The Singapore’s Ministry of Health (MOH) has recently announced that all healthcare providers may soon be required to contribute patient data to the centralised National Electronic Health Records System (NEHR).

It was reported that 80% of Singaporeans visit private GPs instead of polyclinics under primary care. With an ageing population, patients may consult more than one healthcare professionals for multiple conditions.

As not all patients could express their medical histories comprehensively, the NEHR is intended to help all healthcare professionals provide safer care by cutting down duplicate tests and saving more medical costs for patients.

Depending on the nature of health service, doctors will be required to submit only a summary record of patient medical histories, including the patients’ demographics, allergies, number of visits, diagnosis, prescribed medications, laboratory reports, discharge summary, where applicable.

Data from old records and doctors’ personal case notes of every consultation will not be required.

NEHR enables a more accurate diagnosis

Health Minister Mr Gan Kim Yong cited the efficiency of officers at Tan Tock Seng Hospital’s emergency department in handling an unconscious patient, by prescribing the appropriate treatment with the aid of NEHR.

“Patients can only realise the full potential of the NEHR if the data is comprehensive. And for NEHR data to be comprehensive, every provider and healthcare professional needs to contribute relevant data to it,” Health Minister Gan Kim Yong said.

“Patients will benefit from when their doctors and care teams are able to access their key medical history when necessary and, work across settings to provide them with coordinated, holistic and safer care. This is particularly important during emergencies,” he highlighted.

"The information from NEHR enables me to make a more accurate diagnosis, and ensures my prescription does not interfere with their medical condition or medication they are on," commented Dr Low Kee Hwa, a GP who runs Low Medical Clinic in Kallang Bahru, adding that especially most of his patients are elders.

Concerns relating to data privacy

Singaporean authorities are looking into establishing better protection measures for patients, to avoid risking their privacy. Photo credit: The Straits Times
Singaporean authorities are looking into establishing better protection measures for patients, to avoid risking their privacy. Photo credit: The Straits Times

However, since the introduction of NEHR, various concerns were raised over patient-centred issues, such as patients’ privacy. For instance, some patients may be reluctant to share their medical histories, such as mental illnesses or sexually transmitted diseases.

The authorities have asserted that doctors will only have access to their treating patients’ data, and not others who are not directly under their care.

Besides that, anyone who wishes to access to patients’ records for reasons other than medical care will need to get patients’ consent, emphasised Professor Low Cheng Ooi, Integrated Health Information Systems (IHiS) chief clinical informatics officer. This includes situations where specific doctors are hired to review a patient’s health record for insurance purposes or pre-employment check-up.

Mr Bruce Liang, CEO of IHiS have also assured that all patients’ data in the NEHR will be safeguarded with cyber-security measures, similar to what the Inland Revenue Authority of Singapore (IRAS) uses to protect its tax database “when it collects information from thousands of companies”.

Patients may choose to opt-out

Nonetheless, patients may “opt out” of the NEHR. As such, patients’ health records will not be accessible by healthcare professionals – however, their data will still be updated into the system in case of future opt-ins.

Before making this decision, patients are required to undergo counselling sessions on the implications of opting out. Meanwhile, the authorities will consider the patients’ informed knowledge of their data access, which probably can be done through the government portal HealthHub. MIMS

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