· Oct 12, 2020

MESH integration to send Documents to GP's.


I've successfully installed and configured the custom MESH API supplied by intersystems. I'm able to send HTML rendered documents directly to GP's using Kettering.xml. 

Ideally, I'd like to be able to send PDF/RTF files rather than HTML. Is this possible and if so can I still use Kettering xml? I know FHIR is the preferred method of transmission but i've tried sending a test FHIR message through MESH to EMIS but it's not displaying so I'm not sure if EMIS is able to display FHIR formatted messages. 


Anthony Breen

Discussion (20)0
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There are some restrictions on what EMIS is able to receive at present, they are still in the process of rolling out further FHIR support. That said, I believe you should be able to send a PDF file via MESH/Kettering XML, you may just need to change the document type for it to be displayed correctly within EMIS. 

If you need further assistance, please feel free to reach out to me directly, I'm sure we can assist you with this.


Jon Payne

Hi Jon

My organisation is looking to do a similar thing to the original post. We generate PDFs that need to be sent to practices. Most of our clients are EMIS with some on SystmOne and Vision.

We have the MESH API already set up but am looking for some documentation for the Kettering XML. From what I've read it seems that this format is widely used, but not officially supported by NHS Digital. Do you know if EMIS/SystemOne have rolled our FHIR support yet?

MESH is just a message transport mechanism and is agnostic of payload type.  The key thing is the recipient system understands the format you're sending.  You can embed PDF files base64 encoded in a Kettering document, but whether that will work depends on whether EMIS is configured to ingest those PDFs.  

You need to configure the correct MESH Workflow ID so that EMIS understands what kind of message it is.  You can't fire random FHIR messages at another system and expect it to just understand it.  EMIS does understand standard NHSD FHIR Transfer of Care messages and Digital Medicines messages for example.

What kind of documents are these and have you checked the NHSD standard API catalogue for a suitable FHIR standard, and (assuming MESH transport) checked the list of approved MESH workflow IDs?

Hi Ant,

The receiving GP Practice is also using EMIS Web. I presumed, or should I say, hoped that this would be standardised across all EMIS users as well as my belief that DocMan send using Kettering xml and therefore they would be setup to receive Kettering xml.

We currently use DocMan however I want to test a theory as DocMan convert our pdf for EMIS users into a .tif and the conversion tool they use is increasing the size of the files so much that it crashes the EMIS system. 1 file grew from 2MB (original pdf)  to 37MB (converted .tif) during the conversion.

I have now configured the MESHLookup Operation within our system which again bears me bad news as their ODS Code and the "DISCH_KET" workflow ID doesn't return a mailbox.



Hi Anthony,

Thank you for the info r.e. the MESH Lookup, this was really useful and helped me persevere with this. I have now managed to get this working, which I am over the moon about.

Do you send to multiple EMIS sites and if so, how do you find the relevant MESH mailboxes if the lookup doesn't always return a mailbox? And to really push my luck, have you set anything up to send to a TPP site?

Many thanks for all of the information you have supplied so far.