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OCEAN Toolbar

UpdatedOctober 5, 2022
By Peter Hutten-CzapskiKevin Lai

Preface

These are some notes on getting CognisantMD’s Ocean installed and working on your OSCAR.

Document Version History

  • v1.0 – initial notes (18-Sep-2022) KC Lai
  • v1.1 – instructions on displaying Ocean Toolbar for CE (24-Sep-2022) KC Lai

Preamble

Ocean provides a toolbar that allows for integrating with their Cloud Connect server for eForms and eReferrals. You must have a paid subscription to use some of Ocean’s features (such as eForms). Currently, Ocean eReferral is free for primary care providers to get an account and make referrals. If you have a free account, you can simply use their webapge interface to make referrals, however, to enjoy the integration with OSCAR (pushing demographic data to Ocean for referrals), you need the Ocean Toolbar to be working on your OSCAR. There is usually a fee for specialists to accept referrals through Ocean’s eReferral network. However, check with your local OHT and see if they are participating in the funded e-Referral program, in which case, accepting referrals is also free. In addition to contacting CognisantMD, you can contact eHealth Centre for Excellence for support on getting Ocean setup.

eHealth Centre for Excellence was funded by Ontario Health to commission KAI/Well Health and CognisantMD to update their OSCAR endpoint API’s and the Toolbar for an improved user experience. It was mandated, as part of the funding contract, that any changes in the code would be published in open source repositories so other OSCAR-based EMR’s could use it and be compatible. McMaster’s Department of Family and Community Medicine also required Well Health to publish their forked KAI 15 Stable Branch code (aka. OSCAR Pro) in a public repository as well. As such, the OSCAR Ontario open source community was able to bring Ocean functionality to the latest OSCAR Community Edition.

Prequisites

NOTE: The following prerequisite changes have already been baked in to the latest OSCAR Community Edition. You can install the latest deb and then you will get the functional changes automatically! The notes below are for your reference only.

In order for Ocean Toolbar to work with Ocean Cloud Connect, your version of OSCAR must have updated the appointment endpoints to match the changes KAI/Well Health made. EMR forks based on OSCAR 15 (ie. KAI 15 Stable Branch, aka. OSCAR Pro) may have these API endpoint and other changes matching already:

  • Changes found in Revision number: 2e9fc6cc published here.
  • Well OSCAR-3515 Add Includes parameter code changes
  • DemographicService.java for July 2021 changes
  • OSCAREMR-7105 changes

CognisantMD Ocean also access your EMR to pull the demographic data for eReferrals through a URI call that uses [ ] square brackets in a manner not consistent with standard Internet specification. This non-standard approach may work in some cases, however, in updated Tomcat version (such as Tomcat8) these URI requests are rejected. In order to allow for Ocean Cloud Connect to connect with your EMR, the following changes need to be added to the server.xml file (usually found somewhere like /etc/tomcat8/server.xml) under the “Connector” sections:

relaxedQueryChars="[]"

Reload the Tomcat server (sudo service tomcat8 restart) and the changes will take place.

The above changes allows the Apache Tomcat server to accept URI requests with [ ]  square brackets. This change may not be necessary if CognisantMD is eventually able to update their Cloud Connect code to escape the [] characters or encode them with %5B and %5D respectively.

Install Ocean Toolbar

  1. Contact eHealth Centre for Excellence to get set up for a free Ocean eReferral contract and account.
  2. Read the instructions on CognisantMD’s website for self-installation. You can also try contacting eHealth Centre for Excellence to walk you through setup. They have been funded to provide change management and setup support for Ontario doctors and clinics.
  3. Install/Configure the Ocean Toolbar as per CognisantMD’s instructions. [Skip for OSCAR Community Edition]
    For users of the latest OSCAR Community Edition, the Ocean Toolbar is already “pre-configured” on your server, so you don’t need to do this step.
  4. You may also want to download and install the latest Ocean eForm to your eForms folder:
    Go to menu Administration -> Forms/eForms -> Manage eForms -> and click “Upload” to upload the Ocean eForm to your server.
  5. Enable Ocean integration by editing the oscar.properties usual found at /usr/share/tomcat8/oscar.properties
# Ocean Integration
# The default URL for Ocean's live instance
ocean_host=https://ocean.cognisantmd.com
cme_js=ocean

Remember to reload the server (ie. sudo service tomcat8 restart)

Setup Ocean Toolbar

  1. Turn on Ocean Toolbar in the EMR:
    Go the menu Administration -> eChart -> eChart Display Settings -> toggle the “Display OCEAN UI” [ x ] Yes, and Save.
    The Ocean Toolbar will be found under the last Encounter note in the eChart at the bottom, or under the CPP, depending on your setup.
    (If you don’t have this setting which is found in the Community Edition, you may need to follow CognisantMD’s instructions and modify you cme.js file to add a init(); add the end of a function callback, in order to get the Ocean toolbar to show up)
  2. After you receive your credentials from eHealth or CognisantMD, you need to follow their instructions to setup private keys, passwords and enter them in to the Settings of the Ocean toolbar. It’s best if you have some support from eHealth Centre for Excellence for this step if you have trouble following CognisantMD‘s instructions online.
  3. When using Ocean for the first time, you may need to log-in with your Ocean account when prompted.

Acknowledgements

Many thanks to James D (eHealth), Peter HC, CognisantMD, Cortico, and KC Lai (OSCAR Ontario) for your assistance in this endeavor for making integrated health tools accessible to more users.

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