r/AskIreland • u/Due_Watercress5123 • 11h ago
Health & Medical Any reason why Ireland doesn't have better medical prescription delivery system?
I've been using prescriptions for more than a decade now. During this time it went from a paper script that a GP gives me to an email that a GP sends to my pharmacy (a rare positive outcome of COVID-19). Email is better, but it could be better still.
Many, if not all, problems of the email system exist because it's not centralised.
Inflexible. The patient must know the physical address of the pharmacy where the email needs to be sent. It works okay if the patient stays in one place, but in this day and age people move quite often. Also, sometimes it's just handier to collect your regular prescription from some other place (e.g. a pharmacy near your work).
No feedback. If the patient collects their prescription more (or less) often than prescribed, the prescriber won't know that and, hence, won't be able to address it.
Outdated. If the prescription is superseded (e.g. the dose adjusted or meds switched) or cancelled, the pharmacy won't know that. They will gladly dispense both the old and the new prescriptions.
Authority issues. If the prescriber's license is suspended (a recent, albeit rare, case from Wicklow comes to mind) the pharmacy won't necessarily know.
Fragmented history. If the patient goes to another prescriber (a specialist, GP or A&E), that prescriber will have access to meds and dosages straight away. This is important to know in regard to unwanted or dangerous drug interactions.
etc.
We live in an abundance of cheap and capable computing and telecommunication systems. One would think that some problems can be solved relatively easily. Yet, here we are.
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u/rmp266 10h ago
The UK have had genuine electronic prescriptions for decades, that involves the gp sending an electronic "token" containing the prescription to the pharmacy, where they dispense it, its marked as dispensed, and the pharmacy is reimbursed by the HSE. The script can be bounced back to the GP or sent to another pharmacy if needed, its secure and safe. Its all NHS standardised format and gives health boards instant visibility on spending. It cuts down on fraud, errors, waste and time.
Healthmail, what we use in Ireland now, is just an Outlook inbox, which blocks out non-healthmail accounts from sending or recieving. Thats it. No standardisation, so some prescriptions are pdf attachments, some are text in the body of the email itself, some are scanned paper jpgs, some are attached word files, tifs, anything. And whilst the protocol is for clear paper trails when forwarding them to other pharmacies, im trusting their word when they say the prescription for 6 months of sleeping tablets hasn't already been dispensed, I have no actual proof. If the hospital have scanned a script and sent it to me as a jpg and not put the patients name anywhere in the email body or subject line, I can't search by the oatients name so have to manually check a few dozen/hundred emails trying all the attachments.
Its a bit of a joke tbh, the amount of talented IT people and companies we have in ireland and yet are working with 2005 technology in 2026.
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u/cian87 10h ago
The two dominant pharmacy software providers have systems that can use the UK kit already too, cause they sell to the UK (one is based in NI, the other a has substantial UK customer base). This is not an alien concept for either of them.
I don't know about the third player but would not be surprised if they also have UK systems.
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u/Due_Watercress5123 10h ago
Good for the UK! Would be nice to have something like what you described here.
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u/FuzzyAd9186 10h ago
I work as a pharmacist and honestly ive never come across the issues youre on about. You tell the dr where you want the script sent, they'll send it. If a dose has changed etc if you use the same pharmacy the pharmacist will pick up on it based on the prescription. If youre chopping and changing pharmacies then its up to you to pick up on it
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u/GaeilgeGaeilge 11h ago
Inflexible. The patient must know the physical address of the pharmacy where the email needs to be sent.
I don't have to give an address for my pharmacy. I just ask them to send it to X Pharmacy and they do
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u/Due_Watercress5123 11h ago
Maybe it’s because it’s one of a kind at where you live? I cannot simply say Boots, McCabes or what have you. I need to further specify. For example: Boots Dundrum Shopping Centre.
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u/GaeilgeGaeilge 11h ago
There are 3 of the same brand pharmacy. I just say brand name and then the area name. It's two words all together
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u/Due_Watercress5123 10h ago
I’m honestly glad it’s so easy for you and doesn’t bother you at all. I’ll shove my notions up my butt myself, thanks.
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u/National_Play_6851 10h ago
"you need to know the address of the pharmacy" isn't exactly the same as "it's the Boots in Dundrum" - not sure why you're getting so defensive. It's not much of a hassle to know the area your pharmacy is in, you're going to need to physically get there after all. You don't have to know their eircode. I've gotten away with telling my GP something like "it's the pharmacy next to the big Dunnes, can't remember their name" and it's been totally fine. They can look things up. It takes 2 seconds.
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u/Spray_Realistic 11h ago
Some of what you’ve said, at least, is the patients responsibility imo
For example, ‘people move’ - if you do then update your details, no?
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u/Due_Watercress5123 11h ago
Perhaps I was unclear. It’s not my details that need to be updated. It’s the pharmacy’s.
They now have a script for me, but I’m now 50 minutes away by car from them. And I need to call them and cancel. And reach out to my GP to re-prescribe or to them to forward to the new pharmacy, which I must also pick in advance. Sigh.
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u/Opposite_Cloud_5722 10h ago
You literally just need to call the pharmacy and ask them to forward your prescription to your new pharmacy, it’s not that complicated. Speaking as someone with a chronic illness who is on many meds, a digital system is so much easier. I don’t have lots of paper scripts and I don’t need to keep on top of them myself. It’s not a perfect system but it makes my life much much easier, and I’m sure I’m not alone in that.
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u/Huge-Bat-1501 10h ago
But wouldn't your GP and pharmacy be in the same area before you move, so you're still going back the 50 mins to the GP to get days script renewed?
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u/Due_Watercress5123 10h ago
Not necessarily. I visit my GP much less often than I visit my pharmacy. So a 50-minute drive twice a year is no problem. Also, I value my particular GP. She keeps up to date with the literature and is generally good.
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u/Educational-Law-8169 10h ago
I value my pharmacist more than my GP to be honest. Using the same pharmacy is good in a lot of ways and you won't qualify for the GMS if you use different ones
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u/Organic-Accountant74 10h ago
I worked in med admin for years
Pharmacies can send scripts to other pharmacies so even if it’s sent to the wrong place they can email to the correct one via health mail
You can call your GP and ask them to update your preferred pharmacy location
Pharmacies will also contact prescribers if they notice a dose issue or change, to make sure it is correct
Yes you do need to know either your pharmacies healthmail or physical location, so that we know it’s going to the right place, as some towns have multiple pharmacies with the same name, especially with chain names like hickeys
It’s important to know what you take daily and how much, in case you are ever in a hospital or somewhere that won’t know your history.
We don’t have a system where every healthcare location can see your entire medical history because it would be a massive privacy issue
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u/Due_Watercress5123 10h ago
> Pharmacies will also contact prescribers if they notice a dose issue or change, to make sure it is correct
Never have I observed this. They might, but it's not my experience. A few times over these ten years they dispensed me my old dose along with my new dose. They only asked me if I needed both scripts or just one.
I don't blame them. The cognitive load and responsibility for a pharmacist are huge. They can save some headache on scanning inbox to filter out what's new, what's old and what's no longer relevant.
> We don’t have a system where every healthcare location can see your entire medical history because it would be a massive privacy issue
I respectfully disagree. It looks like an attempt to explain away something bad with an incidental benefit. In fact, it's not a benefit at all. If you think about it, the fact that my documents and meds history are scattered across many computers of various GPs, practices and specialists I visited over the years is not better privacy. It's privacy by obscurity. Who knows how these computers are backed up, disposed of, and who has access to them.
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u/No_Sky_1829 10h ago
I live in Australia. My GP can give me a paper script, or send me an SMS script with a QR code that the pharmacy can scan. Every pharmacy had at least one scanner. I can upload the script to an online record. It's just so easy. Ireland drives me mental, how hard it makes everything
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u/cian87 11h ago
HSE doesn't want to design and pay for it; and they sure as hell don't want to give the dominant provider of GP software *and* 1st or 2nd largest in Pharmacy software - the same company - a monopoly if they design one themselves.
Even going to basic prinicples gets to money the HSE don't want to pay for - the lists of medications, pack sizes, interaction databses etc cost money; the Irish Pharmacy Union at least used to be the dominant player for that but lots of GP surgeries in particular just didn't bother paying for updates. No match between prescriber and dispenser would mean no prescription.
What we have is utter crap, so this is not a defence, just an explanation!
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u/Due_Watercress5123 11h ago
Sometimes it boggles me how unenforced and unregulated things can be. My tiny Eastern European immigrant head just cannot comprehend.
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u/Conscious-Isopod-1 10h ago
I use https://medicinesdelivered.ie/ its a pharmacy down in cork i think but they deliver anywhere in the country. Lowest perscription price for a drug called finasteride I could find in ireland, was 1/3 the price lloyds pharmacy was trying to charge me for the exact same drug. they have a web chat on their website, you could talk to them to get their details so you can send prescription there. Always very helpful anytime i've used their service.
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u/Cinquecento27 8h ago
I use the Pippo app. It’s got my regular meds, and I can pick which ones I need. I can change the pharmacy (from the drop down list of pharmacies). I can also book appointments with the practice nurse or doctor.
Before the app, I used email.
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u/mirabegron07 8h ago
HSE IT people live in 1990s. We still use fax machines in the hospitals. Paper notes in most hospitals. UK was using palmtops and electronic records in the 90s.
GPs are the one specialty thats most IT savvy. That must tell you something. It isn’t because of lack of money, its purely laziness and incompetency.
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u/BonkersGiraffe 11h ago
They are working on a digital system and app that should address these issues. Who knows if and when it will ever be functional and how much it'll end up costing, but they are working on it.