EMR Integrations FAQ

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

To check this, follow the instructions below:

Protected Fields

While Ocean allows patients to update their demographic information through Ocean eForms, there are certain protected fields across all EMRs that will not be automatically updated by Ocean as a safety precaution. These fields are:

• First Name
• Surname
• Health Number
• Birth Date
• Sex

These fields are considered patient identifiers which should rarely or never change. As a result, changes to these fields warrant a manual review by clinic staff to ensure that the change is intentional. An exception to this is if the protected field in question is initially blank. In that case, the new information would populate into the field as expected.

In the case of a patient requesting a change to one of the fields listed above, Ocean does not update the protected field directly; however, an additional Ocean note is generated in the patient chart noting the change request. This indicates to clinic staff that a manual review and update is required in order to change the demographic fields in the chart. An example of such a note is provided below.

Updating Other Fields in the Patient Record

The ability to automatically update other fields in the patient record, including the cumulative patient profile, varies by EMR. For additional information on the behaviour of specific fields within an EMR, please see the support articles below.

• PS Suite: List of Ocean Keywords and Associated EMR Fields
• Med Access: List of Ocean Keywords and Associated EMR Fields
• Accuro: List of Ocean Keywords and Associated EMR Fields
• OSCAR Pro: List of Ocean Keywords and Associated EMR Fields
• OSCAR (Legacy): List of Ocean Keywords and Associated EMR Fields

Avaros EMR has implemented APIs that have been made freely available to the OSCAR open source community, providing connectivity to the Ocean Platform. With this integration, Avaros users can take advantage of Ocean’s Provider Network Tools (eReferrals and eConsults) as well as Ocean’s Patient Engagement Tools.

It is important to note that Avaros is not currently a reseller partner or an officially supported EMR. As a result, Ocean Practice Consultants are not equipped to provide onboarding support for Avaros EMR configuration.

Avaros EMR users are welcome to take advantage of our extensive knowledge base which offers comprehensive support guides for all of our products. We recommend that Avaros users refer to the OSCAR Pro-specific resources for the closest user experience.

If you are an Avaros EMR user and you require additional assistance, please contact the Avaros support team.

Ocean allows patients to submit their contact information using a tablet, kiosk, or online form. When connected to an integrated EMR, this contact information is usually automatically inserted into the demographic section of the patient chart. For example, a mobile phone number can be updated automatically and inserted in the appropriate area in the "Patients" window.

However, as a safety precaution, Ocean will not change the following fields automatically if they are already populated:

• Surname
• First name
• Health number
• Birth date
• Sex

These fields are left as-is to avoid the unintentional overwrite of a chart, which could potentially lead to difficulty finding it later.

Instead, the Ocean custom form sends a message to the clinic's secretary group instructing them to update the field manually (after ensuring the change is appropriate).

PS Suite uses the special target "secs" as the initials of the default secretary group, which ensures the message shows in the inbox of all clinic secretaries. 

To change this default message group:

• Click on the Settings button of the Ocean custom form:
  • 
• Sign in to Ocean if you are prompted to do so.
• Click "Advanced..."
  • 
• Change the "Secretary Message Group" to the initials of the desired secretary user
  • 

Why are my initials on this message?

Due to a security restriction, PS Suite forces all messages to be associated with the user account signed in. If a user with "abc" happens to open the chart, it will trigger the message and PS Suite will automatically assign "abc" as the sending user.

• To enable this feature, sign into the Ocean Portal > Admin > Site Features.
• 
• Click the checkbox for "Show Ocean Reference # in your EMR schedule when Forms are manually queued" to enable.
• Save your changes.

You may have received an email notifying you that your Cloud Connect configuration has been de-authorized. A common cause is due to EMR vendors conducting maintenance to ensure our clients with a secure and stable Ocean API connection. Cloud Connect may also be de-authorized manually by an admin user from the Cloud Connect portal.

To re-authorize your Cloud Connect configuration, please refer to this support guide: Re-Authenticating Ocean Cloud Connect.

1. Sign into Cloud Connect and click "Edit Settings".
2. Click on the dropdown menu for "Sync Appointments for Provider(s)" and select the new provider's name from the list.
3. Click "Save".
4. To ensure the provider's appointment schedule is synced, click on the "Sync Recent Appointments" dropdown and select "Sync Full Schedule".

In the rare circumstance where a patient's notes haven't automatically downloaded into the patient's chart, you can follow the steps outlined below to manually restore and re-download this patient's note(s).

Note: If you are a PS Suite user, you may see a "Download" button appear on your Ocean toolbar and/or Ocean custom form. You may click this button to initiate the note to download immediately.

After patients complete their Ocean session, be it via tablet or secure online message, the resulting notes sync into Ocean before being downloaded into your EMR.

In rare instances, circumstances may arise where Ocean is unable to transfer the patient’s notes to the EMR.

Below are some common issues that can inhibit download notes and how to address them:

Connectivity issues on the clinic’s network

Please consult with IT staff or network administrators at the clinic to ensure there are no problems with network stability and the local EMR instance.

Ocean Cloud Connect has become de-authorized

If Cloud Connect becomes de-authorized, Ocean no longer has a connection to your EMR and is unable to send information to the applicable chart. If this has occurred, Ocean will send an automated system message to site administrators alerting them to this problem.

Patient charts are marked as “Private” or “Masked”

If a chart has been marked as “Private” (PS Suite) or “Masked” (Accuro), access to the patient is effectively locked and Ocean is unable to download notes into the chart.

For sites using OSCAR or the legacy (non-API) use of the Ocean custom form in PS Suite, there are some instances where Ocean can appear to be malfunctioning by downloading notes from a previous visit for a patient.

This general problem can be triggered with the following user flow:

• A patient uses the tablet and finishes with it.
• Someone opens the chart in the EMR to download the notes.
• At the end of the day, a clinic user takes the leftover tablet and presses "Back" multiple times to scroll through the patient's forms to get back to the home screen (or presses "Next" to finish off the patient's session).
  • This extra edit to the patient's form will save another copy of the patient's note, which triggers Ocean to queue a re-download request for the note's answers (in case anything of clinical significance has changed).
  • Since the chart isn't re-opened, the unwanted extra note is sitting in Ocean awaiting download; without an external API enabled via Ocean Connect / Cloud Connect, the note cannot download without the chart opening.
• In a future visit, the chart is finally re-opened. This allows the Ocean custom form to check for any pending downloads. Consequently, it finds the extra note from the last visit and downloads it under today's note.
• If the tablet session for the patient on this new visit doesn't reach the final "Please return this tablet" screen, Ocean won't automatically download because it's expecting more updates to the form(s).

This is a temporary note generated by Ocean. Use the Ocean Toolbar to import the following information into PSS. @OceanData: -
Ocean Data Awaiting Import: { "tobaccoUseUpdate" : {"cigsPerDay":"15-20","smoker":"Y"}, "alcoholUseUpdate" : {"drinksPerWeek":"5-8”}}

The above note is generated by Cloud Connect when it sees a field update request for one of the fields that the API does not support. This note contains the value of the field in a structured format, which is needed for the Ocean Toolbar to set the field value in PS Suite directly.

Therefore, the Ocean Toolbar (or the "Ocean Toolbar - Minimized" toolbar) must be visible in the patient's chart in order for the temporary note to successfully be converted into an automatic PS Suite update.

To ensure that your Ocean Toolbar is installed and visible in your PS Suite, please refer to: "Download and Install the Ocean Custom Form and Toolbar" and "Create a Reminder Trigger for the Ocean Toolbar".

To learn more about the limitations of the TELUS API, please refer to: "Limitations of the New TELUS API and Workarounds Using the Ocean Toolbar".

Troubleshooting

If you see an Ocean Temporary Note that doesn't immediately (or nearly immediately) disappear, please check the following:

• Ensure that you have installed the latest version of the Ocean Toolbar.
• Ensure either the Ocean Toolbar (Standard) or Ocean Toolbar (Minimized) is not only installed but also activated (visible) within the current patient's chart (see above for details).
• Confirm that the patient chart is not "checked out" on another computer (e.g. another user or another terminal has made edits to the chart without finishing)
• Try closing and re-opening the patient chart.

If the previous tips do not solve the issue, please copy and paste the entire contents of the Ocean Temporary Note and send it to our support team (after you have selectively removed any personal health information).

This issue currently seems to be affecting PS Suite users only. If you are using another EMR and require assistance, please contact our support team directly at ocean.tips/support.

We have received reports from some clients that information collected via Ocean Tablets has been generating duplicate (or even triplicate) notes in the patient's chart. As we continue to investigate this issue, we ask anyone experiencing this issue to first check the following:

1. Make sure the patient's chart is not open in PS Suite while the patient completes Ocean forms.

Occasionally this may cause issues with Ocean's automatic updating of the patient's chart in the EMR.

2. Enable OceanConnect mode in the Ocean Custom Form.

You will want to make sure OceanConnect mode is activated within your EMR so there is consistent communication between your tablets and PS Suite.

For instructions on correctly enabling Ocean Connect, please follow the steps outlined in: "Enable OceanConnect on Your Ocean Custom Form".

3. Ensure that you have the latest version of the Ocean Custom Form and Ocean Toolbar.

There was a timing issue in one of the older versions of the Ocean Custom Form, that was resulting in occasional duplication of notes. As a result, you will want to ensure that you are running at least v3.96 of the Ocean Custom Form and v5.11 of the Ocean Toolbar.

You can download the latest versions of the Ocean Custom Form and Ocean Toolbar in: "Download & Install the Ocean Custom Form and Toolbar".

4. Refrain from clicking the "Download" button on the Ocean Toolbar.

The Ocean Toolbar may display the "Download" button ahead of its normal automatic upload of patient information into the EMR. Clicking this "Download" button may cause Ocean to prematurely pull new data before OceanConnect has a chance to automatically download this same data, causing duplication of notes to occur when the automatic download does occur.

5. Refrain from inserting the Ocean Custom Form into the patient's chart.

If you were using Ocean prior to January 2018, you would have needed to insert the Ocean custom form into patients' charts to trigger their notes to download. It's important to note that the new connection to the TELUS API no longer requires you to do this. As a result, you will want to avoid clicking the Ocean logo on the Ocean Toolbar because this can trigger a note download, in a situation similar to above (#4), also resulting in multiple note entries.

In order to generate and obtain the Ocean patient reference number needed for a patient to complete their forms on a tablet, the patient must be first uploaded into Ocean. Patients are uploaded into Ocean from OSCAR by loading the Ocean eForm for that patient.

You can load the Ocean eForm for a patient in OSCAR from the Appointment Schedule or the Encounter screen.