Ocean Server Release Notes

The Ocean Server upgrade scheduled for September 14th, 2023 at 9:30 PM EST contains the following improvements and fixes.

Provider Network

Improvements:

• For Med Access and PSS, if the Referring Provider is present in the EMR's Address Book, it will be set for Received Referrals.
  • An indication that the patient has been uploaded by Ocean will be present for both eReferrals and Online Booking in PSS under Patient comments and MA under Care Assignment notes.
• Providers are now protected from communicating with listings that have yet to complete their HINP's listing validation process.
• Added HL7 FHIR v0.11.1 (beta) as the default payload type on the Ocean eReferral Integrations page.
• SMART launch can now be used to launch into a specific referral within the Ocean Portal.
• eReferral PDF documents can now accommodate long MRN values without overlapping other text.

Fixed Bugs:

• Fixed a bug with the "Enable Review Mode" button disappearing when the referral is refreshed.
• Updated the Healthmap search results to rank Test Mode eReferral listings lower than live eReferral listings.
• Fixed bug causing multiple notification emails to be sent when an invalid email address is included in a referral listing.
• Fixed a bug preventing referral API updates from going out when the referrer has no address.

Patient Engagement

Improvements:

• An eForm associated with an Ocean Study (anonymous) can now be used as an Online Booking post-booking form, and count towards the study results.
• Added a font toolbar to provide limited formatting for the Online Booking Introductory Message text.
• Minor update to how the day of the week is displayed in the Online Booking confirmation email.
• Ocean will prevent patients from booking into the 11:55 pm - 12:00 am slot when the appointments are 5-minute duration and the time restriction is set to 11:59 PM.
• Patients with the status of 'Inactive' in Accuro will not be provided access to the Online Booking patient flow.

Fixed Bugs:

• Changes to Patient Messages and Reminders Licence and subsite in Site Admin provider page will now be visible upon saving.
• The "Real-time Ontario Health Card Validation" setting in the Tablet & Kiosk will remain in the enabled mode upon saving the credentials dialogue.
• Patients booked in an EMR schedule that is invisible to Cloud Connect can now be able to use the Ocean Kiosk to check-into the EMR's Walk-in schedule.

Platform

Fixed Bugs:

• Fixed a bug preventing the character '$' in the keyword values from being processed.

The Ocean Server upgrade scheduled for August 24th, 2023 at 9:30 PM EST contains the following improvements and fixes.

Provider Network

Improvements:

• Senders now have the ability to filter and save on Referring Clinicians so only relevant referrals are shown.
• When importing a new referral and a net new patient chart is created in Accuro, the Referring Provider will now be populated into the “Referring Phys” field in the patient demographic, if the referring provider is in the address book. Re-authenticating Cloud Connect will be required to utilize this feature.
• Ocean now supports the GET HealthcareService API for eConsult Bidirectional integration.

Fixed Bugs:

• Remediated bug where FHIR update patient API messages required a birthdate when they shouldn't.

Patient Engagement

Improvements:

• User Activity Report will now log action to determine if a user enabled/disabled a Patient Messaging and Reminders license.

Fixed Bugs:

• Save button for Website Forms and Online Booking no longer behaves like "Save and Close".

Platform

Improvements:

• Externalized Ocean Attachments, and moved them out of MongoDB and into AWS S3.
• Now auditting site 'From' address email approvals.
• Set a call duration warning threshold for FHIR attachment downloads separately from other requests.

Fixed Bugs:

• Mitigate Bugs and Errors found in S3 Referral Attachment Migration Job.
• Manual payments of an invoice for multiple sites in Ocean will now correctly be recorded as processed, alongside capturing the payment.

The Ocean Server upgrade scheduled for August 3rd, 2023 at 9:30 PM EST contains the following improvements and fixes.

Provider Network

Improvements:

• Improved clarity in the User Activity Report when a user initiates the 'Export' action in the eReferrals & eConsults area.
• Improved support for back-dating of faxed referrals sent more than one year ago when creating them in Ocean.
• Ocean now supports the HL7 FHIR eReferral-eConsult Implementation Guide v0.11.1 outbound messages.
• Enabled Ocean to capture and send back the SMART launcher (POS system's) internal referral identifier as part of the FHIR payload.

Fixed Bugs:

• Remediated bug in processing catchment areas sent via the HealthcareService API.
• Updated the sample outbound bundle payloads in the FHIR API documention.

Patient Engagement

Improvements:

• Support for using Altenate IDs for Online Booking, Patient Authenticated Website Forms, and Patient Messaging.
  • Added a Privacy and Security Disclaimer when enabling Alternate IDs for each product.

Fixed Bugs:

• Fixed bug preventing Alternate IDs from populating in Med Access.
• Fixed bug impacting the use of the 'ob#days' individual patient-level restriction
• Fixed bug causing the Ocean Attachment Exporter to fail to read certain S3-based PSS attachments.

Platform

Improvements:

• Added mitigations to prevent users that no longer have access to a site from switching into it in the same session.
• Updated the shared encryption key (SEK) maintenance guidance in the Encryption page.
• Updated the Ocean Support email address and website URL in the EULA and Ontario Privacy Primer.

Fixed Bugs:

• Fixed an issue that prevented the attachment exporter from uploading some types of PSS attachments.

The Ocean Server upgrade scheduled for July 13th, 2023 at 9:30 PM EST contains the following improvements and fixes.

Provider Network

Improvements:

• Ocean now supports the  Ontario eReferral-eConsult HL7 FHIR Implementation Guide v0.11.1 inbound messages.

Fixed Bugs:

• Fixed issue with "Request Decline" functionality on the Review Note when triaging a referral.
• Fixed issue where listings could not be deleted due to master referrals that couldn't be removed.
• Fixed billing issue with website forms when listings were reclaimed under another site.
• Fixed issue where certain listings were not able to be successfully approved as valid by the Regional Authority.
• Fixed issue preventing the upload of data into Ocean from a HL7 FHIR patient/[id]/$everything endpoint.

Patient Engagement

Improvements:

• Updated the values presented in the PSS Online Booking Provider Restriction field to align with the field names in PSS.
• The PSS Online Booking Provider Restriction field now supports the ability to specify when a provider should be excluded.
• Added the ability to specify the location of the Online Booking appointment as being offsite.
• The “Add Appointment Type” button now allows multiple list items to be selected together.
• Customized the confirmation message displayed to the patient depending on whether they were presented with a reply option and typed a reply before clicking "Next."

Platform

Improvements:

• Split the sign up for product updates and critical notifications in the user account sign-up UI into two distinct options.

The Ocean Server upgrade scheduled for June 22nd, 2023 at 9:30 PM EST contains the following improvements and fixes.

Provider Network

Improvements:

• Enhanced Med Access task description to include additional details such as the referral listing name.
• Updated copy of error message when uploading attachments to indicate accepted file types.
• For Early Access Program Users: Ocean can now automatically upload a file attachment into PSS for referrals.

Fixed Bugs:

• Fixed issue where referral notification emails were still being sent to Users that had been removed from the site instead of the Clinical Admin email.
• Fixed issue causing active Problems imported from PSS to populate the "Past Medical History" (pmhx) keyword.

Patient Engagement

Improvements:

• The Online Booking appointment selector will now announce via an accessible screen-reader when the selected element causes a change to other content on the screen.
• Ocean can now utilize alternate identifiers (e.g. student numbers) stored in PSS and OSCAR Pro to authenticate patients with the Kiosk/Tablet.
• For Early Access Program Users: Ocean can now automatically upload a file attachment into PSS. 

Fixed Bugs:

• Fixed issue that was causing the failure of a PSS batch export when the province code precedes the health number.         
• Fixed issue associated with an SMS confirmation link that states that it is expired when opened by the patient.
• Fixed issue that prevented some patients from being able to reply to Patient Messages.

Platform

Improvements:

• Improved the client-facing Accuro CDS link configuration.

• Revised the URL used for Ocean Tablet internet connectivity test to a more typical URL.

• Script errors in the eForm properties will now be flagged for correction when saving a form in the Form Editor.

The Ocean Server upgrade scheduled for June 1st, 2023 at 9:30 PM EST contains the following improvements and fixes.

Provider Network

Improvements:

• Updated CPP keyword mapping to pull additional patient profile fields (e.g. Surgical History) from Med Access.
• Referral task owner assignment in Med Access will now be based on the Referring Provider or the receiver's Directory Listing 'Clinician Information' field.
• Updated PDF Creator handling of unsupported characters.
• Added a HL7 FHIR extension for listings created via the HealthcareService API to be able to set the resubmission restriction.

Fixed Bugs:

• Demographic changes will now consistently update the patient chart in Med Access by ensuring the Health Card Number's 'Province' field is converted into recognized 2 character province codes.
• Fixed issue in Accuro where demographic changes were not updated due to a discrepancy in the province field.
•  Fixed issue in Med Access and PSS where demographic changes were not consistently updated.

Patient Engagement

Improvements:

• Enabled OSCAR Pro Kiosk to support multiple appointment check-ins by a patient on the same day.
• Changed the message displayed on Kiosks and Tablets when it is inactive for more than 30 seconds so that it does not show the patient’s name.

Fixed Bugs:

• Fixed Accuro module to support all provincial health insurance number formats for demographic changes.

Platform

Improvements:

• Added the ability to set the Cloud Connect Sync Days to ‘0’, which will stop the appointment-related syncing across all EMR modules and hide the sync-related fields.

The Ocean Server upgrade scheduled for May 11th, 2023 at 9:30 PM EST contains the following improvements and fixes.

Provider Network

Improvements:

• Enhanced the "Needs Review" functionality to be available for sending site users.
• The Ocean form associated with a listing can now be set from the HealthcareService API.

Fixed Bugs:

• The Healthmap directory listing search will now scan beyond the first 1000 characters of the listing description.
• Both Senders and Receivers now have the ability to resubmit declined or cancelled referrals.
• Addressed issue causing the creation of a new patient in Med Access and PSS to fail when an invalid address province value is entered.  A progress note will be added where manual updates are required.
• The HealthcareService API now supports data removal on update.

Patient Engagement

Improvements:

• Acknowledgement by the patient of the receipt of a Patient Messaging email will no longer require them to manual apply a 'check' in the dialog.
• Updated the instructions provided to the patient when they enter the wrong birthdate on two consecutive tries during a secure Patient Messaging authentication to contact the sending clinic.

• Email communications (for Patient Messaging, Reminders, and Online Booking) will now display the source Ocean site's site number in the email footer.

Fixed Bugs:

• Resolved bug impacting how Ocean determines which appointment to update to "Mark arrived" when there are multiple appointments.

Platform

Improvements:

• When performing a save in the eForm Editor and there is a frontend javascript validation error, the focus of the page will change to highlight the location of the error. 

The Ocean Server upgrade scheduled for April 20th, 2023 at 9:30 PM EST contains the following improvements and fixes.

Provider Network

Improvements:

• Enhanced the Med Access integration to pull in appointment information into Ocean.

Fixed Bugs:

• Fixed an issue where the View Portal button from the Med Access launcher does not always correctly open up the portal view.
• Custom Analytic Exports will now show patientId values and adjusted formatting of referrerClinicianType values.
• An event record will now appear in the referral's event log when patient demographics are updated through the FHIR API.

Patient Engagement

Improvements:

• Updated the copy of the SMS Reminder message template to: Appointment with <Provider Name> - <Demo site> ... ”
• Provider schedules now cannot be saved without a unique, patient-friendly schedule name.
• A link to Ocean's pricing information is now available from dialogs associated with Online Booking schedule and Patient Messaging activation. 
• Modified the error message displayed to the patient when their primary provider does not have an Online Booking schedule set up to reduce confusion.
• Simplified the error message displayed to the patient when a patient-facing Online Booking failure occurs. 
• Removed the guidance on creating complete Reminder templates and the associated support article URL from  the Edit Reminders page.

Platform

Fixed Bugs:

• Provided a visual cue to the user when the Pay Invoice button is processing. 
• Added safeguards to prevent automated directory updates from provincial registries from being applied to listings outside of that jurisdiction.
• Illegal Filename Characters in the HL7 FHIR DocumentReference resource will now be replaced with a legal character.

The Ocean Server upgrade scheduled for March 30th, 2023 at 9:30 PM EST contains the following improvements and fixes.

Provider Network

Improvements:

• Added the ability to search for a user in the primary delegates picklist.
• The Send eConsult and Send eReferral buttons in Healthmap listings will now be shown based on the selected Health Service Offering (HSO) configuration.
• Added new directory listing setting to be able to prevent referrals from being resubmitted
• Added flag to FHIR payloads for test referrals.
• Added Analytic for eRepository Contribution to Ocean Regional Authority listing Export.
• Improved troubleshooting support by updating the appointment related referral event log entries to include the Wait Time type if set via the API.
• Added an end-user troubleshooting flag when the Ocean shared encryption key is not properly transfered during SMART launch.

Fixed Bugs:

• Fixed HealthcareService API issue where service can only be updated once.
• Addressed Repository Contribution permission restricting CMD Admin from editing listings.
• Only the relevant referral forms will appear for the selected HSOs in the healthmap.
• Fixed a bug preventing the subsite setting from saving in the Website Form configuration.
• Fixed a bug that resulted in central intake's review form selections being lost when specialists recorded their own review note.
• Addendum Letter PDF filenames will now have illegal filename characters (e.g. \/:?*) replaced with an underscore (_).

Patient Engagement

Improvements:

• Made the Walk-in Provider field optional in Cloud Connect if kiosks are not being set up.

Fixed Bugs:

• Fixed a bug affecting Patient Messaging when there is only a space included in the secure message portion.
• Added validation to eForm health number inputs.
• Ensured that Website Form submissions that contain mismatching patient information for protected fields generate a secondary Ocean note in Med Access.

Platform

Improvements:

• Invoices will now list bill items by monthly breakdown in the Billing view, email invoice and printable version.

Fixed Bugs:

• Ensured that when a user’s site access is revoked, they are removed from the site administrators list.
• Removed an unnecessary error message that appeared when the  EMR field mappings view was closed without any changes.

The Ocean Server upgrade scheduled for March 9th, 2023 at 9:30 PM EST contains the following improvements and fixes.

Provider Network

Improvements:

• Referral attachments can now be downloaded directly into Med Access EMR. (Contact our Support team to have this enabled.)
• Added the ability for Regional Authorities (RA) sites to link referral analytics data.
• Validated that Ocean's payloads conform to the eReferral Analytics Repository specifications in the  Ontario eReferral and eConsult HL7 FHIR Implementation Guide v0.11.1.

Fixed Bugs:

• Addressed issue so that referral analytics exports are not limited to the first 500 referrals.
• Resolved bug so that catchment area can be set using the Healthcare Service API. 
• Fixed a bug that could result in a duplicated eReferral message or an inability to mark an eReferral as reviewed.

Patient Engagement

Improvements:

• Online Booking can now allow a subsite assignment at the provider schedule level.
• Online Booking provider schedules for Telus PSS, Med Access and OSCAR Pro can now be setup to allow patients to book appointments with other care team members from the other provider fields.
• Updated the copy of the message that is displayed to patients when no appointment slots are available to book into.

Platform

Improvements:

• Created a report in the Admin > Users view to assist site admins with user management.
• Added bill items that have an Ocean credit applied to the downloadable billing report. 
• Minor updates to the Ocean end-user licence agreement (EULA) to improve clarity.

The Ocean Server upgrade scheduled for February 16th, 2023 at 9:30 PM EST contains the following improvements and fixes.

Provider Network

Improvements:

• Established Ontario Health's eReferral Repository FHIR Connectivity
• Added the Integration Name to the Event Log Details.
• Added new spine and surgical Health Service Categories, including: OMF Surgery, Spine Assessment Clinic, CSSP (Centralized Surgical Services Program), Pediatric Neurosurgery, Pediatric OMF, Pediatric Plastic Surgery, Pediatric Cleft Lip and Palate.
• Renamed the 'Pediatric General Surgery' Health Service Category to 'Pediatric General Surgery / Thoracic'.
• Removed deprecated Health Service Categories from the HealthService API export.

Patient Engagement

Improvements:

• Online Appointment Booking (OAB) and Patient Authenticated Website Forms now support all provincial health card number formats.
• The Health Number field during patient check-in/validation process now accepts all alphanumeric characters.
• When a patient with an Ontario Health Number enters the version code characters after their numeric health number, Ocean will automatically ignore the version code characters.
• All hyphens and spaces entered in the Health Number field will be automatically ignored.
• All provincial health card number formats are now supported for patient identity verification when accessing secure content (e.g., secure messages, attachments, eForms).
• Implemented a new OAB feature allowing customization of the message shown to patients when there are no Provider Schedules available for the patient to book into. This can be configured within the 'What action message should the patient be shown when there are no schedules available for them to book into?' setting within Booking Link. The message and options are:

• Default - Shows the default message of "Sorry, we are unable to process your check-in. There are no appointment schedules available to use for online booking. Please contact the office in the usual manner to book an appointment."

  This option is selected automatically which ensures that there is no change for clinics who do not wish to change the existing full message.

• None - No text is shown after "Sorry, we are unable to process your check-in. There are no appointment schedules available to use for online booking."
• Custom - Allows the clinic to include any text they want after the initial message of "Sorry, we are unable to process your check-in. There are no appointment schedules available to use for online booking."
• Added screenreader-compatible headings on eForms.

Fixed Bugs:

• Fixed a bug with Online Appointment Booking for Med Access which would create duplicate time slots when an appointment was booked online. A single time slot will now exist with the booked appointment, and only the 'Type' column in the Med Access schedule will be coloured.
• Fixed a bug to ensure that eForm slider widgets are in the proper direction for right-to-left languages.

Platform

Improvements:

• Updated the company name and logo across the platform to reflect the company's new brand.
• Added a parser to the eForm Editor that will ensure that JavaScript expressions added to the eForm conform with correct and secure coding practices.

The Ocean Server upgrade scheduled for January 26th, 2023 at 9:30 PM EST contains the following improvements and fixes.

Provider Network

Improvements:

• Added the ability to enable contribution to a Service Request Repository.
  • For Regional Authority (RA) sites, a new “Regional Authority” section is available within the Admin settings area for organizing RA-specific configuration options, including the option to enable contribution to a Service Request Repository.
  • For RA sites, the “Approvals” page has been updated to group listings by Site, and a new “Manage Site Agreement” page has been added where RA users can approve individual Sites to contribute to a Service Request Repository.
  • When a Site has been approved by an RA to contribute to a Service Request Repository, a new “Contribute data to repository” setting is available within the Site’s Directory Listing(s), allowing Site Admins to control their contribution to the Repository.
  • Updated the warning prompt shown to users when removing a saved Shared Encryption Key in Cloud Connect if integrations and Service Request Repository contributions are enabled.
• Added a DELETE operation to the HealthcareService API to remove an Ocean Referral Target and added it to the API documentation.
• Updated the FHIR documentation appointment related payload samples to use the text of the appointment type.

Fixed Bugs:

• Ocean HL7 FHIR eReferral APIs will recognize when the health number's province field has been completed with a full province name and convert it to the correct FHIR extension.

Patient Engagement

Improvements:

• The FHIR Patient Engagement module option is now accessible when performing Cloud Connect configuration.
• Patients can now be automatically created by Online Booking in EMRs using the Patient Engagement FHIR APIs.

Fixed Bugs:

• Fixed a bug which prevented the ability to preview .jpeg, .mp4, and other video files attached to a Patient Authenticated Website Form submission.
• Ocean will now export a log of sent bulk cohort emails when the entire cohort is sent successfully.

Platform

Improvements:

• The eForm editor has been updated to highlight specific Javascript errors to assist users when correcting these errors.

The Ocean Server upgrade scheduled for January 5th, 2023 at 9:30 PM EST contains the following improvements and fixes.

Provider Network

Improvements:

• Modified the sorting logic used when displaying search results in the Ocean Healthmap.
• Updated the method for launching Caredove.

Fixed Bugs:

• Fixed a bug that caused an error message when deleting a referral that was ‘Saved for Later’.
• Fixed a bug that was causing incorrect ordering of search results in the Ocean Healthmap.

Patient Engagement

Improvements:

• Updated the name of the ‘HN Importer’ in the patient cohort uploader to more clearly state that Cloud Connect must be enabled.
• Added HL7 FHIR Patient Engagement (PE) API support for importing Ocean eForm results.

Fixed Bugs:

• Fixed a bug for Online Booking with Med Access that was preventing the mapped EMR Appointment Type from matching the restricted Template type if the restriction was configured first.
• Addressed a bug preventing the creation of new patients from Online Booking submissions using the FHIR PE APIs.
• Addressed a bug appearing to patients that received multiple secure Patient Messages within 24 hours that used different validation checks.

The Ocean Server upgrade scheduled for December 15th, 2022 at 9:30 PM EST contains the following improvements and fixes.

Provider Network

Improvements:

• Added new “Neuropsychology” and “School Psychology” health services offerings to support additional psychology services.
• Established proof-of-concept authorization connectivity with ONE Access Gateway.
• When a Directory Listing is updated by the HealthcareService API, it will be noted in the listing’s “last modified by” field.
• Ocean will now utilize the Referral Target’s Longitude and Latitude fields within the HL7 FHIR Location resource, when populated, to map the address on the Healthmap.
• Ocean can now store images associated with a Directory Listing that has been created using the HealthcareService API.
• The Ocean HealthcareService API now supports ISO 639 language codes.
• Ocean will now use a POST(Update) operation to accept complete Healthcare Service Bundles and update Referral Targets in Ocean.

Fixed Bugs:

• Adjusted the wording used in referral appointment notification emails to state the appointment medium more clearly.
• Fixed a bug that temporarily calculated and displayed wait times for test referrals (only at listings that have not yet received real eReferrals).

Patient Engagement

Improvements:

• When text message reminders are enabled, Ocean will now send French SMS text messages to patients whose preferred language is specified as French within the EMR.
• Added a search feature to the Template selection field when configuring a Reminder Rule, making it easier to find a specific Template.

Fixed Bugs:

• Ocean will now verify that the Patient ID values in an uploaded patient cohort file only contain numeric formatting for the PSS and Standard Patient Importer files.
• Fixed a bug the Reminder History Log that could lead to "(Encrypted Patient)" showing for the Patient Name.
• Appointments booked online through Ocean will now book directly into the applicable Template slot in the Med Access schedule, rather than creating a duplicate time slot in the schedule.

Platform

Fixed Bugs:

• Resolved billing issues related to Online Booking licences.
• Added validation of file type to block unsafe file types, (including .html) from being uploaded from EMRs.
• Resolved issue preventing Referral and Website form notifications from being sent out.
• Added safety checks to prevent invalid health number values from being saved within the Patient object.

The Ocean Server upgrade scheduled for November 24th, 2022 at 9:30 PM EST contains the following improvements and fixes.

Provider Network

Improvements:

• A new report is available for Support Site users that shows the latest referral sent date by user for all users that they support.
• Senders of an eReferral can now change their request to an eConsult and vice versa.
• Added a 'spyglass' icon to the side menu of the Healthmap to make the Advanced Search more accessible.
• Added an "Accepting New Patients" directory listing tag.
• Ocean Healthmap directory listings can now be created using a FHIR API
  • The POST endpoint is specified in our FHIR eReferral documentation.
  • Ocean will log an audit event specifying that the listing has been created by an API author.
• Added support for the Ontario Health Card Number OID 2.16.840.1.113883.4.59 to the Ocean SMART launch.

Fixed Bugs:

• Improved error message clarity when attempting to resubmit a referral that has already been sent.

Patient Engagement

Improvements:

• OSCAR Pro sites can now utilize Ocean Kiosks for walk-in (non-scheduled) patient visits.
• All Ocean Sites using Online Booking can now specify a ‘Medium’ (i.e., ‘Telephone Call’ or ‘Virtual Visit Video’) for each appointment type when the ‘Location’ is set to ‘Virtual’. The booking confirmation page and confirmation email will indicate the medium for the booked appointment.
• Created FHIR APIs to support Ocean Kiosk walk-in (non-scheduled) features.

Fixed Bugs:

• Enhanced controls for enabling unsolicited replies to Patient Messaging.
• When a user that has sent a Patient Message with Ocean forms is no longer a part of a site, Ocean will now send the email notification of form completion to the clinical administrator email.
• Added an 'Attachment Upload' event to the virtual visit audit report.
• Added a check to prevent users that do not have a Patient Messaging license from sending out cohort messages.

Platform

Fixed Bugs:

• Resolved bug preventing internationalization of an Ocean form when the caption has too many non alphanumerical characters.

The Ocean Server upgrade scheduled for November 3rd, 2022 at 9:30 PM EST contains the following improvements and fixes.

Provider Network

Improvements:

• The Appointment Date(s) will now appear at the top of downloaded referral summaries in the referral status line.
• Modified the default “File Type” selection within Referral Analytic Export settings from “All” to “Clean”, which excludes master, test, and deleted referrals.
• The FHIR Questionnaire resource in the ServiceRequest bundle now includes both the referral form question and answer text.
• When registering an integration (Admin > Integrations view), the FHIR payload type will now be the default option.
• The integration setting for contextual launch to an external referral system will now need to be enabled by CognisantMD Support.

Patient Engagement

Improvements:

• Patient Engagement FHIR API development.

Platform

Fixed Bugs:

• Improved the accuracy of the start and end dates that are being reported on weekly usage report tables.
• Fixed bug that prevented FHIR events from being sent when Cloud Connect is offline.

The Ocean Server upgrade scheduled for October 13th, 2022 at 9:30 PM EST contains the following  improvements and fixes.

Provider Network

Improvements

• The referral summary will now be automatically hidden in the "Referral Request Initiated" modal for External Launch integrations.

• Sites will now be able to generate site-specific analytic exports that include custom fields.

• Sites will now be able to generate site-specific analytic exports in the API that include custom fields.

• Removed legacy 'ax_' fields from the default referral analytics export.

• Facilitated URL redirect using FHIR eReferral APIs.

Fixed Bugs

• Fixed a bug that created referral demographic values that could not be found using the surname prefix search.

Patient Engagement

Improvements

• Added capabilities and methods to facilitate integration between Ocean's patient engagement tools and point-of-service (POS) systems using FHIR endpoints.

Fixed Bugs

• Included 'failed login attempts' events into the Admin > Reports audit reports.

• Added checks to prevent non-numeric values from being stored in eForm items that expect numeric fields.

• Resolved bug causing OSCAR attachments to be linked to the wrong patient.

• Resolved error arising when a new patient is created using the Ocean tablet into PSS.

Platform

Improvements

• The password requirement will now be 12 characters going forward for new users and when resetting passwords.

• Added the CognisantMD data retention clause to the end-user licence agreement (EULA).

• Created a Virtual Visit audit report.

Fixed Bugs

• Resolved bug associated with assigning credits to unassigned provider licences.

• Added the logging of the recipient's IP address to audit reports related to accessing a secure message (virtual visit)

• Resolved bug causing duplicated invitations to the same email addresses during a bulk email invite.                                                                                                                            

The Ocean Server upgrade scheduled for September 22nd, 2022 at 9:30 PM EST contains the following  improvements and fixes.

Provider Network

Improvements

• The Directory Listings dropdown menu within both the ‘Admin’ area and the ‘eReferrals & eConsults’ area are now alphabetically ordered.
• Referral Integrations with an external system launching will now have the redirect link automatically loaded without a manual click in the same tab.
• The same URL for the FHIR wait time extension will now be accepted across all Ocean environments.

Fixed Bugs

• Fixed a bug where attachments added to a referral that was ‘Saved for Later’ were no longer present when revisiting the referral from the ‘Incomplete’ folder.
• Resolved a bug causing Ocean Message contents to be cut off in the Referral PDF if the special character "<" was included in the message.
• The Ocean API will now return a meaningful error message when referral attachments exceed the 10MB file size limit.

Patient Engagement

Improvements

• Updated pricing specified within the platform to reflect changes that will take effect October 1, 2022. 
• Added capabilities and methods to facilitate online appointment booking using FHIR endpoints.

Fixed Bugs

•  Improved handling of javascript expressions for Reminder Rules.

The Ocean Server upgrade scheduled for September 1st, 2022 at 9:30 PM EST contains the following  improvements and fixes.

Provider Network

Improvements

• If a referral is forwarded more than once after a Central Intake, the secondary Regional Authority will now dynamically update in the referral analytics.
• Existing site-specific analytic exports will now only appear in the reports for the relevant site.

Fixed Bugs

• Fixed bug preventing the name of the provider that received an email notification from displaying in the eReferral's event log. 

Patient Engagement

Improvements

• Users can now insert the keyword [weblink_french] into the Patient Messaging email body so that when there is an eForm to complete or a secure message, Ocean will add a French version of the hyperlink into the email to the patient. 
• Developed HL7 FHIR R4-based EMR/POS synchronization capabilities to determine which providers, schedules, and appointment types are available within an EMR.
• Developed HL7 FHIR R4-based methods to perform patient query and import notes into an EMR. 

Fixed Bugs

• Fixed bug blocking Patient Reminder rules from being sent if they have been edited prior to the scheduled daily run time. 
• Mitigated bug that enabled an attachment that had been uploaded to Ocean and instantly removed from being included in a Patient Message. 

Platform

Fixed Bugs

• The keyword @apptDate.DDMMdyy will now insert the weekday along with the calendar date (e.g. Thursday, September 1, 2022) and exclude the time. 
• Ocean will now immediately recognize when a Cloud Connect module has been changed from being an EMR module to a 'no EMR' module.

The Ocean Server upgrade scheduled for August 11th, 2022 at 9:30 PM EST contains the following  improvements and fixes.

Provider Network

Improvements

• Changes to the UI displayed to Referral Senders when they are redirected to another application to encourage completion of the entire referral flow. 
• Changed the OH eConsult listing page button to “Send Ontario eConsult”.
• Updated the eReferral receiver notification email copy from “eReferral Resent” to “eReferral Resubmitted” and corrected copy for "eReferral Ownership Reclaimed" email to be consistent.
• Added a survey link to the booking notification email sent for patient self-referrals.
• Ocean can now process multiple foci within an inbound HL7 FHIR message.

Fixed Bugs

• Added the capture of the ‘Referral Resubmitted Automatic Email Notification” event to the eReferral Event log.

Patient Engagement

Improvements

• Accessibility improvements to the eForm answer types for dates, numeric scale, and diagram components.

Fixed Bugs

• Added a field for the user to enter the oscar server url when re-authenticating the Oscar toolbar so that it matches the emristanceID already stored in Cloud Connect.

The Ocean Server upgrade scheduled for July 21st, 2022 at 9:30 PM EST contains the following  improvements and fixes.

Provider Network

Improvements

• If the primary care provider that requested an eConsult chooses to 'Proceed with Referral', the (converted) eReferral will now appear in the Specialist's NEW Folder.
• A new setting is now available in the Directory Listing page to specify the default appointment medium for scheduled appointments.
• Added an email notification to notify the Regional Authority clinical administrator/Ocean support when a new listing has been submitted for validation.
• Added a  "Referrals Received by Modality" Section to the weekly Ocean usage report emails.
• Updated the Navigation Menu with the terms "Ocean Provider Network" and an "eReferrals & eConsults" Page.
• Added new HSOs to support Paediatric Centres.

Fixed Bugs

• A notification email will be sent to the receiving site when an appointment update is made by the eReferral sender site, regardless of whether the patient is notified.
• Resolved a bug that caused the "Send eReferral" Button to be disabled when users that are not associated with a Regional Authority (RA) switch in the Healthmap from an RA-assigned service listing to a non-RA listing. 
• The “Preview Appointment Time Options” list in the eReferral Scheduling pane will now display options according to the 24-hour clock when this is the setting selected in the eReferrals > Settings > Configure page.
• Resolved a bug in the Healthmap that appeared when searches based on the patient’s location included a listing result that did not contain sufficient location information.
• Addressed bug preventing the attachments associated with the Notes pane from downloading into Accuro upon referral import.

Patient Engagement

Improvements

• Implemented ARIA hinted button options to make the eForm answer options (e.g. No/Yes, No/Yes/Not Sure, Menu) more accessible. 
• Improved the labeling of eForm inputs to increase readability by screen-readers.
• When a user is being removed from a site, Ocean will now check if they are assigned as a primary delegate to another user and remove them from this role before their site account is deactivated.

Fixed Bugs

• Addressed bug preventing the ability to reverse tab through inputs.
• Addressed a bug that was preventing the patient-facing Online Booking pages from displaying when the browser’s default language was set to a language other than English or French.
• Ocean can now load Med Access schedules that include appointments that are marked ‘Confidential’. 
• Patient message email notifications will now only be sent to the specific user(s) at the site that has set the “Allow reply” option. 
• Fixed the appointment suggestions search in the Online Booking schedule to display results even before an exact match is found.

Platform

Improvements

• By default, sensitive site administration configuration information will be obfuscated, with a toggle to reveal the information.

Fixed Bugs

• .avi, .mov, and .mp4 file types can now be uploaded via our FileUploader.

The Ocean Server upgrade scheduled for June 30th, 2022 at 9:30 PM EST contains the following  improvements and fixes.

Provider Network

Improvements

• Implemented virus scan when attaching EMR files to new eReferrals and when attaching EMR files to existing eReferrals.
• Users with a clinician type of ‘Nurse practitioner’ can now send a CT or MRI eReferral without requiring an authorizing physician.
• The appointment medium will now be displayed to eReferral senders in the Scheduling Pane.
• Open API integrations can now add an outbound authorization service in the Integrations page.

Fixed Bugs

• Updated the method for capturing the referral notification email when an eReferral is sent using the Delegate "Other Referrer" option.
• Referrals forwarded to a standard directory listing at a Central Intake site will now be included in the site's referral analytics.
• Addressed an error caused when users attempt to update a directory listing claimed to the eFax site.
• Addressed an error preventing Referring Providers from being able to save updates in the Scheduling Pane of eReferrals sent via eFax.

Patient Engagement

Improvements

• A single Online Booking appointment type restriction can now be applied to multiple EMR time slots within a single provider schedule.

Fixed Bugs

• The Template Manager > advanced setting > overdue notification will now accept a value of zero (0) or blank.
• Addressed an error causing reminder rule failures for sites that have converted their referral reminder rules to patient reminder rules.

Happy Canada Day!

The Ocean Server upgrade scheduled for May 19th, 2022 at 9:30 PM EST contains the following features, improvements and fixes.

Provider Network

Improvements

• Added a new Health Service Offering "Healthcare Navigation Service".
• Added a new analytic column "integrationName" that captures the name of the API integration bound to a directory listing.
• When an appointment date is submitted with the HL7 FHIR Wait Time extension set to Wait 1a, Ocean will now use that date as the Initial Assessment appointment date for its wait time calculations.
• Added fields to enable a site using the Ocean Open APIs to retrieve its own Public Key that has been encrypted with the one-time-key.
• Added the ability to retrieve a Referral PDF with a cover sheet from the FHIR API. 

Fixed Bugs

• Addressed a bug preventing eConsults that are ‘saved for later’ from being retrieved. 
• Addressed a bug preventing updates made to the phone number field in the Site Admin > Organization page from being saved.
• Addressed a bug affecting eReferral appointment dates when an update is made to them via the HL7 FHIR API.

Patient Engagement

New Feature

• A new Template Manager section is now available from the Ocean Launcher to make it easier to create and manage the templates used in the Patient Messaging and Patient Reminders products.
  • Site admin users now have access to a Template Manager landing page that lists the existing templates and provides a summary of key properties.
  • A new Template Settings page groups all of the global settings relevant to template management into a single location.
  • Every new Ocean site created will have two default templates available in the Template Manager - one targeted for Patient Messaging and the other for Patient Reminders - that can be used immediately by any user or as a content guideline that can be customized. 
  • A new Edit Template pages makes the editing of templates easier and more intuitive.
  • Site admin users can now access a shortcut to the Template Manager from the bottom of the template list appearing in the Patient Messaging dialog.

Improvements

• Implemented translations for key Ocean tablet sign-in and form completion instructions in twelve languages (Tamil, Hindi, Punjabi, Portuguese, Turkish, Spanish, Vietnamese, Korean, Japanese, Filipino, Tagalog, Traditional Chinese).

Fixed Bugs

• Resolved bug causing patient-facing errors when an Accuro schedule interval ends with hour = 24.

The Ocean Server upgrade scheduled for April 28th, 2022 at 9:30 PM EST contains the following features, improvements and fixes.

Provider Network

Improvements

• Revised the increment options listed in the billing time field of eConsult messages to support the Ontario eReferral-to-eConsult workflow. 
• The "Apply to respond to eReferrals as eConsults" feature is now only available to users with the clinician type of “Specialist”, “Family Physician”, or “Nurse Practitioner”.
• Added a new analytic to the main eReferral analytics export that documents which provider sent the latest eConsult message.
• Updated the font of the referral reference ID in the footer of the referral record file format.
• Directory Listings claimed to the eFax Ocean Site will be treated the same as unclaimed listings when ‘carbon copied (cc’ed)’ on a sent eReferral.  (Note: This is only available for the eFax proof of concept project at this time.)
• When an eReferral is sent to the eFax Ocean site, the sender will have the option to have an email notification sent to the patient when updating the Scheduling pane. (Note: This is only available for the eFax proof of concept project at this time.)
• Added an option to the HL7 FHIR "Retrieve Referral Letter PDF" API endpoint to retrieve the referral summary and all attachments as a single consolidated PDF.

Fixed Bugs

• Resolved a bug causing the PSS eReferral custom form to display "Needs Review" for referrals with initial attachments.

Patient Engagement

Feature

• Online Booking is now generally available to (WELL EMR) OSCAR Pro sites. 

Improvements

• Users can now search the Patient Messaging template list using a text-based search feature.
• Improvements in how Ocean manages routing of form completions and patient message notifications when multiple Ocean users at a single site interact with the same patient.
• Added corrective guidance to the Reminder rule configuration page to disallow appointment confirmations when the rule same-day reminder rules.

Fixed Bugs

• The Online Booking edit schedule page will now save multiple alternate configurations at the same time.

The Ocean Server upgrade scheduled for April 7th, 2022 at 9:30 PM EST contains the following improvements and fixes.

Provider Network

Improvements

• Ocean directory listings claimed to the eFax site will display a "Send eReferral via eFax" button and the status updates within the Ocean Portal will reflect that of an eFax (limited to eFax Proof of Concept (PoC) participants)
• eReferrals that have been sent to an eFax directory listing can be updated by the referring provider with the appointment date and time (limited to eFax PoC participants).
• Improved the layout of the Admin > Integrations > eReferrals page and clarified the scope and outcomes of the settings and permissions.
• When an API integration fails, Ocean will immediately send an email notification to the clinical administrator (if populated in the Admin > Site Account > Clinical Administrator field) and after 24 hours of continued failures. 
• When there are multiple recipients of a eReferral HL7 FHIR payload, the referral target will be specified in the MessageHeader.destination field.

Fixed Bugs

• Added text wrapping for the health number and gender fields in the Referral Note PDF. 
• Resolved a bug causing multiple health service offering (HSO) dialogs to open when an site admin user user double-clicked on an HSO. 
• Resolved a bug preventing referrals from closing when launched from the Patient Summary dashboard.

Patient Engagement

Improvements

• The template code description will now be included in the Online Booking appointment summary.

Platform

Improvements

• Ocean now supports the client_secret option during the SMART launch flow "Exchange the authorization code for an access token" step.
• Improvements to the human readability and guidance provided in several Ocean error messages.

Fixed Bugs

• Resolved bug affecting the use of Ocean keywords "ptFamilyDoc" and "ptFamilyDoc.name" with Telus PSS patient records. 
• Ocean will now send notifications of Cloud Connect sync errors over the weekend.

The Ocean Server upgrade scheduled for March 17th, 2022 at 9:30 PM EST contains the following improvements and fixes.

Provider Network

Improvements

• Enhancements to the new multi-factor authentication (MFA) enablement process:
  • The "Disable Two Factor Authentication" Button in the User Account page will be visible, but inactive once the user joins a site that requires MFA.
  • Enhancements to the MFA enablement UI.
• When the eReferral status is updated in Ocean to “Declined” or “Cancelled”, OSCAR Pro (Well EMR) will now move these into its “Completed” consultation status.

Fixed Bugs

•  Removed the ‘Any listing containing’ default when the search button is selected on the Ocean Healthmap.
• Changes to the Referral Note's “referralDescription" item reference will now update the Description of the referral.
• ‘Child’ referrals' currentHealthservice will no longer be updated due to changes to other referrals from the same ‘source’ referral.
• Referral senders will now be redirected to the central intake directory listing of a site regardless of which directory listing they selected in the Healthmap.
• Resolved a bug causing an incorrect row to appear in the weekly Ocean Usage Reports emails for sites that have a self-referral form.
• Changed the Hubly catchment area parsing to Hubly's new data format.
  

Patient Engagement

Improvements

• OSCAR Por (WELL EMR) users can now set where their secure message and eForms notes appear using a new Cloud Connect setting. 
• The “Open” button on the OSCAR Pro (WELL EMR) Ocean toolbar has been replaced with a “Patient Summary” button that will launch into a patient-centred view within the Ocean portal.
• Removed the patient experience survey link at the end of the patient-facing Online Booking flow. 
• Reduced the date range of appointments that will be retrieved when Ocean is applying booking restrictions before presenting Online Booking appointment options to a patient. 
• Improvements to the UI and field validation of the OSCAR Pro (WELL EMR) Cloud Connect setup page.

Fixed Bugs

• Resolved bug causing the user to be automatically logged out from the Ocean portal when their computer’s system clock is ‘fast’ (in the future).

Platform

Fixed Bugs

• The “Remember this device” for the two-factor authentication function for Ocean now works on mobile devices.

The Ocean Server upgrade scheduled for February 24th, 2022 at 9:30 PM EST contains the following improvements and fixes.

Provider Network

New Features:

•  Ocean site administrators can now enable mandatory multi-factor authentication (MFA) for all users invited to their Ocean site. Once enabled, all users without MFA enabled will be prompted to enroll when they receive the invitation to join the site. They will not be granted site access until the MFA has been enabled. 

Improvements:

• The Gender field on eReferral forms is no longer mandatory.
• Recipient sites that are not yet using Ocean fully can now mark their referrals as received and managed externally, completing them within their Ocean site.

• • A disclaimer will appear on the Directory Listing view for the site: “This listing does not update the [eReferral/eConsult] status in Ocean. Contact the listing directly as needed for follow-up.”
• eReferral sites that are designated with a Listing Type of ‘Central Intake’ can now move eReferrals to the 'completed' status via the API.
• Ocean will now resend API messages that have failed (i.e. Ocean has received a response code other than 200) hourly for up to four days.

Fixed Bugs:

• • Resolved bug preventing logos from appearing in the Directory Listing View of sites accepting eReferrals.

Patient Engagement

Fixed Bugs:

• Improved dynamic focus order when navigating through patient facing Online Booking pages. This will ensure that when a user navigates through these pages, their view will automatically be brought to the top of the page.
• Improved how Reminder rules evaluate when the condition includes a provider that has been removed from the EMR.

The Ocean Server upgrade scheduled for February 3rd, 2022 at 9:30 PM EST contains the following improvements and fixes.

Provider Network

Improvements:

• The Status column in the Sent folders of the Portal view has been cleaned up and simplified to match that of the Patient Dashboard view, for ease of sorting and reviewing referrals.
• An “Appointment Type” and “Booked” column has been added to the Sent - Booking folders to allow senders to filter and sort on referrals by booking dates.
• Aligned the Ocean eReferral status mapping with the expanded list of  OSCAR Pro (WELL EMR) Consultation statuses. For example, this includes mapping “Booked - Confirmed” referrals to a new “Booking Confirmed” status in the Oscar consultation, instead of updating the consultation to “Completed” right away.
• Notes added by a referrer within the Ocean eReferral page will now update the new "Notes" section in the OSCAR Pro (WELL EMR) Consultation window.
• eReferrals sent via eFax will appear in the Patient Dashboard view’s Status column as ‘Sent via eFax’ (NOTE: This is only applicable to participants in the eFax pilot at this time).
• The HL7 FHIR eReferral “Notify Update Appointment” API can now be used to remove an appointment.
• The ‘Allow note entry’ configuration setting for API integrations has been updated so that when it is disabled, neither sender or receiver can add a note to the referral.  It has been relabeled as "Allow shared note entry".  
• The "Allow referral note edits" configuration setting for API integrations has been relabeled as "Allow Referral Form Summary edits" for clarity.

Fixed Bugs:

• Addressed bug preventing Regional Authority admin users from viewing the Patient and Provider Survey Link Fields.
• Patient self-referrals will now be counted in the referral analytics.

Patient Engagement

Improvements:

• As part of our Online Booking WCAG AA improvements, patients booking an online appointment will be warned before their session times out. The warning will give the patient the option to continue where they left off. If the session timeout is exceeded, the patient will be redirected back to the check in page.
• Accessibility improvements have been made to the progress bar that guides patients through the Online Booking flow.
• Patients booking online with their browser language set to French will now receive the email notifications for booking confirmations and cancellations in French.
• eForms submitted via Patient Messages, Patient Reminders and Tablets into the OSCAR Pro (WELL EMR) Documents section as Ocean notes will now always be in PDF format. 

Fixed Bugs:

• Resolved bug causing Ocean to send an Oscar appointment confirmation update that incorrectly changed appointment status.
• Resolved bug so that appointments on the last day of the month are retrieved from OSCAR Pro (WELL EMR).
• Trimmed whitespaces that were causing email addresses to be considered invalid when converting from an OSCAR Pro (WELL EMR) Patient into an Ocean Patient.

Platform

Improvements

• Ocean users will now be warned before their session times out. The warning will give the user the option to continue where they left off. If the session timeout is exceeded, they will be redirected the Ocean login page.

The Ocean Server upgrade scheduled for January 13th, 2022 at 9:30 PM EST contains the following improvements and fixes.

NOTE:  The 'eServices' section will now be labeled 'Provider Network'.  Along with eReferral and eConsult improvements and fixes, it will also include new and emerging provider-to-provider capabilities, such as the eReferral via eFax capabilities listed below.

Provider Network

Improvements

• Automatic referral splits will now only send the 'child' referrals via the HL7 FHIR API webhook messages.  Manually split referrals will send both the source and child referrals.

The following improvements are currently only available to participants in the eFax pilot:

• A site can now enable their Healthmap listing to display a “Send eReferral via eFax" Button. 
• When a referral is sent as an eFax via a Central Intake, the intended recipient will be displayed in the eReferral Dashboard’s Provider column. It will also display “Sent via eFax” in the Status column. 
• The carbon copy (cc) function will not appear within the eReferral page for listings receiving eReferrals as via eFax.
• Updated the 'referralSource' analytic field to capture eReferrals sent via eFax.

Fixed Bugs:

• eReferrals will now display a “Please Wait” dialog when various actions are being processed (e.g. when an eReferral is being sent, actions are performed in the eReferral page). 
• Ocean user accounts must now be associated with an Ocean site before they can create an eReferral from the Healthmap. 
• Addressed bug preventing some users from viewing referral attachments that have been uploaded via an API. 

Patient Engagement

Improvements:

• Implemented a WCAG 2.0 AA compliant progress bar in the Online Booking patient-facing pages.
• Replaced several EMR-generated error messages that can appear in the Online Booking patient-facing pages so that they are meaningful to the patient. 
• Online Booking will now prevent the creation of duplicate demographic update notes in Med Access. 

Fixed Bugs:

• Addressed bug causing the caption field to be overwritten by a custom note when using the "Internationalization" feature in the eForm editor.
• Ensured that Online Booking appointment cancellation page displays once the appointment has been successfully canceled  in the EMR.