Cloud Connect

Ocean Cloud Connect is a secure, cloud-based application housed on a server independent of the Ocean Platform. Cloud Connect’s primary purposes include the following:

1. Storing and safeguarding your Ocean Site’s Shared Encryption Key (applicable to all Ocean Sites).
2. Enabling the secure exchange of data between your Ocean Site and your EMR (for Ocean Sites with an integrated EMR).
3. Facilitating automated Patient Reminders and Patient Alerts (for sites using Patient Reminders, eReferrals, or eConsults).

Storing Your Site’s Shared Encryption Key (SEK)

• Ocean Cloud Connect acts as a secure vault for all Ocean Sites, providing a secure and convenient way to store your SEK.
• Access to Cloud Connect is limited to Ocean Site Admin users only, with all interactions subject to auditing and logging. Furthermore, any access to the SEK through Cloud Connect triggers an automated email alert to the Ocean Site’s Clinical Administrator.

Enabling the Secure Exchange of Data Between Ocean and Your EMR

• Cloud Connect acts as a data bridge connection between Ocean and your EMR, using the SEK to encrypt and decrypt PHI, as needed, to facilitate the exchange of information between Ocean and your EMR while using SSL for secure data transmission.
• Cloud Connect provides configuration options to allow a site to customize how Ocean interacts with the EMR (e.g. combining progress notes from multiple Ocean eForms or selecting specific providers' appointments to sync).
• Cloud Connect receives EMR-bound messages in real-time, ensuring that these messages are handled and processed all at once (e.g., when a patient completes a questionnaire, the result is immediately downloaded and sent to the EMR). In the event of an EMR connectivity issue, Cloud Connect also uses a “message queue” so that EMR actions can be retried in a timely manner, while protecting against data loss.

Facilitating Patient Alerts

• Cloud Connect allows Ocean Sites to enable patient alerts or reminders that are automatically delivered to the patient on a scheduled basis.

About Ocean Cloud Connect

If you use an integrated EMR, Ocean Cloud Connect enables total configuration of your EMR integration from a secure instance in the cloud that is accessible from any internet-connected device. No on-site device acting as a server is needed to keep Ocean and your EMR synchronized and active.

If your EMR does not have an integration with Ocean or you do not use an EMR, Ocean Cloud Connect can still be used to safely store your Ocean Site's Shared Encryption Key. This enables you to take advantage of additional Ocean functionalities, including automatic appointment reminders based on booked eReferral appointment dates.

Setting Up Ocean Cloud Connect

1. Log in to Ocean Cloud Connect.

   • Navigate to cloudconnect.cognisantmd.com in a web browser.
   • Go to Cloud Connect
   • Log in using your existing Ocean user account credentials. This is the same Ocean user account that you use to log in to the Ocean Portal.
   • 
   • Note: Despite using the same Ocean user account credentials, you must log in to Cloud Connect seperately. Being signed into the Ocean Portal does not automatically sign you into Cloud Connect (or vice versa).

2. Store your Shared Encryption Key in Cloud Connect.

   Integrated EMRs (PS Suite, Med Access, Accuro, OSCAR Pro) Non-Integrated EMRs

   • After logging in to Ocean Cloud Connect, click the 'Integrate my EMR' button.
   • 

   • You will be prompted to enter your Shared Encryption Key. After entering it, click 'Save and Continue'.
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   • After logging in to Ocean Cloud Connect, click the 'Store my Encryption Key' button.
   • 

   • You will be prompted to enter your Shared Encryption Key. After entering it, click 'Save'.

     At this point, your Shared Encryption Key has been successfully saved in Ocean Cloud Connect.

     Skip to Step 6 below to complete the final step of enabling Cloud Connect within your Ocean Site.

   • 

3. Setup Your EMR Integration.

   • After storing your Shared Encryption Key, select the EMR type you would like to integrate and then click 'Next'.
   • 
   PS Suite & Med Access Accuro OSCAR PRO

   • Acquire your EMR Instance ID and EMR Secret credentials by configuring your Ocean integration module.

     See module configuration instructions for PS Suite or instructions for Med Access.

   • 
   • Once entered, the Ocean and TELUS servers will connect to authenticate the integration.

   • Click on the "Connect with Accuro" button.
   • 

   • Enter the following details, supplied to you by QHR:

     • Tenant ID (ALL CAPS)
     • API username
     • API password
     Reminder: If you are connecting multiple Ocean sites to the same EMR instance, please ensure QHR has provided you unique API usernames and passwords for each site before proceeding.
   • 

   • Select "Log in" and then approve Ocean's third party access to the Accuro API.

     The Ocean and Accuro servers will then connect to authenticate the integration. This may take a few seconds to initialize.

   • 

   • To finalize your integration, enter your UUID (also supplied by QHR) and select "Save and Continue".
   • 

   Log Out of OSCAR Pro

   Please Note: Before proceeding, ensure that you are fully signed out of your OSCAR Pro EMR in any other browser windows or tabs. We recommend clicking the 'Log Out' option in the top right of the EMR to ensure the session is fully signed out.

   • In the 'OSCAR Credentials' window, enter your OSCAR Server URL, Client Key, and Client Secret. Enter the OSCAR username and password for the newly created "Ocean Connect" user you created in step 3.

     Note: Ensure that your OSCAR Server URL includes your EMR directory (e.g., the '/oscar' or equivalent component at the end of the URL).

     Please also ensure there is no trailing slash at the end of the server URL - i.e. /oscar is correct, while /oscar/ is incorrect.

   • 

   • Enter the username and password for the 'OceanConnect' EMR user that you created earlier.

     Please do not enter your personal EMR login credentials into these fields. If your browser pre-fills these fields with your personal details, please fully erase those values and enter the proper “OceanConnect” EMR user credentials.

   • Once all credentials have been entered, click the blue 'Connect with OSCAR' button.

   • On the following screen, please re-enter your “OceanConnect” details, in addition to the pin number, and sign in.

     You will be brought to a page where you will be asked to confirm Ocean's request to access your OSCAR EMR. Ensure the box next to EMR Access is checked. Click the blue 'Authorize Ocean' button.

   • A window will prompt that you have successfully authenticated with OSCAR. Click 'Save and Continue'.

Configure your Cloud Connect settings.

• Note: If your clinic does not accept walk in patients, you can safely ignore the fields under the "Walk In" section of the configuration. For more information about walk ins, please consult our guide: Set Up Ocean to Support Walk-In Patients.

1. Configuration is complete!

   • You will now return to the main summary screen.
   • The "Sync Status" panel on the left will show you if Ocean is synchronizing appointments with your EMR via Cloud Connect, when the last synchronization occurred, and when the next synchronization is scheduled for (full syncs will automatically occur once a day at midnight and appointment syncs will occur automatically every 30 minutes).
   • 
   • Once an initial sync has completed, feel free to verify patients are being uploaded correctly by signing into the Ocean Portal, click the Menu button in the top left corner and click Patients.
   • If there are any errors with the configuration, an alert will be displayed on the main summary screen, in the "Sync Status" panel. If this occurs, try clicking the arrow button next to "Sync Recent Appointments" and select "Sync Full Schedule". If the issue persists, contact the OceanMD Support team.
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2. Ensure that Cloud Connect is enabled in your Ocean Site.

   • Log in to the Ocean Portal using your Ocean user account credentials.
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   • Open the 'Menu' in the top left corner and click 'Admin'.
   • 
   • From the Admin Settings page, click 'Site Features'.
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   • Ensure that the 'Enable Ocean Cloud Connect' checkbox is enabled.

     Note: Ocean Sites with Non-Integrated EMRs will need to manually enable this checkbox. Ocean Sites that have completed an EMR integration will have this checkbox enabled automatically.

   • 

For instructions on how to set up Cloud Connect, please consult the full Setting Up Ocean Cloud Connect guide.

If at any time you need to make adjustments to your Cloud Connect configuration, you can click the "Edit Settings" button located under the "Sync Status" panel on the Cloud Connect dashboard.

PS Suite Med Access Accuro OSCAR Pro

General

Schedule Days to Sync

This setting will configure the number of days to sync appointments in Ocean's Day Sheet view. For most clinic environments, the default value of 1 day is sufficient.

Note: More internet bandwidth is required for longer time intervals for appointment synchronization.

Sync Appointments For Provider(s)

Ocean will automatically source a list of providers from your EMR and display them in the dropdown menu. Ensure that all providers who are using Ocean are selected within the dropdown menu to ensure that they are synchronized in Ocean.

Mark appointments as Arrived in the next(hours)

This field allows you to define the time range after a patient checks in at the kiosk, in which you'd like to mark their appointment(s) as arrived (e.g. if you set this to 2 hours, any appointments that a patient is booked for, within 2 hours of them checking in at the kiosk, will be flagged as arrived).

Clinical Notes

Combine Progress Notes

If this checkbox is checked off and a patient fills out multiple Ocean eForms in one sitting, all resultant notes from those eForms will go into one single note in the patient's chart in PSS (vs. each form creating a separate note in the patient's chart).

Automatically Import Attachments to EMR

This is an early access feature that enables Ocean to automatically import Website Form submissions, file attachments included in Patient Authenticated Website Form submissions, and eReferral/eConsult records directly into the patient's chart in PDF format. If you are interested in joining the early access program, please contact the Ocean Support team.

Walk In

All walk in settings

To learn how to set up your kiosk to accept walk-ins, please refer to Set Up Ocean to Support Walk-In Patients.

General

Schedule Days to Sync

This setting will configure the number of days to sync appointments in Ocean's Day Sheet view. For most clinic environments, the default value of 1 day is sufficient.

Note: More internet bandwidth is required for longer time intervals for appointment synchronization.

Sync Appointments For Provider(s)

Ocean will automatically source a list of providers from your EMR and display them in the dropdown menu. Ensure that all providers who are using Ocean are selected within the dropdown menu to ensure that they are synchronized in Ocean.

Mark appointments as Arrived in the next(hours)

This field allows you to define the time range after a patient checks in at the kiosk, in which you'd like to mark their appointment(s) as arrived (e.g. if you set this to 2 hours, any appointments that a patient is booked for, within 2 hours of them checking in at the kiosk, will be flagged as arrived).

Clinical Notes

Combine Progress Notes

If this checkbox is enabled and a patient fills out multiple Ocean eForms in one sitting, all resultant notes from those eForms will go into one single task note in the patient's chart in Med Access (vs. each form creating a separate task for each Ocean eForm completed).

Automatically Import Attachments to EMR

This checkbox is enabled by default, and ensures that Website Form submissions, file attachments included in a Patient Authenticated Website Form submission, and eReferral/eConsult records with their respective file attachments will be automatically imported into the EMR in PDF format. It is strongly recommended to keep this setting enabled.

Please note that it is important to understand the impact of disabling automatic attachment imports, particularly for eReferrals. eReferral users should keep the checkbox enabled to ensure that they receive referral attachments.

Note Status

Control whether certain Ocean notes will import into Med Access as Active or Completed tasks. See Ocean Note Tasks for more detailed information.

Walk In

All walk in settings

To learn how to set up your kiosk to accept walk-ins, please refer to Set Up Ocean to Support Walk-In Patients.

Verify the 'Document From Field' in Accuro is Enabled

• Before configuring how Ocean notes are saved into Accuro, please verify that Ocean has sufficient permission to access Accuro Document folders by:

  Accuro Crosshair menu > Users > Manage Security > System Settings > General > EMR Settings sub-heading > verify 'Enable Document From Field' is enabled.

  Press 'Save Settings'.

• 

General

Schedule Days to Sync

This setting will configure the number of days to sync appointments in Ocean's Day Sheet view. For most clinic environments, the default value of 1 day is sufficient.

Note: More internet bandwidth is required for longer time intervals for appointment synchronization.

Sync Appointments For Provider(s)

Ocean will automatically source a list of providers from your EMR and display them in the dropdown menu. Ensure that all providers who are using Ocean are selected within the dropdown menu to ensure that they are synchronized in Ocean.

Note: If additional providers start using Ocean in the future, ensure that you enable them within the dropdown menu and Update the Accuro Provider Permissions for the 'OceanAPI' EMR User to include the new provider(s).

Sync Appointments For Office(s)

Ocean will automatically provide a list of Accuro Offices from your EMR. This setting allows you to further filter or exclude certain Offices, if needed.

Mark appointments as Arrived in the next(hours)

This field allows you to define the time range after a patient checks in at the kiosk, in which you'd like to mark their appointment(s) as arrived (e.g. if you set this to 2 hours, any appointments that a patient is booked for, within 2 hours of them checking in at the kiosk, will be flagged as arrived).

Clinical Notes

Combine Progress Notes

If this checkbox is checked off and a patient fills out multiple Ocean eForms in one sitting, all resultant notes from those eForms will go into one single encounter note in the patient's chart in Accuro (vs. each form creating a separate encounter for each Ocean eForm completed).

Letter Type

Select the letter type that all Ocean-generated Encounter Notes will enter as in Accuro. Letter types are customizable in Accuro by using the Template Wizard (Tools > Template Wizard > Manage Option in the Type selection list at the top center of the Template Wizard screen).

The letter type is shown under the 'Type' column in the patient's Virtual Chart, and in the 'Type' field at the bottom of the Encounter Note window. If you create new letter types in Accuro, they will appear as a selectable option in the dropdown list in Ocean.

Save secure message note as

Control where secure messages to and from patients are imported to in Accuro.

When set to 'Documents', messages sent to from patients (and any patient-submitted file attachments) will be imported into Accuro as Documents and be categorized into the specified document folder/sub-folder.

When set to 'Encounter Notes', typed messages to and from patients will be imported as Encounter Notes and categorized using the 'Letter Type' specified above. Any patient-submitted file attachments will be imported as a Document and be categorized into the specified document folder/sub-folder.

Note: For insight on optimally configuring folder/sub-folders in Accuro, please refer to the bottom of Configuring Cloud Connect Document Folders for the Ocean Health Messenger.

Custom Fields

Use Custom Fields

Use this checkbox if you are planning to map any Ocean eForm fields to Accuro custom fields (e.g. custom demographics, lab values). For more about custom fields, please refer to: Mapping Answers from an Ocean eForm to a Custom Demographics Field.

Ocean Reminders

Appt Reminder Sent Custom Status Name

Optional. If you created a custom status in Accuro to identify when an Ocean reminder has been sent, you must enter the custom status verbatim in this field. Refer to Set Your Custom Status in our Accuro set up guide for more information.

Walk In

All walk in settings

To learn how to set up your kiosk to accept walk-ins, please refer to Set Up Ocean to Support Walk-In Patients.

Referrals

Note: It is important to understand the impact of selecting Encounter Notes vs Documents, particularly for eReferrals. eReferral users should select the Documents option to ensure that referral attachments are imported into Accuro.

Save Sent Referrals as

Control where sent referrals will save in Accuro. When "Documents" is selected, you must specify an Accuro document folder, and you will have an option to select a subfolder.

Save Received Referrals as

Control where received referrals will save in Accuro. When "Documents" is selected, you must specify an Accuro document folder, and you will have an option to select a subfolder.

Automatically assign Referral Documents to providers in Accuro

Controls if Ocean will automatically assign the Document Provider in Accuro for referral documents imported into the EMR when the 'Save Sent/Received Referrals as' settings are set to 'Documents'. For more information on this functionality and assignment logic, please refer to Accuro Automatic eReferral Document Assignment.

When enabled, you can optionally specify a 'Fallback Provider' for Ocean to use in the case that provider matching is unsuccessful.

Website Forms

Save Website Forms as

Control where Website Form submissions will save in Accuro. If Documents is selected, you must select a folder and you will have an option to select a subfolder.

General

Schedule Days to Sync

This setting will configure the number of days to sync appointments in Ocean's Day Sheet view. For most clinic environments, the default value of 1 day is sufficient.

Note: More internet bandwidth is required for longer time intervals for appointment synchronization.

Sync Appointments For Provider(s)

Ocean will automatically source a list of providers from your EMR and display them in the dropdown menu. Ensure that all providers who are using Ocean are selected within the dropdown menu to ensure that they are synchronized in Ocean.

Mark appointments as Arrived in the next(hours)

This field allows you to define the time range after a patient checks in at the kiosk, in which you'd like to mark their appointment(s) as arrived (e.g. if you set this to 2 hours, any appointments that a patient is booked for, within 2 hours of them checking in at the kiosk, will be flagged as arrived).

Clinical Notes

Save secure message notes as:

Control where Secure Messages to and from patients will save in OSCAR Pro. If Documents is selected, the note will be imported as a PDF Document into the patient's chart. If Encounter Notes is selected, the note will be imported into the Encounter Notes area of the patient's chart.

Save eForm notes as:

Control where completed eForm notes save in OSCAR Pro. If "Documents" is selected, the note will be imported as a PDF Document into the patient's chart. If "Encounter Notes" is selected, the note will appear in the Encounter Notes are of the patient chart in plain text without font, colours, or formatting.

EMR Attachments

Enable OSCAR Pro Attachment Manager

This setting must be enabled to allow OSCAR Pro to Create PDF Attachments to Add to a Secure Message in Ocean.

Walk In

All walk in settings

To learn how to set up your kiosk to accept walk-ins, please refer to Set Up Ocean to Support Walk-In Patients.

There are a few instances where you may need to return to Cloud Connect to make changes to your configuration:

• Your EMR configuration changes
• Your Secure Encryption Key has changed
• EMR authentication has expired (i.e. PS Suite Mobile Activation Code)

If Cloud Connect detects an error with your setup, the email address specified as the Clinical Administrator Email for your Ocean site (located in the Admin Settings page under "Site Account" in the Ocean Portal) will be notified immediately, informing them to make the necessary changes.

If no Clinical Administrator Email has been defined, the user that created the Ocean site will be notified via email.

Common Issues

“Cloud Connect credentials are not working.”

“Cloud Connect is not syncing.”

“Appointments are not syncing.”

“Cloud Connect has been deauthorized.”

“Specific provider’s appointments are not syncing."

Diagnosis Questions

Please follow the instructions below if you need to update and re-authenticate your EMR's Cloud Connect API connection. This should take no longer than 5 minutes to complete.

Re-Authenticating Ocean Cloud Connect

1. Sign in to Ocean Cloud Connect.

   • Go to Ocean Cloud Connect in a web browser.
   • Go to Cloud Connect
   • Sign in using your Ocean credentials (i.e. the same credentials as the Ocean Portal).
   • 
   • Once you've logged in to Cloud Connect, you’ll be able to connect Ocean with your EMR. Click the white "Reconfigure EMR" button under the EMR Integration section to begin.

2. Re-Authenticate your EMR integration.

   • Select the EMR you would like to integrate with and then select “Next”.
   • 
   PS Suite & Med Access Accuro OSCAR PRO

   AML Activation Mobile Activation (Legacy)

   • Acquire your EMR Instance ID and EMR Secret credentials by configuring your Ocean integration module.

     See module configuration instructions for PS Suite or instructions for Med Access.

   • 
   • Once entered, the Ocean and TELUS servers will connect to authenticate the integration.

   Please refer to these instructions only if you have specifically been directed to do so by CognisantMD Support.

   • Enter your Mobile Activation Code.

     If you are unaware of how to acquire a Mobile Activation Code, please refer to our Instructions for PS Suite or Instructions for Med Access.

   • 
   • Note: Please select “Copy Manual Code" when copying the code from your EMR to Cloud Connect to ensure that the code is copied correctly and in a format that is acceptable to Cloud Connect.
   • Once entered, the Ocean and TELUS servers will connect to authenticate the integration.

   • Click on the "Connect with Accuro" button.
   • 

   • Enter the following details, supplied to you by QHR:

     • Tenant ID (ALL CAPS)
     • API username
     • API password
     Reminder: If you are connecting multiple Ocean sites to the same EMR instance, please ensure QHR has provided you unique API usernames and passwords for each site before proceeding.
   • 

   • Select "Log in" and then approve Ocean's third party access to the Accuro API.

     The Ocean and Accuro servers will then connect to authenticate the integration. This may take a few seconds to initialize.

   • 

   • To finalize your integration, enter your UUID (also supplied by QHR) and select "Save and Continue".
   • 

   • Enter your OSCAR Server URL, Client Key, Client Secret. Enter the OSCAR username and password for the "Ocean Connect" user you created in step 3 of your initial EMR integration.

     Note: Ensure that your OSCAR Server URL includes your EMR directory (e.g., the '/oscar' or equivalent component at the end of the URL).

     Ensuring that you are fully signed out of your OSCAR EMR in any other browser tabs, click Connect with OSCAR.

   • 

   • You will be brought to a page where you will be asked to confirm Ocean's request to access your OSCAR EMR. Ensure the checkbox next to EMR Access is checked. Click Authorize.

   • A window will prompt that you have successfully authenticated with OSCAR. Click Save and Continue.

Re-configure your Cloud Connect settings.

1. Re-configuration is complete!

   • You will now return to the main summary screen.
   • From here, all of your Ocean services should continue to work seamlessly. If you experience any issues with your appointment synchronization, please feel free to reach out to us.

When setting up the Ocean integration with your EMR, please feel free to make use of the applicable Ocean Credentials Reference Card to keep track of all relevant site and integration details.

This file can be securely stored on a network drive at the clinic and/or printed off for reference so relevant staff have access to all Ocean credentials in case of an emergency.