Mobidoctor scripts no longer accepted in pharmacies?

Where exactly?

I couldn’t find such language in the Cross-Border Healthcare Directive.
 

That is probably technically a valid prescription.

However, you have a doctor from Romania, with an address in Malta, prescribing online, for a patient in Ireland who they have presumably never examined. It may also be for a drug with significant potential side effects.

The pharmacist is obliged to make sure this is a valid prescription before dispensing and I think they would be understandably wary of a script like that.

I think there are some pharmacists here on AAM - it would be good to hear their experience and they probably have up to date info on this.
 
Well that's the thing they have examined me, we do a detailed video consultation.

I have been on a particular medication since September 2022 which has been dispensed in this way along with other prescriptions for ear/sinus infections over the same time.

My pharmacist recommended that I use a different company in Ireland and the funny thing is I'm getting a script for a pretty serious medication without any face to face interaction whatsoever, they are just taking my word for it so I've gone from having a consultation and having medical interaction with somebody to just getting something online sent via a secure mail system.

So as a patient, in order for the pharmacist to satisfy one regulation, this is actually worse for me because I'm not being medically managed at all even though I'm well versed on what it is that I'm taking.

Makes no sense!!
 
arbitron said:
I don't know, I have seen it referenced HSE, PSI documents, etc. I will have a look and see if I can find any shared with me.
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@Dr Strangelove , had a quick check in emails and saw this quote:


Looks like it comes from a 2011 directive but I can't find which one.

[Edit: seems to be "Directive 2011/24/EU of the European Parliament and of the Council of 9 March 2011 on the application of patients’ rights in cross-border healthcare"]

In the same email, the document for discussion quoted a paper saying:


This is probably what they would point to in @Sarah Ryan case.

IANA(EU)L or a pharmacist so would be good to hear from them.
 
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arbitron said:
This is probably what they would point to in @Sarah Ryan case.

IANA(EU)L or a pharmacist so would be good to hear from them.
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So basically, after over a year and a half of prescribing a medication they can decide we don't like the format or the people that you are procuring this medication from, but if you'd like to use this service in Ireland we'll accept it from this service no problem.

Oh and by the way this service will not give you any guidance or follow-up information and we don't really care about your patient safety so long as it comes through the magic mailbox.

Right ok i got it lol. I just find it really difficult to resonate with silly decisions.
 
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@Sarah Ryan

I've taken what you had and re-drafted quite a bit for you to send to the European Commission. I'm basically trying to make very clear where the gap is between Irish law and practice and what EU law obliges. EU law is of course supreme and member states are supposed to implement it although frequently they don't. This is where the European Commission is supposed to investigate and take action up to the EU courts which can impose fines on a member state

Anyway if I was of a conspiratorial frame of mind I would imagine Irish doctors love nothing more than a prescription system that can't be accessed by doctors who aren't registered in Ireland

Back to the text below, I've made it quite neutral and specific. They get a lot of people with legitimate complaints but who leave out key details and put in irrelevant personal stuff so I've tried to keep it very dry.



I will send you the addressee by PM.

It's no harm as well to send it for information to the MEP candidates in the constituency where you live. This is the kind of thing where MEPs might take an interest as it means lower prices for Irish consumers via EU policy. National politicians are much more likely to be influenced by lobbyists for Irish medical professionals.
 
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That's a really useful insight from the inside. I'm a layman and it's always surprised me how much drugs and prescription defaults differ so much from country to country and I've never really understood the medical rationale given that human bodies do not vary that much!

I'm sympathetic to pharmacists who have to deal on a daily basis with fraud and abuse and need a minimum level of assurance that the prescription in front of them (electronic or paper) is valid. But at the same time the net effect of Healthmail has been to freeze out hundreds of thousands of medical professionals from prescribing drugs to Irish patients. This is despite these same medical professionals prescribing drugs on a daily basis to hundreds of millions of other Europeans without question!

I know there is a patient safety angle but it's hard to think there aren't medical professionals who don't like competition and this is a way to keep it out.
 

We are lucky in Ireland as the standard of care and service from pharmacists is remarkably high. There is a lot of variation across Europe, within and between countries, in both the quality of care delivered and the systems of delivery.

Unfortunately human bodies vary a lot... which is what keeps me in a job!

Dr Strangelove said:
I'm sympathetic to pharmacists who have to deal on a daily basis with fraud and abuse and need a minimum level of assurance that the prescription in front of them (electronic or paper) is valid.
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One hospital I worked in the catchment area had a high rate of prescription fraud. We would often get calls querying if a script was really from Nurse X or Dr. Y because there was some small detail off. Pharmacists are really good at picking these things up but with random emailed scripts from anywhere in the EU it would be very difficult. HealthMail helps with this and I suspect it benefits far more patients than it would disadvantage.

I was recently in another European country and needed a prescription medication that I had forgotten but knew it was over the counter there. No safety questions at all, they just sold me 8 months supply, as if I was buying Mars bars. That is not a good approach to drugs that can kill you. I would rather wait an hour and pay a bit more.

Dr Strangelove said:
I know there is a patient safety angle but it's hard to think there aren't medical professionals who don't like competition and this is a way to keep it out.
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Patient safety is a pharmacist's main job and they are good at it. That's why they ask really annoying questions and give a Paddington stare when you ask for codeine. I have no doubt that the industry as a whole wants to minimise competition but individual pharmacists care about their professional registration and not harming anyone.

I am personally anti-protectionist and think competition is healthy but in this area you have to be very cautious. The 3 worst patient safety cases I was ever asked to review all involved irresponsible treatment abroad in the EU: 1 related to surgery and 2 to prescribed items. I can't go into details but I can tell you the surgical one was horrific, with a near death for the patient and a cost to the HSE of at least 7 figures in aftercare (so far). The other 2 each cost the HSE low 6 figures to treat, not to mention the life-long side effects for the patients. None of these incidents could have happened in Ireland, which is why these people ended up going elsewhere in Europe, sadly with disastrous consequences. We have enough problems and costs in the HSE without adding to them.

The aim in healthcare is for it to be affordable, accessible, and safe. It is extremely difficult to achieve all 3, so you always have to consider if a doctor/pharmacy is accessible and cheap, are they providing high quality care? Maybe, but I would tread very carefully.
 
I can hand on heart say that the level of care I have gotten from Mobidoctor is on par with what I have gotten from my own GP the very odd time I have had to physically go and see him.

Anytime I have done a video consultation for sinus / ear infections they go through all symptoms in detail and also ask very specific questions which I gather are doing checks for infection / potential sepsis issues. Very thorough.

Accessible, affordable and quality are possible with this service and I can say that from experience. I guess it's one of those things it needs to be seen to be believed.

Also extremely handy when you are travelling around Europe as well no trying to find a doctor or hospital.
 
I assume you can print out several and present it to other chemists.

I remember ringing a local chemist for an urgent script for my mother and they gave me both the healthmail address and the ordinary email.
 
beautfan said:
I assume you can print out several and present it to other chemists.

I remember ringing a local chemist for an urgent script for my mother and they gave me both the healthmail address and the ordinary email.
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No quite the opposite there is a code on each script that you can check has it been filled already.
The pharmacist needs to mark the script as filled on the website - if the pharmacist doesn't complete the process should the end user have to suffer?
 
Sarah Ryan said:
No quite the opposite there is a code on each script that you can check has it been filled already.
The pharmacist needs to mark the script as filled on the website - if the pharmacist doesn't complete the process should the end user have to suffer?
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Oh I see, I thought it was like the old paper script that was stamped.
 
Finally, some updates from the guys in charge!

thepsi.ie/practice-supports/guidance-and-guidelines-pharmacists-and-pharmacies/guidance-dispensing


Important points:

"Principle 1: Verification:

1.1 You verify the authenticity of the prescription to ensure it is issued by a registered practitioner/qualified healthcare professional in an EEA country. It is important that you only dispense prescriptions where you can verify the registration status and authorisation of the prescriber.
1.2 The prescription must be traceable back to a prescriber so there is a clear and documented record linking the prescription to the prescriber who issued it. For example, this may include a direct email from the prescriber in an EEA Member State to the pharmacy, or the prescriber may issue a paper copy of the prescription. A prescription presented on a patient’s phone/electronic device would not be considered appropriate as it is not traceable back to the prescriber, making it difficult to confirm its legitimacy or authenticity. "

On Mobidoctor , this is done via this page :

mobidoctor.eu/verify

Another VERY important point here:

For example, this may include a direct EMAIL from the prescriber in an EEA Member State to the pharmacy, or the prescriber may issue a paper copy of the prescription

So theres no need to have the original signed prescription.


Principle 4: Record keeping
While electronic prescriptions may be endorsed digitally in some Member States, this is not available in Ireland. Therefore, you must print a copy of the EEA prescription as transmitted and treat it as an original prescription for record-keeping and to assist with dispensing preparation and checking.


Great new for us all!
 
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