Letter of the week: Internet separation holding back healthcare progress

Nearly two years have passed but the Internet separation largely remains the same as it was in its first week.
Nearly two years have passed but the Internet separation largely remains the same as it was in its first week.PHOTO: REUTERS

The Government instituted Internet separation for public healthcare institutions in July 2018 after a cyber attack on SingHealth that led to patients' data being leaked.

It was a crude measure, but perhaps the quickest and most effective at the time, while more nuanced solutions could be thought through.

Nearly two years have passed but the Internet separation largely remains the same as it was in its first week. We have learnt to live with the inefficiencies and increased waiting times and have devised workarounds.

Covid-19 is ushering in a new era with new challenges. We are encouraged to work from home and to do virtual teleconsultations with patients.

But with Internet separation, these teleconsultations pose new cyber-security challenges as healthcare providers end up having to use their personal devices for patient care.

Huge investments in hardware and wireless bandwidth will be needed to meet the requirements.

Singapore's healthcare system is not the only one in the world that has been a victim of hacking and data theft, but it is probably the only one that has resorted to such measures.

Internet separation in other countries is used only in high-secrecy areas such as military establishments. Healthcare systems around the world have used smarter, more secure and agile solutions. There is so much more we can do with a connected healthcare system.

Recognising that clinicians often take clinical photos with their smartphones, a photo app serving that purpose was developed in the United States. It securely uploads such photos to an electronic health record (EHR) and then deletes them from the phone.

Patient-reported outcome measures are recognised as increasingly important to optimising health and empowering patients, but these need mobile apps or Web-based survey forms to communicate with an EHR.

A connected healthcare system can deliver home medical services or even "hospital at home".

Nurses can use a single device that wirelessly transmits vital signs and observations into the EHR as structured flowsheet data.

Cloud-based voice recognition can be used instead of manually typing notes, saving doctors' time for more valuable patient-care activities.

Medisave, insurance and community assistance data can integrate seamlessly and financial subsidies for patients can flow across institutions.

In healthcare, we need close interaction with the general population. Indeed, it is the purpose of our existence.

This is an appeal to the Government to reconsider Internet separation in the larger interest of the health of our nation.

Manjari Lahiri (Dr)