Secure Messaging: Frequently Asked Questions (FAQs)

Secure Messaging lets you send and receive referrals, results, and correspondence electronically through vendors like Medical Objects, HealthLink, and MQ Link (also known as QML). This article answers some of the most common questions we hear about message statuses, rejections, and configuration.

Contents:

1. Message Statuses
2. Rejection Reasons
3. Configuration and Setup
4. Vendors and Message Types
5. Inbound Message Handling

Message Statuses

What's the difference between "Sent" and "Delivered" on the Correspondence Out grid?

For messages sent via Medical Objects: "Sent" means the broker (Medical Objects) has successfully processed the message. "Delivered" means the message has been acknowledged by the receiving practice's software. In other words, "Sent" is similar to a message being sent, and "Delivered" is similar to a message being seen.
 

My outbound message shows a "Pending" status. Does that mean it hasn't gone through?

Not necessarily. "Pending" simply means MediRecords hasn't yet received a delivery acknowledgement for that message. There's a scheduled process that checks and updates message statuses roughly every 15 minutes, so it can take a little while for the status to update even when everything is working correctly.

A message can stay on Pending for a few different reasons:

• Secure Messaging configuration is incorrect (a mismatch between MediRecords and the vendor). The message will not be delivered until this is corrected, and won't automatically retry once it's fixed, you'll need to resend it manually.
• The recipient is inactive in the vendor's provider directory. The message will not be delivered.
• The sender's provider number is missing, invalid, or inactive in the vendor's provider directory. For Medical Objects specifically, the message will actually be delivered, but the status will keep showing Pending because the delivery acknowledgement can't be matched back to a valid sender.
• Occasionally, an issue on the vendor's side, such as their delivery report service being temporarily unavailable, can also delay status updates.

I received a green "Outbound message sent" toast, but the message is still showing Pending, even after resending. Is something wrong?

Rejection Reasons

What are the common causes of a "Cannot Find Recipient" rejection?

This is the most common rejection reason we see across all Secure Messaging vendors, and it usually comes down to the recipient's provider number not being recognised. Common causes include:

• The provider number in the incoming message isn't registered against any active user in any MediRecords tenant.
• The provider has left the practice, so external senders such as labs or radiology providers are still sending to a provider number that no longer has an active match.
• The receiving practice or tenant can't be resolved, because the identifiers in the message don't map to a configured tenant.
• The provider's number is recorded under a different identifier field to the one the sending vendor uses to match against.
• A name-matching fallback fails because the name format in the incoming message doesn't exactly match how the provider's title, first name, and last name are recorded in MediRecords.
   

What does "Duplicate Key Identifier" mean in a Secure Messaging rejection report?

It means MediRecords has already received that message. If you keep seeing this for a particular message, contact the Secure Messaging vendor and ask them to stop resending it.

Configuration and Setup

A user has both a Provider No. and a Medical Obj. number set up. Which one does Medical Objects use?

The Medical Obj. column takes priority: if a value is set there, it's used ahead of the Provider No. column. If the Medical Obj. column is empty, the Provider No. column is used instead. You can check and update these under More > Settings > Subscription Details > Users > click the user's name > Identifiers.

If we're receiving incoming letters fine, does that mean our Secure Messaging configuration is set up correctly?

Not necessarily, this is a common misconception. Inbound and outbound Secure Messaging use different mechanisms, so inbound working correctly doesn't confirm that your outbound configuration is correct. 

You can review your configuration under More > Settings > Configuration > [Practice name] > Secure Messaging, and it's worth checking these details with your Secure Messaging vendor directly if you're troubleshooting outbound issues.

I validated a contact's details a while ago. Could that recipient still cause a rejection now?

Yes. A contact's details are only checked against the Secure Messaging vendor's provider directory once, at the time it's created or updated in MediRecords, they aren't automatically re-checked afterwards. If a recipient later becomes inactive with the vendor, messages to them can silently stay on Pending with no warning. If you suspect this, you can manually re-validate a contact under More > Resources > Contacts > Health Professionals > select the Secure Messaging Provider > Validate.

Vendors and Message Types

Is QML the same Secure Messaging vendor as MQLink?

Yes, QML and MQLink are the same vendor, just referred to by two different names.
 

What HL7 message formats and file types does MediRecords support for Secure Messaging?

For inbound messages, MediRecords supports HL7 versions 2.3, 2.3.1, and 2.4, covering Observation Results, Referrals, and Medical Document Management message types. Supported attachment file types are PNG, JPG/JPEG, CDA, RTF, and PDF. For outbound messages, MediRecords supports HL7 version 2.3.1, and only Referral messages can currently be sent outbound.

Inbound Message Handling

If a result comes in for a provider who's been deactivated, what happens to it?

For an inbound result to be automatically matched and delivered straight to a provider's Inbox, both the provider and the patient need to be in an active status. If the provider is inactive:

• Via Medical Objects: the message will be rejected.
• Via HealthLink: the message will go to the Holding Bay instead, rather than being rejected outright.

Instructions for deactivating and reactivating a user can be found in User & User Group Management: Quick Guide.

Further Reading

• Secure Messaging: Outbox
• Secure Messaging: Holding Bay
• Secure Messaging: Configuration - Healthlink, Medical Objects, Clinical Labs, MQ Link, & Fetch