, but also provides you with the choice to accept the response.
  • If you select 'Yes', the referral is also removed from the 'Awaiting Reply' folder and is automatically categorizes the referral back into its appropriate status folder.
  • If you select 'No', the referral will continue to be categorized in the 'Awaiting Reply' folder until you choose to accept the response.

How do I Resubmit or Redirect a cancelled/declined eReferral/eConsult?

  • If an eReferral/eConsult is cancelled or declined, you may choose to resubmit it to the last recipient, or alternatively redirect it to a new recipient.
  • These options are available within the Action Menu of the eReferral/eConsult.

Resubmit (Last Recipient)

The 'Resubmit (Last Recipient)' option is available to both senders and recipients, and can be used to resubmit the referral/consult to the last recipient they were previously cancelled from, or declined at.

  • If necessary, the original sender can update or add additional information to their referral form answers prior to resubmitting by clicking the pencil icon within the 'Referral Form Summary' area.
  • Once the referral form answers are updated, you can click the 'Resubmit (Last Recipient)' option in the Action menu.

Redirect (New Recipient)

The 'Redirect (New Recipient)' option is available to senders only, and can be used to initiate a new referral/consult to a brand new recipient on the Ocean Healthmap, while reusing the patient demographic information and any attachments found in the 'Messaging' area of the original referral/consult.

  • Within the original referral/consult, open the Action menu and select 'Redirect (New Recipient)'.
  • You will be prompted to optionally include a 'Reason for Redirect', which will be shared with the patient and the new referral recipient via email notification, and recorded in the 'Messaging' area of the new referral.

    Note: If no reason is provided, there is no indication to the new recipient that the new eReferral/eConsult originates from the redirection of a prior referral.

  • After selecting a new recipient to redirect the referral/consult to using the Ocean Healthmap, the Patient Information and Attachments from the original referral are automatically populated on the new referral form.
  • Complete the new recipient's referral form, review the included attachments, and click 'Send'.
  • If a 'Reason for Redirect' was provided, it will appear in the 'Messaging' area of the new referral, along with any attachments.

Redirection Analytics

The analytics for the original declined/cancelled referral are not impacted.

The new referral created as a result of the redirection will have a 'redirectedFromReferralRef' analytic value containing the unique referral reference value of the original cancelled/declined referral.

Note that the 'redirectedFromReferralRef' analytic is not included in the Core Analytics Export. It must be obtained using a custom Export Template.

Can I download a complete copy of the referral record?

Yes, you're able to download a complete copy of the entire referral record at any point in a referral's lifecycle.

  • Locate and open the relevant referral within the Ocean Portal.
  • Open the 'Action' menu in the top right corner, and select 'Download Referral Record'.
  • A new tab will open in your web browser showing the complete referral record, including all scheduling information, notes, messages, and attachments included in the eReferral.
  • Use your web browser's printing or downloading functions to save a copy of the record.

How do I change the Health Service and Description for eReferrals that I receive?

You are able to change the current Health Service and/or Description of a received eReferral directly within the referral itself. This can be helpful in the case where an incorrect or inaccurate Health Service was selected by the referrer. It can then be corrected to a more appropriate or more specific service by the referral recipient. You can also modify the Description that is shown for the referral, while still maintaining the assigned Health Service.

  • After logging in to the Ocean Portal, locate and open the referral that you would like to change the Health Service and/or Description for.
  • Within the referral, click on the current Health Service displayed at the top.
  • Use the 'Health Service' text box to search for and select your desired service. After typing in a few key characters, the list of matching Health Services will appear for you to select from.
  • Use the 'Description' text box to enter your desired description of the referral. This is useful for adding more specific information, such as the right or left side of the body, if applicable.
  • Press the 'Save' button to apply your changes to the referral when ready.
  • If a new 'Description'' was provided, it will be visible within the referral and it's corresponding status folder.

Note: While it visually appears that the 'Description' overwrites the 'Health Service', rest assured that the currently assigned Health Service is properly recorded for referral analytics reporting.

In the example above, the original 'General Surgery' Health Service ID is recorded as the 'initialHealthService' analytic value, while the updated and more specific 'Orthopedics: Shoulder' Health Service ID is stored as the 'currentHealthService' analytic value. The textual 'Right Shoulder' description is not stored as an analytic value.

How can I communicate with an eReferral sender/recipient?

  • You're able to communicate with an eReferral sender or recipient by using the 'Messaging' area within an eReferral.

How do I send a message?

  • Within the 'Messaging' area of the eReferral, simply select the appropriate message recipient (if multiple parties are involved in the referral), type your message into the text box, optionally add an attachment, and press 'Send'.
  • For increased efficiency, you can also create canned responses for your Ocean Site that are easily selectable using the speech bubble icon.
  • The message recipient will receive an email notification that you have sent them a message.

Additional Message Functionalities

  • Once a message has been sent, additional functionalities can be accessed by clicking clicking on the message header.
  • Note: The 'Amend' and 'Delete' options are only available to the user who sent the message.

Download Addendum Letter
Downloads a PDF document containing basic eReferral information and the selected message.
Copies the selected message into the new message text field, to allow for additional information to be added.
Deletes the message.

Can I add notes to an eReferral/eConsult?

  • Yes, the 'Notes' area within an eReferral or eConsult can be used for general documentation regarding the request.
  • Additionally, if you're taking advantage of the eReferral reviewal workflow, the note generated by the review form will be automatically stamped into the 'Notes' area.

How do I add a new Note?

  • To add a new note to an eReferral or eConsult, simply open the request and type into the 'New Note:' text field and press 'Save'.
  • Alternatively, you can use the speech bubble icon to select a short pre-worded note.

Additional Note Functionalities

  • Once a note is saved to an eReferral, additional functionalities are available by clicking on the note header.
  • Note: These functionalities are only available for Notes created by your own Ocean site.

Allows you to modify the responses to the Review Form.
*Only available for the note created by the Review Form. For more information on Review Form notes, please see how to review incoming eReferrals.
Email Note
Emails a copy of the note to the original referring provider.
Download Note
Downloads a PDF document containing basic referral information and the selected note.
Make Private for This Site
Makes the note private, so only users on your Ocean Site can see the note. Private notes are shown in italics.
Deletes the note.

Can I send messages and eForms to patients ahead of their referral appointment?

Yes, eReferral recipients can use Ocean's Patient Messaging functionalities to securely message patients and send them Ocean eForms to complete ahead of their appointment.

Please note that to use Ocean's Patient Messaging functionalities, a Patient Messaging & Reminders License is required. For additional information on the cost of Ocean's Patient Engagement products, please see our pricing page.

1. Set Up Patient Messages

Complete the steps in the Set Up Patient Messages guide to enable and configure patient messaging on your Ocean site.

2. Sending a Patient Message and/or eForms from an eReferral

  • Locate the relevant eReferral within Ocean, and click on it to open it.
  • Within the eReferral, expand the 'Patient's Note' tab by clicking on it, and then press the envelope icon.
  • Use the pop-up window to send a customized message and/or eForm to the patient, or select one of your existing templates for convenience. When your message is ready, press 'Send'.

    For additional information regarding the options in this window, please refer to Patient Messages Settings.

3. Patient Confirms Secure Message and/or Completes eForms

  • The patient will receive an email prompting them to view any secure messages, and complete any outstanding eForms.
  • After clicking the hyperlink in the email, patients will be able to view any secure messages, and press 'Next' to complete any outstanding eForms.

3. Review Patient's Note within the eReferral

  • After the patient completes their eForm(s), the generated eForm note can be found within the 'Patient's Note' area of the eReferral.

    Note: If your Ocean site is integrated with your EMR, the generated eForm note will automatically be added to the respective patient's chart.

    If your Ocean site is not integrated with your EMR, you will need to manually import the generated notes.

Can I assign an eReferral to be reviewed by someone on my Ocean Site?

Ocean has built-in functionality to allow you to easily assign an eReferral for review by another user on your Ocean site.

This is helpful for flagging, triaging, organizing, and actioning eReferrals. An eReferral can be flagged for review at any time during the referral process, allowing for appropriate reviewal even before deciding to accept or decline it.

The review process can also be performed without flagging a specific person that an eReferral needs to be reviewed. In other words, the review form functionality can be used as a standalone tool for applying a structured review process to the referrals that you receive.

Please expand the appropriate tab below to learn more about each aspect of the reviewing process:

Steps to Flag an eReferral for Review
  1. Locate and Open your eReferral

    • Start by logging in to the Ocean Portal.
    • Navigate to the eReferrals area by opening the 'Menu' and selecting 'eReferrals & eConsults'.
    • Locate the eReferral that you wish to flag for review by using the folder categories or the search bar. Open the eReferral by clicking on it.
  2. Flag the eReferral for Review

    • After opening the eReferral, locate the 'Needs review' field in the bottom left.
    • Clicking inside the text box presents a list of users on your Ocean site. Select the user that you wish to notify. Alternatively, type their name to automatically filter the list.
    • Once you have selected your desired user, the 'Notify' button will appear. Press it to send an email notification to the user you selected, indicating that their reviewal is required.

      Note: To assign an eReferral for review without triggering an email notification, simply press 'Save & Close' after selecting a user.

    • A confirmation message will appear on screen confirming that an email notification has been sent, and the email address that it was sent to.

      Note: The email notification will be sent to the Email Address listed in the reviewer's Ocean user account settings.

    • An example of the email that the reviewer will receive can be seen by expanding the image on the right.
    • Press 'Save & Close' to close the eReferral.
    • The eReferral will be moved into the site-wide 'Needs Review' folder. It will also appear in the 'For Me' folder of the assigned reviewer.
Steps to Review an eReferral Flagged for Your Review

1. Locate and Open your eReferral

There are three options to locate and open your eReferral:

  • Option 1:
    You can open the assigned eReferral by clicking the 'View the eReferral' button in the notification email.
  • Option 2:
    If the eReferral was assigned to you without an email notification, you can locate it in the 'For Me' folder.
  • Option 3:
    You can use the 'Reviewer' filter within the 'Needs Review' folder to locate all referrals that have been assigned to a particular user(s) or group.

2. Review the eReferral

  1. Note: The 'Review' panel functionality described below is not available to eReferral senders, as it is used for reviewing/triaging by the eReferral recipient. Once the recipient performs the review, the resulting note will be visible to all referral stakeholders within the 'Notes'' area.

    • The 'Review' panel within the eReferral will automatically open for physician users.

      For non-physician users, this panel can be accessed by selecting the speech bubble icon in the 'Notes' area, and pressing 'Review...'.

    • Assign a priority level to the eReferral and any additional comments.
    • Complete the review process by selecting one of the options below:
1. Request Decline
Stamps a simple note into Notes pane indicating that the eReferral should be declined, and automatically recategorizes it back into the appropriate status folder. The eReferral should then be manually declined by the next user actioning it.
2. Save
Stamps a summary note of the review into the Notes panel.
3. Reviewed
Stamps a summary note of the review into the Notes panel, completes the reviewal process, and moves the eReferral into the folder it was previously in.
4. Reviewed Arrow
Provides additional options for completing the reviewal.
'Review and Accept' completes the reviewal process, and moves the eReferral into the 'Pending Booking' folder. Note: This option is only available if the eReferral has not already been accepted.
'Review and Decline' completes the reviewal process, and moves the eReferral into the 'Declined' folder.

Quick Tip

  • The 'Enable Review Mode' toggle button in the bottom left corner can be used to expedite the process for reviewing eReferrals.
  • When review mode is enabled and there are multiple outstanding eReferrals for review, the 'Reviewed & Close' button in the bottom center of the eReferral is replaced with a 'Reviewed & Next' button, allowing you to quickly move into the next outstanding eReferral without having to manually close and open each time.
Step to Review an eReferral without being Flagged

1. Locate and Open your eReferral

  • In the 'eReferrals & eConsults' area of the Ocean Portal, locate your referral and click on it to open it.

2. Review the eReferral

Note: The 'Review' panel functionality described below is not available to eReferral senders, as it is used for reviewing/triaging by the eReferral recipient. Once the recipient performs the review, the resulting note will be visible to all referral stakeholders within the 'Notes'' area.

  • Within the 'Notes' area of referral, press the speech bubble icon and select 'Review...'.
  • The review note area will appear on the right hand side.

    Note: Review forms can be customized to suit the review processes of each Ocean Site, so your specific form may look slightly different.

  • Assign a priority level to the eReferral and any additional comments. Your review form may have additional questions if it has been customized.
  • Complete the review process by selecting one of the options below:
1. Request Decline
Stamps a simple note into Notes pane indicating that the eReferral should be declined. The eReferral should then be manually declined by the next user actioning it.
2. Save
Stamps a summary note of the review into the 'Notes' panel.

Can I send the patient details about how and where their eReferral Appointment is occurring?

eReferral recipients can now specify the method for how appointments booked on their referrals will occur (in person, as a home visit, or a virtual visit by phone or video). This is done in the Scheduling pane of eReferrals in the Medium dropdown to the right of each appointment date and time.

  • To specify the appointment Medium, click on the dropdown to the right of the appointment time and select if the appointment will be In Person at the listing location, In Person at an alternate location, by Phone, Video Visit, or as a Home Visit.
    • Ocean will include the selected appointment medium, alongside the other scheduling details, in the booking email notifications automatically sent to the patient and referring provider.

Note: Medium is a mandatory field. It will default to "In Person" at the address of the directory listing the referral belongs to. If this is not accurate, please ensure the dropdown selection is changed before saving the booking details.

  • If you select "In Person (Alternate Location Specified in the Booking Comments)" please ensure the address details are included in the booking comments. If desired, you can configure the alternate locations as canned booking comments.
  • Details regarding the phone, video or home visits can also be configured and included in the canned booking comments.
  • If booking multiple appointments on the eReferral, you can select a separate medium for each appointment.
  • Patients who have consented to email notifications will receive the standard booking email with the appointment date and time, followed by the medium. See the following support article for further examples.

What does the "Copy of referral and status updates to" setting do on an eConsult and/or eReferral?

How to Specify Copied Stakeholders

  • When a consult or referral is first sent, the referrer can specify additional stakeholders to copy on the referral/consult by using the 'Copy of referral and status updates to' field at the bottom of the referral window.
  • If a consult or referral has already been sent, the referrer or referral recipient can add or remove copied stakeholders by using the same functionality within the 'General' area within the referral.
  • In order to add a copied stakeholder to the consult/referral at any point in the referral lifecycle, the stakeholder must exist as a Directory Listing within the Ocean Healthmap. After typing a key term into the text field, the matching Directory Listing(s) will appear for selection.

How are Copied Stakeholders Notified?

  • If a stakeholder is copied when the consult/referral is first sent, they will receive an email notification alerting them with specific language indicating that they have been copied as a stakeholder.

    Note: The email notification is sent to the 'Referral Notification Email' listed in the copied stakeholder's Directory Listing.

  • If a stakeholder is copied after the consult/referral has already been sent, they will receive an email notification at the time of the next important status update (e.g., appointment booking, cancellation) alerting them of the status update.
  • If you are copying a stakeholder after the referral has already been sent and you would like to notify them immediately, you can manually alert them by sending them a message using the 'Messaging' area within the referral.

Copying Claimed vs. Unclaimed Listings

When a status changes, Ocean determines how each stakeholder should be notified.

Stakeholder listings that have been claimed by an Ocean site are notified automatically via notification email as described above.

Stakeholder listings that have not been claimed by an Ocean site cannot be notified via an Ocean email or be sent results electronically via Ocean. Consequently, the consult/referral and its associated information must be faxed to the listing or sent in some other manner.

  • When a consult/referral with an unclaimed stakeholder listing is updated by a user, Ocean informs the user that a manual notification is necessary for the listing. Users can send these manual notifications by clicking 'Print Notification Sheet for Faxing', print the faxable referral record onto paper, and then fax it to the recipient.
  • Alternatively, the user can select one of the other options to indicate that they will notify the them via a phone call, or that they have already been notified, or that no notification is necessary.

When are Copied Stakeholders Notified?

Electronically copied stakeholders receive an email notification for each of the following scenarios:

  • When the new consult/referral is first sent and they are included in the 'Copy of referral and status updates to' field
  • When the consult/referral is Cancelled, Declined, or Resubmitted
  • When Appointment Information is added or modified in the referral/consult
  • When Booking Comments are added or modified in the referral/consult
  • When Booking Attachments are added or modified in the referral/consult
  • When the referral/consult is Forwarded

Where are Copied Stakeholders Displayed?

Copied stakeholders are shown in the following areas:

  • The 'General' area within the consult/referral in Ocean
  • The list of electronic message recipients in the Messaging area of the consult/referral (only if the stakeholder listing has been claimed by an Ocean site)
  • The Referral Notification Sheet, which is used to help sites notify other offline sites via Fax
  • The Referral Record
  • The Referral Note
General Messaging Referral Record Referral Note Notification Sheet

How do Copied Stakeholders Access the Consult/Referral?

  • Stakeholders that have been copied on a consult/referral can access it by clicking on the 'View the eReferral' button within the email notifications they receive.
  • Copied stakeholders can additionally access the consult/referral directly within the 'eConsults & eReferrals' area of their Ocean site by using the 'All Received' status folder.

What Actions Can a Copied Stakeholder Perform Within the Consult/Referral?

Copied stakeholders can:

Can a Copied Stakeholder be Removed from the Consult/Referral?

Yes, a copied stakeholder can be removed from a consult/referral at any time. Copied stakeholders can be removed by the referral sender, referral recipient, or by the copied stakeholder themselves.

  • Press the edit icon within the 'General' section of the consult/referral.
  • Press the red 'X' icon to remove the copied stakeholder, and then press the checkmark icon.
  • A message will automatically be added within 'Messaging' area informing the removed stakeholder that their access to the referral has been revoked.
  • The removed stakeholder will be unable to view any patient health information regarding the referral once their access has been revoked.

Can I add multiple patient appointments to my eReferral?

Once you've accepted a referral and begin scheduling a patient's appointment, you may want to schedule more than one appointment time. You can do so within the eReferral window.

  1. Once you've accepted a referral, open your referral from the "Pending Booking" tab and navigate to "Scheduling". 
  2. To add an additional appointment, click the (+) button. Similarly, to remove an appointment, click the (-) button.
  3. You can select an appointment label depending on the appointment labels configured for your site. The appointment label is important as it will impact which appointments are saved to your referral analytics and used in wait time calculations. It is also what will be displayed in referrer and patient booking email notifications. To see how you can add appointment labels, and review these details, refer to Step 4 of this guide: Confirm Your eReferral Site Settings.
  4. Confirm the appointment time and details, save your changes. 


Note: If you are unsure of the exact appointment time, you can book a blank appointment slot which will place the referral back into "Pending Booking". This allows you to keep track of appointments to book in the future. Once you confirm the appointment, you can repeat the steps above.

Can I make a copy of a received referral?

If your site receives a referral that needs to be managed in a couple different ways, or split into multiple health service offerings, you can use the Add Related Referral functionality. For example, perhaps your site receives an Orthopedic referral for a patient's right hip, but an assessment outcome determines the left hip should be treated as well. The related referral functionality allows the recipient to make a copy of the original referral for the right hip, so that the left hip referral can be forwarded or booked separately.

  • Open the referral you wish to make a copy of and select the Action menu. Choose Add Related Referral.
  • In the pop up window, choose the desired Health Service for the new referral.
  • If you would like to change the description of the original referral, add it to the Original Referral Description field. To add a new description to the copy of the referral, type in the Related Referral Description field.
  • Click Add. You will now see a copy of both referrals in the eReferrals page in your Ocean site, with their own unique descriptions. The referral note and information on each referral will be identical, but they can now be booked and managed separately. Ocean refers to each of these as "child" referrals.
  • Note: The inbox the original referral was sitting in will impact which inbox(es) the child referrals will be found in, after the related referral is generated. For example, if the original referral was in the Booked Confirmed inbox, it will maintain it's booking information and remain there after the related referral is added. The new related referral will be found in the Pending Booking inbox with a blank scheduling pane.
  • If you open one of the child referrals, you can view the status of the other child (or the related referral), in the Related Referrals section below the referral note. Click the blue text of the related referral to open it directly from the current referral.
  • When a related referral is added, a third referral, called the "source" referral, is also created and stored in the Ocean site. Updates made to the patient's information in the source referral will be pushed to all child referrals. You can also add Source Notes, which are notes that can be viewed on both child referrals. To open the source referral, click the "View Source Referral" link in the Related Referrals section of the child referral, or click "View Source Referral" from the Action Menu of any child referral.

How can I save an eConsult and/or eReferral for completion at a later time?

If you have initiated an eConsult/eReferral but you require additional information before it can be sent (e.g. physician is waiting on a prior imaging report, or lab result to include in the referral), you can use the 'Save for Later' functionality to temporarily save the incomplete eConsult/eReferral in Ocean, and then complete and send it later on.

Saving an eConsult/eReferral for Later

  • In these scenarios, press the "Save for Later" button in the bottom left corner of the referral window.

    Note: The incomplete consult/referral will only be saved in Ocean for 30 days, so you'll need to complete and send it within that time.

    After 30 days, the incomplete consult/referral will be purged from Ocean, and the URL can no longer be used. A brand new consult/referral would need to be initiated.

  • You will be provided with a URL that you can use later to access the incomplete referral.

    If your Ocean Site is integrated with your EMR, the URL will be automatically saved into the patient's chart for quick access.

    If your Ocean Site is not integrated with your EMR, copy and store this link in a safe place for later use.

Accessing an eConsult/eReferral that was Saved for Later

To access an eConsult/eReferral that was 'Saved for Later', you can do so directly from: 1) within the Ocean Portal's 'Incomplete' folder, or 2) copy and paste the URL from the patient's chart in the EMR into a new web browser window, or 3) access it directly from within the Ocean Patient Dashboard.

1) Ocean Portal 'Incomplete' Folder

  • You can access any referrals that have been 'Saved for Later' within the 'Incomplete' folder in the Ocean Portal.

2) Patient's Chart in the EMR

PS Suite Med Access Accuro OSCAR OSCAR Pro
  • In PS Suite, the URL is saved into the patient's chart as a new Progress Note.

Note: When opening the URL in your web browser to access the referral, you will be prompted to sign in to your Ocean user account (if you're not already signed in).

Ocean Incomplete eReferral Custom Form (Optional)

  • Clicking "Save for Later"  will trigger this form to be added to the patient's notes in their chart in PS Suite.
  • From there, the "Resume Completing eReferral" button can be clicked to open the saved eConsult and/or eReferral form again, complete the form, and then send it (versus copying and pasting the URL into a new browser).
  • A PS Suite internal message (i.e. sticky note) will also be triggered to ensure it is completed.

3) Ocean Patient Dashboard

PS Suite Med Access Accuro OSCAR OSCAR Pro
  • From within the patient's chart, click 'View in Ocean' on the Ocean Toolbar.
  • The incomplete referral will appear within the 'Outbox - Saved for Later' section.