What is a Central Intake?

What is a Central Intake?

A Central Intake is a special type of Ocean site that is used to coordinate referrals and make best use of a geographical region's resources. This special site configuration allows the Central Intake users to remain as stakeholders on the referrals, and see the status update as the referral is continued to be processed downstream. Healthcare providers within the region can choose to route their referrals to a Central Intake rather than referring directly to a specific service provider.

The Central Intake site can ensure completeness of the referral, transcribe faxed referrals, triage referrals, and manage other administrative aspects. They may forward the referral to an Assessment Center for additional investigation, or directly to another healthcare service provider who delivers the referred service.

What makes a Central Intake site unique?

Since the primary purpose of a Central Intake is to manage referrals within a region, there are unique functionalities that have been created in Ocean to assist with their workflows.

Directory Listing Configuration

Central Intake sites have unique Directory Listings that are specifically configured by CognisantMD. If you are interested in having your Directory Listing configured to be a Central Intake listing, please submit a ticket to our support team.

Forward Button

  • Once configured as a Central Intake site by CognisantMD, a 'Forward' button will appear in each referral received.
  • This provides Central Intake users with the ability to forward the referral to the appropriate service provider.

Forwarded Folders

  • Central Intake sites gain access to the 'Forwarded (New)' folder in the eReferrals area.
  • The 'Forwarded (New)' folder contains referrals that have been electronically forwarded by the Central Intake and are now waiting in the 'New' folder of the recipient site.

Processed Button

  • Once a referral has been marked as 'Booked' or 'Completed' by a recipient site (in the case of electronic forwarding), or has an appointment added to the Scheduling pane by the Central Intake site (in the case of manual forwarding), Central Intake users can then use the 'Processed' button within the referral.
  • This moves the referral into the 'Completed' folder for the Central Intake site, while keeping it in the existing folder for other referral stakeholders. Marking the referral as 'Processed' has no impact on wait time calculations.
  • This 'Processed' workflow is useful for Central Intake sites if they are performing any of their own administrative functions to close out the referral from their perspective (e.g., any manual recording outside of Ocean).

How do Central Intake sites receive referrals?

Central Intake sites receive referrals by either having referring providers send them directly to their Central Intake Listing on the Ocean Healthmap, or by having recipient sites automatically redirect their inbound referrals to the Central Intake Listing. Central Intake sites can also receive manually faxed referrals, and transcribe them into Ocean to take advantage of the digital functionalities.

  • The image on the right is an example of a Central Intake listing on the Ocean Healthmap which a referring provider could directly send to.
  • Referral recipient sites who would like to automatically redirect their referrals to a Central Intake can select the appropriate Central Intake site by searching for it in the 'Central Intake Listing' field within their own Directory Listing settings.

Central Intake Processes

Please expand the appropriate tab below for information on the different processes that Central Intake sites use to forward referrals.

Electronically Forwarding a Referral

The steps below can be used by Central Intake sites when they are forwarding a referral to a healthcare provider that is accepting eReferrals through the Ocean platform.

  • Locate the relevant referral within the 'New' folder, and click on it to open it.
  • Optional: Within the Notes area, click the speech bubble icon, and select 'Review...' to open the review form.

  • Optional: Complete the review form, and press 'Save' to stamp the note into the 'Notes' pane of the referral.

  • Use the 'Forward' button at the bottom of the referral to forward the referral.
  • Select or search for the desired referral recipient with a green icon. The green icon indicates that they are accepting eReferrals.
  • Review the recipient's listing information, and press 'Forward Referral' when ready.
  • The forwarded referral can now be found in your 'Forwarded (New)' folder, with a green arrow indicating that it was electronically forwarded to the recipient site.

    If the recipient site accepts the referral, it will move into the 'Pending Booking' folder.

    When the recipient site books an appointment for the referral, it will move into the appropriate 'Booked Unconfirmed' or 'Booked Confirmed' folder.

    If desired, the Central Intake site can mark a referral as 'Processed' once an appointment has been booked, moving it into the 'Completed' folder for only the Central Intake site.

Manually Forwarding a Referral

The steps below can be used by Central Intake sites when they are forwarding a referral to a healthcare provider that is not accepting eReferrals through the Ocean platform.

This involves manually faxing the referral outside of the Ocean platform, and simply updating the status within Ocean on behalf of the true referral recipient.

  • Locate the relevant referral within the 'New' folder, and click on it to open it.
  • Optional: Within the Notes area, click the speech bubble icon, and select 'Review...' to open the review form.

  • Optional: Complete the review form, and press 'Save' to stamp the note into the 'Notes' pane of the referral.

  • Use the 'Forward' button at the bottom of the referral to forward the referral.
  • Select or search for the desired referral recipient with a grey icon. The grey icon indicates that they are not currently accepting eReferrals.
  • Review the recipient's listing information, and press 'Print Referral' to obtain a printable file of the referral.
  • Print the file and manually fax the referral to the recipient using a fax machine.
  • Use the confirmation checkbox in Ocean to confirm that you have manually forwarded the referral to the recipient.
  • Press 'Forward Referral' to complete the process.
  • The referral is moved to the 'Pending Booking' folder, with a grey arrow indicating that it has been manually forwarded.

    Since the referral was manually forwarded to the recipient, the Central Intake site maintains the responsibility to update the referral and appointment scheduling information within Ocean.

  • If desired, the Central Intake site can use the 'Processed' button to move the referral to the 'Completed' for only the Central Intake site.

As a Central Intake user, how can I determine the Requested Provider for an eReferral?

Central Intake sites receive referrals by either having referring providers send them directly to the Central Intake Listing on the Ocean Healthmap, or by having recipient sites automatically redirect their inbound referrals to the Central Intake Listing.

When an automatically redirected referral is received at a Central Intake site, Central Intake users can see which listing the referral was originally sent to by looking at the 'Requested Provider' within the referral.

If no 'Requested Provider' is specified, then the referral was sent directly to the Central Intake listing on the Ocean Healthmap.

The example below shows a referral which was originally sent to the 'Dr. Lisa Smith' listing on the Ocean Healthmap, but was then automatically redirected to the 'Orthopedic Central Intake'.


Can I modify the eForm used during the eReferral/eConsult reviewal process?

  • Yes, the questions presented in the 'Review' panel during the eReferral/eConsult reviewal process are customizable.
  • The questions in this panel correspond to a specific Ocean eForm (named 'Referral Notes') in your Ocean site. By modifying this eForm, it modifies the questions presented during the reviewal process.

Warning: Advanced eForm Editing

The Referral Notes eForm should only be modified by Ocean users who are familiar with advanced eForm editing. We recommend creating a backup version of your Referral Notes eForm before modifying it.

How to Modify the Referral Notes eForm:

  • Locate the 'Referral Notes' eForm in your eForm library. This eForm has the reference value 'referralNotes', which is the eForm reference value that Ocean will use in the 'Review' panel of an eReferral.

    In other words, the eForm which has the 'referralNotes' reference value will be shown in the 'Review' panel.

  • Select the eForm, and press 'Edit' to launch the eForm editor.
  • Within the eForm editor, you can modify or add additional questions that should be displayed within the 'Review' panel during the reviewal process.
  • The preview panel on the right hand side shows how the note will appear in the 'Notes' panel of the eReferral once it has been reviewed and saved.
  • Use the 'Save Changes' button in the bottom right corner to save your eForm when you are done making changes.

Important eForm Item References

Each item in an eForm is assigned a specific item reference value. Item reference values are often used to implement conditional logic into eForms, however they are also sometimes used to push information from the eForm into a specific area or functionality within Ocean.

  • For the 'Referral Notes' eForm specifically, the item references 'protocol' and 'priority' can be used to push information into the respective 'Protocol' and 'Priority' columns in the eReferrals area.
  • Expand the image on the right to see where the 'priority' item reference value is stored for the highlighted eForm item. The 'protocol' value is not present in the default version of the Referral Notes eForm, but it can be manually added.
  • The text value shown on each of the response choices represents the text value that would be pushed into the respective column in the screenshot above. These can be modified in the 'Menu Choices' tab.
  • Note: We highly recommend using an eForm item type that allows for discrete response choices (e.g., a Menu) to simplify the process within the 'Review' panel of the eReferral. This also ensures that the values pushed into the 'Protocol' and 'Priority' columns are standardized across all reviewed eReferrals.


How to Manually Import a Sent eReferral into PSS

In the rare case that an Ocean eReferral Custom form, or the referral note summary, does not download into the patient's PSS chart after an eReferral is sent, users can re-trigger the download by following the steps outlined below.

  • Access the Ocean Patient Dashboard by selecting "View in Ocean" on the Ocean Toolbar in the patient chart.
  • Locate the sent eReferral that needs to be re-downloaded into the patient chart, and click it to open.
  • Once the referral opens, click the Action menu located in the top-right corner.
  • Select the "Import into EMR" option.

This action will trigger the entire referral form summary, as well as the Ocean eReferral tracking form, to download into the patient chart. Any internal PSS messages or Pending Tests/Consults, associated with the referral, will download as well.


What happens when an eReferral is sent with more than one Health Service Offering requested? (eReferral Splitting)

In some referral pathways, such as the Diagnostic Imaging pathway, it is common for a patient to be referred to a listing with more than one Health Service requested (for example a referral for a CT and an Ultrasound).

In these cases, rather than having the referrer complete two separate referral forms (one for the CT and one for the Ultrasound), the referral form at the recipient site can be designed to allow both exams to be requested on the same referral.

  • Here's an example of a referral form where the referring provider can select more than one exam.
  • Note: Selecting more than one exam will assign more than one Health Service Offering to the referral form. This will give the recipient the opportunity to "split" the referral into separate referrals - one for each offering assigned.

The Splitting Policy

  • As the referral recipient, you can configure your listing to automatically "split" referrals into multiple referrals that can be managed separately within your Ocean site. This setting is configured from the Admin Settings page by clicking on Directory Listings. From here, scroll down to the eReferral Policy section, and you should see a box next to Splitting Policy.
  • If the Splitting Policy is enabled at the recipient site, the referral will automatically come into the New box as separate referrals. The sender will see the same thing occur in their sent folders.
  • If the Splitting Policy on a listing is turned off (left unchecked), the referral will come into the site as a single referral with multiple services assigned to it.
  • The recipient can review the referral first and choose to split it into multiple referrals (one for each service). This manual split can be done using the "Split" button displayed at the bottom of these referrals when opened.

The Relationship between Split Referrals

  • When referrals are split, a relationship is established between the original referral that was sent, called the "Source" referral, and each of individual referrals that were generated after the split. These individual referrals are commonly referred to as "Child" referrals. Both the Source Referral and each of the Child referrals can be found listed in the Related Referrals section, displayed at the bottom of each split referral.
The Source Referral
  • The Source Referral can be viewed if the referral sender or recipient would like to see a summary of the original referral that was submitted, and a list of each Child referral and their corresponding statuses.
  • The Source Referral can be accessed from the Action menu of each of the individual referrals.
  • Or it can be opened from the Related Referrals table, by clicking the "View Source Referral" link displayed on any of the individual Child referrals.
  • The Source Notes section on the Source Referral, can be used to add notes or information that is relevant to all of the related referrals.
  • Any notes added to this section will display on each of the Child referrals, separate from their Notes pane which captures notes specific to that individual referral.
  • Note: If there are no Source Notes added to the Source Referral, then this section will NOT display on the individual Child referrals.
The Child Referrals
  • When a Child referral is opened, any other Child referrals from the original split can be viewed, along with their status, in the Related Referrals section at the bottom of the referral view.
  • To navigate between these referrals, you can click on the name of the related referral, or click the "View Referral" link, in the right hand column of the Related Referrals table.
  • Note: After a referral is split, each of the child referrals will operate individually in Ocean, with its own appointments, status updates, email notifications, notes, and messages tied to it. 

The Referral Form Summary on Split Referrals

  • The Referral Form Summary is generated from the information filled out by the referring provider on the referral form. The Source Referral will display all of the information completed on the form, including sections that are applicable to each of the services selected.
  • In a standard referral split, that same Referral Form Summary will be displayed on each of the Child referrals that get generated. However, the referral form can also be designed at the recipient site to only display specific parts of the original Referral Form Summary on each of the child referrals. This is to help with the management, and triaging of each child referral. For example, when you view the Ultrasound child referral, you may only see the sections relevant to that service in the Referral Form Summary.
  • Note: Both the referral splitting, and the generation of these child referral form summaries, will depend on the design and configuration of the recipient's referral form and listing.

Deleting Source & Children Referrals

  • Source referrals cannot be deleted directly. Source referrals are automatically deleted when all their respective children referrals have been deleted first.

Creating Inbound Requests

If your Ocean site receives referrals by phone or fax, you can convert these into Ocean eReferrals by creating a New Inbound Referral.

If your Ocean site receives referrals by phone or fax, you can convert these into Ocean eReferrals by creating a New Inbound Referral by following the steps outlined below.

  • Log in to the Ocean Portal and navigate to the eReferrals & eConsults area.
  • Expand the "Actions" menu at the bottom left and select "New Inbound Referral".
  • Select the source for the new referral.
  • If there are multiple listings tied to your site, you will be prompted to select which listing the referral was directed to.
  • Complete the patient information and all relevant fields on the referral form, including the date the referral was sent if it differs from the current date.

    Note: Referrals can be backdated up to a maximum of 10 years in the past.

  • Manually enter the referrer's information, or click "Import..." to auto-populate the information from the referrer's Directory Listing (if available).
  • To import the referrer, type their name into the text box and choose their listing from the list of results.

    Note: If any information requires updating, update these fields in the 'Referrer's Information' pane of the eReferral and it will be saved for next time.

  • When all of the information for the referral has been entered, click the "Send Referral" button in the bottom right corner of the window.
  • The eReferral will now appear in the "New" inbox in the eReferrals & eConsults area of your Ocean Portal.

    These inbound eReferrals can be managed in the same way as any other Ocean eReferral, with the exception that no referral notifications will be sent to the referrer through Ocean.


How are referral forms managed for sites with Central Intake?

Ocean listings can be specified to send referrals to central intake, their own site, or both. The referral's destination is determined by the owner of the chosen referral form. In other words, if a central intake form is used, the referral will be sent to central intake. When a specific site's form is used, it will be sent to that specific site.

Multiple referral forms can be displayed in the site's "Send Referral" dialog. The most specific referral forms are shown at the top of the list. When specific referral forms are available, the generic forms are not shown.

Which forms are shown specifically?

Suppose a clinic's site has a Clinical Listing that is linked to a Central Intake Listing that has an Orthopedics health service offering. For each Orthopedics offering that the Clinicial Listing has, a list of potential referral forms is returned in the following order:

  1. A form specified for "Orthopedics" in the Clinical Listing
  2. A form specified for "Orthopedics" in the Central Intake Listing

If there are no forms in 1 or 2, it will proceed to include:

  1. A general form specified in the Central Intake Listing
  2. A general form specified in the Clinical Listing

If there are no forms in 1, 2, 3, or 4, it will proceed to include:

  1. Any general Ocean referral forms for "Orthopedics"

If there are no forms in 1, 2, 3, 4 or 5, it will proceed to include:

  1. The Quick Referral Form
  2. Standard Referral form