NHS.net mail to CDA/MESH app

Hi all

We are a NHS primary care practice looking for a document management solution.

Its wonderful that we are getting a growing (& already significant) about of clinical correspondence via nhs.net - its quick & saves NHS postage costs.

BUT, the downside is that we then have to either:
1/ print, delete email, scan, find patient, attach; or
2/ print to pdf, delete email, find patient, attach to patient & delete pdf
neither of which are terribly desirable. We have over 750 email in a single folder that need transferring in to EMIS Web.

I’m looking to hunt down a solution that we can set up a forward/auto-forward to that will receive these emails, identify the NHS number and present them within the EMIS Web DTS/MES/CDA workflow seemlessly.

Anyone know of such a thing?
Many thanks

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Are the providers sending you these emails able to use other methods?

I’m not aware of any simple methods for getting the document metadata (patient name, NHS number, sender, etc) out of an email. (other than getting someone the grab them out of the pdf and/or email)

Some new ways of getting documents to a GP practice system (epr or docman) are being discussed but that would still need the document meta data to be extracted from the email.

Hi Kev, thanks for reply.

Sadly no. I’ve been round a few asking can you send them to us via CDA/MESH/DTS and most simply dont have clue what that is.

It would mean me having to write some sort of app to interogate the email contents and extract this (easier with the plain text & HTML emails, less so with the PDF ones), before redespatching it into the MESH system to deliver it in to Web.

That said, I’m not familiar with the data flows, interfaces, specs etc, so very much beginning to work out what the problems/challenges are first.

It would be great if there as an off-the-shelf product to this instead!

Does Docman address any of the problems?



I’ve been thinking about this for a while. The diagram above represents a ‘simplified’ design. I’ve simplified the inputs to just being a document (FHIR Binary) and metadata (FHIR DocumentReference). In reality in a NHS trust it’s likely to be a custom XML format or HL7v2 message - however both normally contain the document and some metadata.

In a NHS trust we normally do something like this in the Trust Integration Engine (TIE) but also something like this will exist on the system/organisation sending or receiving the document.

So it’s looking like a standard pattern with maybe a standard app

For it to work in you scenario, you’d need to get the senders to use it. Here you would register what capabilities you support in the directory. So for PDF’s they would need to go to the ‘GP Connect Send Task’ route (when your supplier supports it) and HTML goes the Kettering XML route.

I believe an app like this can be done using open source components such as Apache Camel, HAPI, NHS CCRI, Rabbit/Artemis MQ, Angular 6, Activiti, spring boot (sounds like a lot but it’s mostly plugging it together).

It doesn’t work with documents received by NHS Net email

Mark, hi, we do this within our RIVIAM service. Currently, we deliver PDF documents to EMIS and TPP in real-time ever day for the clinical services we support. We are in the process of developing a service that will take a document from an account in NHS email and then deliver into EMIS and TPP. We mark the documents with the meta data of NHS Number and the patient’s core details that allows both TPP and EMIS to manage in work flow.

Happy to discuss how we can help.



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Hi Paul, yes please. What’s the best way to link up?

Hi Phil

Having used DocMan, I’m loathed to introduce it. I really dont like it.

We have terrible problems with inbound GP2GP documents from DocMan, its an external app that adds to the complexity of using the clinical system & EMIS Web’s document management is perfectly adequate.

I want something that will sit between nhs.net and EMIS Web without additing to Web.

But thanks for the suggestion :slight_smile:

Hi Kev

It sounds like you are working for a trust that is substantially more IT literate than some of our local providers.

Our mental health trust for example has just switched to emailing correspondence. This is great. It used to take them 6-8 weeks to post out clinic letters, so I’m immensely happy to have stuff emailed within a few days.

But their workflow is simply, write the letter in Word and email it to us. I can’t believe Southampton is the only place where this is happening too, so there must be a lot of practices facing similar workflow problems around the country.

best wishes

I have worked in trusts implementing paperless 2020, integration/sending documents is too complex and my interest is making it simple (but not too simple it adds other problems)

The tool that Paul suggests looks very interesting, it does what I was suggesting earlier hides the complexity and more. It’s something a trust could use instead of NHS mail and enable automation in receiving systems (in smaller organisations like GP’s) .

Hi, we use Docman to autoprocess our nhsmails in primary care. Works quite well. I know what you mean, though, about having a whole extra app to worry about when you are trying to keep things simple.

I have used Docman in the past but have moved to EMIS and just use the EMIS functionality.

Would be interested if you find anything.


Email is no better than Fax in my opinion. Add the complexity of importing into the GP system and the workflow becomes more complex.

We have MESH from our local trust and also access to their documents via IHE interface which is also helpful.

I also find webmail frustrating. Do many people have local outlook installed?


Thats more than I’d expect from a trust but - it should be what is expected??

Hi Phil, I agree fax/post/email are all the same thing, just very in speed of delivery.

We have a outlook installed on a backoffice PC and use that to process nhs.net emails to the generic ac. Thankfully we don’t have to wrestle with webmail interface!

Its a great pity that the move to all referrals being paperless this Sept didn’t also place a requirement for all correspondence to be sent back electronically into systems, but hey.

We all need a tool that just patches our current problems, but hopefully would become redundant in the near future

Interesting thread - I’m involved in developing an app that currently makes use of NHS.net to deliver pdfs to GP surgeries - @Paul interested in anything you can say about how your RIVIAM service hooks into EMIS & TPP

Dave, hi, we use MESH and an old messaging format support by the GP systems. It took us a lot of testing to get the service to work as there are different encodings involved in both GP Systems. We haven’t tested with Vision but I expect it to work.

Happy to talk ptargett@riviam.com


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Hi, you can contact me on ptargett@riviam.com I am away on holiday this week so may be a delay in responses :slight_smile:

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Thank you @paultargett you’re a star - I’ll email later in the week - have a great hols!