Singapore Healthcare Providers Must Soon Contribute To National Electronic Records

Singapore will introduce a new bill mandating all healthcare providers in the country to contribute to the national electronic health record system (NEHR).

Launched in 2011, the system was developed to create a central database from which clinical summary records from different providers could be stored and shared to facilitate the delivery of healthcare.

Touting the maxim "one patient, one health record", the database is owned by the Ministry of Health and managed by its agency Integrated Health Information Systems (IHIS). Data contribution currently is voluntary for private healthcare licensees and the ministry, over the years, has been encouraging all providers to participate.

However, various stats put the figure at fewer than 70, out of the 1,600 GP clinics operating in Singapore today, that were part of the NEHR today.

More than 1,100 healthcare providers across public and private sectors currently had access to the NEHR, which last month processed more than 1 million patient searches.

However, out of the total of more than 4,000 private healthcare providers that included GPs, hospitals, dental clinics, and nursing homes, just 3 percent contributed to the digital database. And according to an IHIS survey, which polled 1,500 of this community, two in every 10 private GPs and specialist clinics depended on written health records.

In a move to change these stats, Singapore's Ministry of Health would introduce a new Healthcare Services Bill to compel all licensed healthcare providers, including clinical laboratories and private GPs, to contribute data to the NEHR.

Expected to be tabled next year, the bill would likely include a two- or three-year period during which affected licensees would have to prepare for compliance. The government would be offering assistance to help them get there, including conducting technical workshops and providing online resources to offer advice on how to contribute to the NEHR.

In addition, a S$20 million grant would be set aside to help healthcare providers and labs defray part of the costs needed to upgrade their IT systems so these could interoperate with the NEHR.

Only "early birds"--those that contribute data by June 2019--would be given access to such funds in order to encourage early adoption. The government's healthcare agency, IHIS, would manage this funds and work with participating healthcare providers.

Singapore's Minister for Health Gan Kim Yong said: "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."

He added that having access to healthcare records was increasingly important as more patients suffered from multiple medical conditions requiring "team-based care".

"Patients will benefit from the NEHR 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," Gan said.

Commenting on the need to get all healthcare providers on board the NEHR, the health ministry's CIO and IHIS CEO Bruce Liang noted: "This will not be an easy journey. The state of IT adoption is uneven across the 4,000 over healthcare institutions in Singapore and there is a large number of IT solution providers with wide variation of offerings.

"As such, we expect challenges in on-boarding all licensees to the NEHR. However, it is a journey we must make as a strong digital backbone is essential in meeting our patients' and healthcare system's needs in the future," Liang added.

Noting that the ministry had received feedback on issues such as system security and safeguards, Gan said the government would look at ways to "strengthen and refine" these.

According to the Singapore government, safeguards already were in place to ensure only those providing healthcare had access to patient records, which included information such as medication, allergies, and vaccination history. The records did not include data such as doctors' personal case notes.