The upcoming launch of the HSE Health App is a significant milestone in the digital transformation of Ireland’s health services. By providing patients with direct access to their health records, including medication data, the app has the potential to enhance patient engagement and improve access to healthcare information.

The app will include information about medicines supplied to patients under community drug schemes, with this data initially sourced from HSE PCRS claims records. It remains unclear which community drug schemes will be included. As PCRS claims data is now being used beyond its primary purpose, it is important for pharmacists to be aware of its role in the app. This reinforces the need for vigilance when responding to patient queries about medication records and highlights the importance of ensuring claims are processed in a timely manner.

How medicines information is populated

The app will include a list of medicines reimbursed through HSE schemes, but this will be based on PCRS claims data rather than dispensing records. This means that:

• Patient medication records may be incomplete, both if data is limited to certain community drug schemes and in situations where certain medications are supplied to the patient but not reimbursed under the scheme(s) in question;
• There will be a delay — up to seven weeks — before recently dispensed medicines appear in the app;
• Private prescriptions, Drug Payment Scheme (DPS) sub-threshold medications, and rejected claims will not be reflected; and
• The app does not display directions for use, which may limit its usefulness for patients and healthcare professionals.

Key concerns identified by the IPU

While the IPU supports the use of the patient app to enhance patient care, presenting reimbursed medicines under the medicines information section without the full picture may have implications for patient safety, pharmacy workload, and public confidence in the accuracy of the information provided.

The IPU initially raised these concerns with the HSE when the use of PCRS claims data to support medicines reconciliation was introduced in the hospital setting. In such a setting this data is used by healthcare professionals who reconcile it with information from other sources to get as complete and accurate a picture as possible about a patient’s medication. However, the use case for PCRS data as it will be shared in the app is different, and it is unclear how this will be communicated to patients. The IPU has concerns on several levels and believes that, with appropriate engagement, a better solution for patients can be achieved.

Patient safety considerations

• Data source and update delays: Since the app relies on PCRS claims data, updates to medication records will not be reflected in real time. This lag poses a risk, particularly if recent medication changes are not visible to healthcare professionals using the app;
• Incomplete medication data: A patient’s full medication history may not appear in the app due to limitations in PCRS reimbursement data. Private prescriptions and medications requiring approval may be missing, creating an incomplete picture. Research has shown that while the PCRS database is relatively accurate, it does not always reflect the full range of medications a patient may be using;
• Inability to edit medication data: Once a medicine appears in the app, it cannot be marked as stopped or changed, even if a patient has discontinued it due to side effects or an allergic reaction. This could lead to outdated information being relied upon for medication reconciliation; and
• Missing directions for use: The app does not display dosage instructions, which could pose a particular risk for:
• High-risk medications (for example, methotrexate, insulins, anticoagulants, opioids);
• Medicines requiring titration (for example, steroids, certain anticoagulants); and
• Medications with complex dosage regimens (for example, injections given at extended intervals).

Impact in the community pharmacy setting

Patient confidence in pharmacy records

Due to the time lag associated with PCRS records, patients may start to query the accuracy of the records being maintained by their pharmacist. This has consequences for the patient pharmacist relationship.

Patient confidence in the app

If patients find missing or outdated medication records in the app, they may lose trust in the system, which could undermine its potential benefits. Ensuring the most accurate and up-to-date data is essential for the app to gain widespread acceptance.

More patient queries

As a trusted source of medicines information, pharmacists are likely to receive queries from patients who notice discrepancies or gaps in their app data, which may add to the administrative workload of community pharmacies. Additionally, the app includes a section where patients can manually list their medications. Experience from previous campaigns suggests that this could lead to additional queries at the pharmacy counter.

The road forward

The HSE Health App is a positive step in digital healthcare, but collaboration between pharmacists, the HSE, and healthcare IT stakeholders will be essential to addressing the challenges identified. Developing a roadmap to integrate real-time, structured dispensing records — including private prescriptions — and ensuring community pharmacy expertise contributes meaningfully to future app development would be a significant improvement.

In the meantime, pharmacists should be prepared for patient queries and continue to emphasise the importance of professional medicines reconciliation in supporting patients with their medication management.