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Integrations FAQ

Common questions related to Ocean's integrations.

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Can active referrals be resent to an eReferral API endpoint?

Yes, active referrals in Ocean can be resent to a FHIR or Open API endpoint.

This is helpful in the case where an Ocean Site originally received referrals without an integration, but then subsequently configured a FHIR or Open API integration, and would now like to send the referrals received prior to the integration into the newly integrated system.

This functionality is also valuable in the case where a user may want to send an active referral (that may already have engaged the integration) as an update to the integration. This may be because a previous attempt to send an event failed.

  • In the Ocean Portal, open the 'Menu' and select 'Admin'.
  • Select 'Integrations'.
  • In the 'Referral Integrations' table, click the 'Bulk Actions' button for the relevant integration.
  • Click the 'Upload file' button to upload a CSV file (without a header row) containing the referral reference values for the referrals that should be resent to the FHIR or Open API endpoint.
  • Use the dropdown to select an action ("Send as a new referral", or "Send as an updated referral").
  • Click 'Submit'.

  • After submission, a CSV file will be downloaded to your computer that includes the list of referral reference values and whether Ocean can perform the update to it. Ocean will automatically proceed to begin sending the referrals.

    Note: The referrals will be sent in a phased manner so that they do not overwhelm the receiving API endpoint. If a large number of referrals are being actioned, please allow several hours before validating that they have all arrived in the receiving system.

Advanced Notes

  • Only 1000 referral reference values can be uploaded at one time.
  • Patients, referrers, and recipients will not be notified about this new referral event.
  • There is no impact to referral analytics.
  • There is no impact to referral retention/purge timelines.
  • An event will be added to the Event Log within the referral to indicate that the referral has been ‘resent’ via the webhook.
  • Ocean will avoid resending a duplicate referral on behalf of a listing that is feeding a Service Request Repository.
  • Ocean will include all of the existing appointment info and/or messaging that has been sent between providers to-date as part of either the 'Send as a new referral' or 'Send as an updated referral' actions.
  • The add-service-request ServiceRequest will contain the original date that the referral was received so that the chronological order is maintained

Is there an authorization process for systems to connect/integrate with Ocean for clinical, administrative, or analytic purposes?

Each Ocean Site has the ability to integrate their Point-of-Care systems with Ocean in a 'self-serve' manner. When an Ocean Site Admin adds the integration authorization and API endpoints to their Ocean Site configuration in this self-serve manner, they are authorizing that system. There is no direct communication with the Point-of-Care system vendor or separate approval by Ocean.

What EMR field does Ocean use for Alternate ID?

When configured to authenticate patient access using an Alternate ID, Ocean uses the EMR fields indicated below:

Note: While Ocean does have the ability to access an Alternate ID stored in an existing patient's chart in the EMR, it does not have the ability to modify the Alternate ID or create brand new patient charts using an Alternate ID.

PS Suite Med Access Accuro OSCAR Pro
  • In PS Suite, the Alternate ID value must be stored in the 'Chart number' field within the patient chart.

Privacy and Security Disclaimer

Ocean typically authorizes patients for certain actions using a combination of their health number, name, and date of birth. This authorization is reasonably secure due to the inherent privacy of the patient’s health number.

Since health numbers are not always available in certain clinical environments, your site may opt in to support an alternate identifier, such as a student number or chart number.

These alternate identifiers should be relatively private and difficult to guess for a given patient. Otherwise, unauthorized individuals could potentially masquerade as the patient using this identifier, in combination with the patient’s surname and date of birth.

The unauthorized individual could potentially exploit this access to:

  • Obtain the patient’s email address or other contact information as part of a privacy breach.
  • Commit unauthorized actions under the guise of the patient, such as booking an appointment.

When configuring Ocean products to support an alternate identifier, you will be prompted to confirm on behalf of your clinic that you understand and accept the risk of using an alternate identifier.

Which EMR demographics are not automatically updated by Ocean?

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.

PS Suite Med Access Accuro OSCAR

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.

Does Ocean work with Avaros EMR?

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.

How can I display Ocean Patient Reference Numbers in my appointment scheduler?

For all supported EMR integrations, Ocean has the ability to display the Ocean Patient Reference Number in the scheduler for patients that have eForms available to be completed. This gives clinics the flexibility to conveniently track patients that have to fill forms for their appointment and to unlock staff-initiated tablets upon the patient's arrival.

Prerequisite: Your site must be integrated with Ocean Cloud Connect.

    • 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.

Note: The Patient Reference Numbers will not appear for existing patients with pending eForms in their queue. To have their Patient Reference Number display in the scheduler, you must manually add an eForm to the patient's queue after enabling this feature.

Why was my Cloud Connect server deauthorized?

  

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.

How do I sync a new provider schedule into Ocean?

If a provider recently created an Ocean account, you may notice that their EMR Schedule does not appear to be syncing in Ocean. If this is the case, please follow the instructions below.

  • Click on the dropdown menu for "Sync Appointments for Provider(s)" and enable the EMR Schedule within the list.
  • Click "Save".
  • To ensure the EMR Schedule is synchronized, open the dropdown menu within the 'Sync Status' panel and click "Sync Full Schedule".

My notes aren't appearing in my patient's chart. What do I do?

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).

  • Login to the Ocean Portal. If you aren't already in the Patients view, click the "Menu" button in the top left corner and select "Patients". Find the patient who's notes have not automatically downloaded into their chart in your EMR.
  • Click on the patient and select "Reset Downloaded Status for Notes", from the "Advanced" menu.
  • Go back to the patient's chart in your EMR. The note should automatically download correctly into the patient's chart. If you the patient has filled out some other forms recently, there may be some duplicates notes that get downloaded.

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.

What situations cause note downloads to fail?

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

If network connectivity issues cause the internet to drop out, run slowly, otherwise not operate consistently, this can temporarily inhibit the EMR from downloading information until the connection has stabilized. This is especially true for EMR instances that are locally hosted, as information is stored 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.

Resolving this issue requires staff to follow the steps in the Re-authenticate Cloud Connect guide.

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.

To correct this, staff will need to set patient’s charts to be public/un-masked to allow for access for the API user that has been configured in the EMR. (Please consult with your EMR vendor for the correct settings and configuration of chart status.)

Why do extra notes sometimes download into the patient chart from the previous visit?

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).