New laws in Singapore to promote digital management of medical records

A 'National Electronic Health Record' (NEHR) already exists for people in Singapore, but private health care providers are not obliged to contribute towards it. They can do so voluntarily, though.

Under the draft Healthcare Services Bill, however, all health care licensees will be required to provide information to the NEHR system. The default position will be that individuals' health data will be uploaded to the system by health care providers, however an opt out mechanism will be established to allow patients to select for their health data not to be accessed, or in some cases even uploaded to the system at all.

The Ministry of Health, which is consulting on the proposals until 15 February, said "only core data set containing critical patient health information" will need to be uploaded by health care providers subject to the new law.

"The NEHR is a key enabler for better coordination and continuity of care and patient safety," the Ministry of Health said. "As more patients have complex needs requiring coordinated care across providers, the NEHR enables their health record to follow them regardless of where they seek treatment. Their records will not be lost should a provider cease operations."

"The NEHR also supports better assessment and decision making among healthcare professionals through access to a patients’ medical history. In an emergency, timely access to medical records saves lives," it said.

The Ministry of Health said the new Bill would contain "safeguards" to restrict the circumstances in which data uploaded to the NEHR could be accessed,

"The NEHR can be accessed only for purposes of patient care, and not for other purposes including assessment for employment and insurance," it said. "Measures, including the provision of access logs to patients and regular audits on NEHR access, will be instituted to protect against illegitimate access. Penalties will be imposed for unauthorised access."

The way that health care services are licensed is also set to change, according to the proposals.

Under the Private Hospitals and Medical Clinics Act (PHMCA), which the Healthcare Services Bill would replace, health care services are licensed based on physical premises. Under the new Bill, licensing would instead be "services-based" to take account of "new and emerging healthcare service models and businesses that are not based out of physical locations, such as telemedicine and mobile medical services", the Ministry of Health said.