Email deliverability

We occasionally receive queries regarding emails sent via Mediref and whether they have gone through to the recipient or not (especially in cases where the recipient claims not to have received the emails). This diagram/article goes over what an email journey looks like:

Mediref's role in sending out emails:

1. Mediref can only guarantee that emails were actually sent out by our server. Beyond that, control of an email is out of our hands (more information below).
2. The recipient server can (but does not always), relay a message back to our servers regarding the status of an email (more info below). If it does, and the email status points to the recipient not having received the email, Mediref will automatically generate a notification to let you know of this fact.

Possible email statuses:

1. Sent - self-explanatory - email has been sent out by Mediref.! Note - Sent does not necessarily equal read/that it has hit the recipient inbox.

   
   

   Note - It is possible that the recipient server may not respond with any kind of update regarding the status of an email. If so, the status will remain as 'Sent'. If/when the correspondence is opened, Mediref will update your Sent correspondence status to reflect this.

2. Failed - The recipient email server 'bounces' the email. This can take two shapes:
   1. A hard bounce - E.g. If the email address has a typo and doesn't exist - Provided that the recipient email server relays this back to Mediref, we will notify you of this, allowing you to resend to a different email address.
   2. A soft bounce - E.g. If the email inbox is full and does not have space to receive any more emails. We will notify you as well as keep trying to deliver the email for three more days.

A note on spam:

Email inboxes generally have two sets of spam filters:

1. The spam folder created by their email program (e.g. Microsoft Outlook) - When an email is forwarded by a recipient email server to the recipient, it is possible that the program in question may think an email is spam, and categorise it as such. In such cases, if the recipient checks their spam folder (in a timely manner as spam folder emails get periodically deleted), they will see the email in question.
2. The spam filters put in place by the recipient email service provider - In cases where a recipient email server categorises an email as spam, it will not be sent to the recipient at all. In such a scenario, the recipient will not see the email in their spam folder, nor will Mediref be aware of this in most cases as this information is generally not relayed to the sending party (in this case, Mediref).

What to do if a recipient is claiming not to receive email notifications:

1. Ask them to check their spam folder. 
2. Ask then to do a mailbox search for 'Mediref' - we have come across many instances where email notifications have simply been missed/not been acted upon before they got drowned out by newer incoming email.
3. If the above two fail and the email seems to have been swallowed up (see point two regarding the note on spam above), then this is a conversation that they will need to have with their IT and/or their email service provider because chances are that legitimate emails are getting filtered out before reaching their inbox.

Note - You are welcome to contact us to double check whether an email notification has been sent out. Let us know the recipient email address in question and we can check it for you.

Take-home summary:

1. Mediref guarantees that emails will be sent out. Our control beyond that is limited. If an email fails and our servers are made aware of this, then you will automatically be notified (via an email to you as well as a red mark on your dashboard).
2. In an ideal scenario, all recipients will be on Mediref so that delivery of patient correspondence is not reliant on the email protocol.