Ocean eReferral vs Fax: How Canadian Specialists Can Run One Referral Queue
Quick answer
Most Canadian specialty clinics now receive referrals through both eReferral platforms like Ocean and fax. Rather than running two processes, the most efficient clinics bring both channels into one queue: every referral is structured the same way, checked against the same criteria, triaged by the same rules and tracked to the same outcome.
What is Ocean eReferral?
Ocean, developed by OceanMD, is the platform behind eReferral in Ontario’s eServices Program. Referring providers send structured referrals electronically, and specialists receive them with key fields already filled in. The network includes a searchable directory of providers with wait times, referral forms, reporting and automated status alerts for patients and providers. In Ontario, the eServices Program is funded by the Ministry of Health, so participating referrers and receivers do not pay for it, and it offers change-management support for onboarding.
eReferral vs fax: what is the difference for the clinic?
Structure. eReferrals arrive with structured fields. Faxes arrive as images that must be read.
Completeness. eReferral forms can require key fields. Faxes vary by sender.
Status updates. eReferral platforms can send status back to the referring provider and patient. Fax requires a return fax or call.
Privacy. Fax is vulnerable to misdirection, a risk the CMPA and privacy regulators have highlighted.
Adoption. Not every referring office uses eReferral, so fax remains common. In 2023 the Ontario Medical Association said more than 90 per cent of Ontario doctors still used fax.
Why run one queue instead of two?
Two channels often become two processes: an eReferral inbox and a fax tray, each with its own checks and follow-ups. That makes prioritization inconsistent. An urgent fax can wait behind a routine eReferral simply because it is in a different place. A single queue applies the same completeness checks and urgency rules to every referral, regardless of how it was sent.
How do you combine eReferral and fax intake?
Read faxes and structure them into the same fields as eReferrals.
Apply the same completeness criteria to both.
Triage both with the same physician-defined urgency rules.
Place accepted referrals on the same urgency-sorted waitlists.
Send status updates back through the channel each referral came from, and use Health Report Manager for consult reports where available.
Should clinics list themselves in the Ocean directory?
For most Ontario specialty clinics, yes. A directory listing with accurate wait times and referral criteria helps referring providers send the right referrals to the right place, which reduces incomplete and misdirected referrals before they reach you.
What should you measure?
Share of referrals by channel over time
Completeness rate by channel
Time from receipt to triage by channel, which should converge
Status calls from referring offices
Key takeaways
Most clinics receive both eReferrals and faxes.
Separate processes lead to inconsistent prioritization.
Structure faxes to match eReferrals, then treat them identically.
Return status updates through the original channel.
Frequently asked questions
Should we ask referring offices to switch to eReferral?
You can encourage it, but you should not depend on it. Clinics that process fax well do not lose referrals from offices that still fax.
Is eReferral always complete?
It is usually more complete than fax, but not always. Apply the same completeness checks to both.
Is Ocean available outside Ontario?
Ocean is also used outside Ontario, but the funded eServices Program described here is Ontario’s. Check what is available in your region.
This article is about administrative workflow, not medical advice. In every clinic, physicians own the clinical criteria, urgency rules and triage decisions.
How Ample helps
Ample brings Ocean eReferrals and faxes into one queue, structures every referral the same way, checks it against your criteria, triages it with your physicians’ rules and sends updates back through the channel it came from.
Ample is built in Canada for specialty clinics in British Columbia and Ontario. It is PHIPA and PIPA compliant, keeps patient data in Canada, and works with Accuro, OSCAR Pro, PS Suite, Med Access, Juno and virtually any other EMR. More than 100 specialty clinics use it today. Book a 30-minute walkthrough to see it on your own referrals.
Sources
North York General Hospital, An Introduction to the Ontario eServices Program: eReferral
OceanMD, OntarioMD’s HRM now sending Ocean eReferral consultation reports
CBC News, Why doctors still use faxes, and why Ontario aims to phase them out of health care
CMPA, Using fax in your practice? Ten ways to reduce privacy risks
