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EMIS Health

Solution ID: 10000-051

Solution information last updated: 2 December 2020



Keystone is a middleware solution that facilitates the movement of clinical data & messaging, (to international standards), between Secondary & Primary Care providers and other organisations (e.g. NHS / PHE Laboratories), using nationally defined transport mechanisms.

Full description

Keystone is used to translate and transport pathology, radiology and clinical correspondence documentation from a source of origin (e.g. Lab System), to a source destination, (typically a GP Practice Management System). The clinical order communications solution enables clinicians to send and receive for viewing, test results from other care settings, allowing them to read test results in context, so that they can better evaluate treatment choices.


This Catalogue Solution has the following features that can help meet needs in primary care:
  • Clinical middleware solution for integration of LIMs & RIS with Primary Care PMS
  • Admin GUI showing current schedule, errors & details highlighting recent processing
  • Communications Module
  • Processing Services Module
  • Multiple Interchange Message Types including EDIFACT Writers, ASTM Writers & others
  • Report Validation including Pathology, Radiology, Clinical Correspondence & Batch Validation
  • Incoming Interchanges
  • Readers include: MEDRPT v1.003 (PMIP) Reader, FHSREG Reader, FHSPRV Reader & others
  • This is not an exhaustive or detailed list – for more information, please get in touch

Capabilities met - NHS assured

This Catalogue Solution has demonstrated that it can help meet the following needs in primary care:

Productivity, 1.0.1

Supports Patients/Service Users and Health and Care Professionals by delivering improved efficiency or experience related outcomes.
How this capability was met
Capabilities are a set of requirements that are defined using short descriptions called epics. Capabilities are achieved when a Catalogue Solution meets the required epics.
There are two types of epic: must and may. Some capabilities require the Catalogue Solution to meet all of the must epics, some require only one must epic to be met. May epics are optional.
This Catalogue Solution has achieved the following:

Implementation timescales

These are the typical processes and timescales to implement this Catalogue Solution:
A typical deployment will take less than 1 week, however this is dependent upon the range of modalities required and the agreed infrastructure requirements being met. EMIS’ Deployment & Implementation Team has in depth experience in supporting the deployment of Keystone as a middleware solution. Our team is comprised of Project Managers and technical support staff who work in partnership with your IT Infrastructure teams to ensure we meet and exceed the requirements of each contract. Our project management approach is based on Prince2 methodology, providing a robust yet flexible framework to help ensure the best possible outcomes for all stakeholders. Early engagement with the IT infrastructure team on the existing topology is recommended to give an accurate reflection of the likely implementation timescales. We can shorten this lead-time to support practices in response to COVID-19 by working with them as a team.

Client application type

This Catalogue Solution is supported by the following client application types:
Browser-based application

Supported browser types

  • Internet Explorer 11
  • Internet Explorer 10

Mobile responsive


Mobile first approach


Plug-ins or extensions required


Minimum connection speed


Screen resolution and aspect ratio

16:9 - 1920 x 1080

Hardware requirements

Operating System Windows Server 2019 , 2016 , 2012 R2 & 2008 R2 Database MS SQL Server 2017* , 2016* , 2014* , 2008 R2 *Database must be in Compatibility Mode 100

Additional information

The web application component of Keystone is backhanded on the server using Visual FoxPro 6 code. Visual FoxPro code is run under internet information services using the foxisapi.dll.
Native desktop application

Supported operating systems

Windows Server 2019, 2016, 2012 R2, 2008 R2

Minimum connection speed


Memory size


Storage space


Processing power

16 (32)

Screen resolution and aspect ratio

16:9 - 1920 x 1080

Device capabilities

Device needs access to web services for viewing front end UI to configure and monitor the processing activities. When configured with permissions, the user can also see the contents of incoming and outgoing messages through the Tracker Results Screen.

Hardware requirements

Operating System Windows Server 2019 , 2016 , 2012 R2 & 2008 R2 Database MS SQL Server 2017* , 2016* , 2014* , 2008 R2 *Database must be in Compatibility Mode 100

Additional information

There are a number of Generic Windows Services which are used in Keystone. These include: SMTP Mailer I4 Multiport Listener Service I4 Multiport Talker Service MS SQL DB Checker Watcher Service

Hosting type

These are the ways this Catalogue Solution can be hosted:
Public cloud


To have EMIS host your service requires the provision of the necessary hardware at our site in Fulford Grange. To feed data from a lab to a GP estate via our Hosted service requires use of either Physical Hosts or Virtual Machines. For Physical Hosts we operate the following min spec; CPU – 16 (32) RAM – 128GB OS Disk – 2012 R2 (x2) Data Disk – 1.6 TB Raid 1 SSD (x2) VMs CPU – 2 RAM – 8 OS Disk – 60 OS – Server 2012 R2 Data Disk – N/A Number Req – 2 All messages are output to MESH.
End user devices must be connected to HSCN/N3
Private cloud


It is possible to Host your own service if required following the specification requirements given above.

Data center hosting model

See details above
End user devices must be connected to HSCN/N3

About supplier

We’re the UK leader in connected healthcare software & services. Through innovative IT, we help healthcare professionals access the information they need to provide better, faster and more cost effective patient care. Our clinical software is used in all major healthcare settings from GP surgeries to pharmacies, communities, hospitals, and specialist services. By providing innovative, integrated solutions, we’re working to break the boundaries of system integration & interoperability. We also specialise in supplying IT infrastructure, software and engineering services and, through our technical support teams, we have the skills and knowledge to enhance your IT systems. Patient ( is the UK’s leading health website. Designed to help patients play a key role in their own care, it provides access to clinically authored health information leaflets, videos, health check and assessment tools and patient forums.

Learn more

Learn more about this Catalogue Solution, for example its price, the standards it has met and any additional or associated services available.

Contact details