Most major Ontario EMRs — OSCAR, Telus PS Suite, Accuro, Med Access, Practice Solutions — can integrate with DOS referral and consultation workflows. The setup is a one-time investment that saves significant time.
This guide is for clinic managers and IT-leaning clinicians evaluating integration. It covers the typical setup, what changes day-to-day, and the practical limitations.
What integration provides
The core benefits at a connected clinic:
- Outbound referrals from inside the EMR — no copy-paste, no re-keying patient data
- Consultation notes returned directly to the patient chart
- Lab and imaging results forwarded to the referring clinician automatically
- Status visibility — you see referral state without leaving the EMR
- Reduction in faxes (most clinics report 60–80% reduction once integrated)
The Ocean layer
For most Ontario clinics, the integration goes through the Ocean platform. Ocean acts as the secure transport layer between your EMR and DOS. Key components:
- Ocean Cloud — the central platform that handles eReferrals, online forms, and result delivery
- Ocean Tablet (optional) — clinic check-in and patient-completed forms
- EMR adapter — the piece that lets your EMR read/write Ocean data directly
Each EMR has its own adapter setup. OSCAR’s is open-source and configured by clinic admins. Telus, Accuro, and Med Access have vendor-managed adapters, set up via support tickets.
Typical setup timeline
For a clinic that hasn’t used Ocean before:
- Week 1: Vendor account creation, billing setup, license activation
- Week 1–2: EMR adapter installation by your IT support or vendor
- Week 2: Test transactions — send a test referral, confirm it routes correctly
- Week 2–3: Staff training (typically 1–2 hours per role)
- Week 3+: Live operation
Clinics already using Ocean for other referrals can add DOS to their existing setup in days, not weeks. The DOS listing (ID 18301) just becomes another available destination.
What changes day-to-day
For clinicians
Referrals start from a button or right-click in the patient chart. The patient demographics, problem list, medications, and allergies populate automatically. You add the clinical question and any specific notes. Send.
Consultation notes return into the chart with the original referral linked. Lab and imaging from DOS-ordered investigations flow back the same way.
For administrative staff
Less faxing. Less call-back-the-clinic-to-confirm-they-got-the-referral. The Ocean dashboard shows status of all referrals in flight, including patient acknowledgment of appointments.
For patients
They receive a text or email after the referral is sent. They can book appointments online (within available slots) without playing phone tag.
Practical limitations
A few honest notes:
- Initial setup has friction. Most clinics find the first 1–2 weeks bumpy as workflows adjust.
- Not all data flows are seamless. Some EMRs handle attached labs better than others.
- Cross-organization workflow exceptions exist. If you’re sending from a non-OHIP-billing setting, billing reconciliation is manual.
- Patient self-booking creates new edge cases (no-shows, double-bookings) that need clinic policies.
For non-Ocean clinics
DOS still accepts referrals via fax, secure email, and phone for clinics not on Ocean. The faster, more reliable path is Ocean, but the older channels remain available indefinitely. The DOS-side workflow handles all of them.
The takeaway
EMR integration is one of those investments that produces small daily wins rather than one big breakthrough. Two minutes saved per referral times hundreds of referrals per year times multiple clinicians becomes meaningful. The clinics that have done it report clear ROI within months.
If you’re a clinic admin evaluating this, the conversation to have isn’t “should we integrate?” — it’s “which integration path makes sense for our stack?” Reach out to the DOS clinical coordinator and we can connect you with the right resources.
