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One small change: A GP in Ballymun on how to make Ireland’s health system better

GP time is taken up transcribing hospital discharge and outpatient prescriptions

As our health system begins to return to normal activity levels following the Covid-19 pandemic, we would like to hear from doctors, nurses, paramedics, medical secretaries, hospital porters, canteen staff and others about one change they would like to see in our health system.

It can be something simple that annoys you, day in, day out, that is easily fixed, or it can be a small change in practice or attitude that would make life easier for everyone.

Dr Claire Gleeson

(GP in Ballymun, Dublin)

“As a GP, the One Small Change I would like to see would be the creation of a shared electronic prescribing record, accessible by all doctors involved in a patient’s care.


“One of the positive innovations of the Covid era was the introduction of electronic prescribing, whereby GPs can send prescriptions directly to pharmacies by email, saving on time, paper and the potential for errors. Of even greater value, however, would be an online prescription record which could be accessed by all doctors who are involved in caring for a patient, whether they are based in hospital or in the community.

“Every week, hours of GP time are taken up transcribing hospital discharge and outpatient prescriptions – many of which are still handwritten – onto our practice database, so we can then issue prescriptions to pharmacies for our patients. As well as the obvious potential for copying errors, inevitably there are discrepancies between what has been prescribed by the hospital and the long-term medications our patients have been taking. It can be very difficult in our fragmented healthcare system to establish whether these medications were deliberately stopped, accidentally omitted, or whether the specialist team was ever aware the patient had been taking them in the first place. Additionally, when a new prescriber does not have access to all of a patient’s information, medication can be inadvertently prescribed which may interact negatively with other drugs the patient is taking.

“A shared online medication record would go a long way towards preventing these issues, leading to safer care for all, and would free up hours of valuable time in GP practices every week. It would, of course, require the introduction of new software, a unique patient identifier and the careful navigation of data protection issues including clear and informed patient consent. So perhaps this is a a fairly big change rather than a small one – but the benefits to both patients and prescribers are clear.”