Draft Bill eases privacy fears over electronic health records

People can agree to store their data in the National Electronic Health Records (NEHR), but it will not be uploaded for doctors to access until they give their permission.
People can agree to store their data in the National Electronic Health Records (NEHR), but it will not be uploaded for doctors to access until they give their permission. PHOTO: ST FILE

Employers, insurers barred from databank; doctors can access data only to treat patients

Many Singaporeans have been worrying that employers and insurers can obtain their medical history without their consent when it becomes compulsory for such information to be stored in a national health databank.

Yesterday, their fears were allayed when a proposed piece of legislation was unveiled.

The draft Healthcare Services Bill made it plain that employers and insurers will be barred from accessing the information. Also, people can choose between two options should they want to shield their medical history even from doctors.

They can agree to store their data in the National Electronic Health Records (NEHR), but it will not be uploaded for doctors to access until they give their permission. Alternatively, they can choose not to have their medical history in the system.

These measures for the NEHR are part of the draft Bill, which sets out changes in store for the healthcare sector as the Health Ministry prepares to update the law. These include regulations to cover mobile and online care as well as protection for the frail elderly, areas not covered in the Private Hospitals and Medical Clinics Act, which last underwent major changes in 1999.

The centralised databank was set up in 2013, but public-sector medical institutions were inputting patient information, with only a few private clinics contributing.

Last year, Health Minister Gan Kim Yong announced it will be made compulsory for everyone.

The move is to enable all Singapore doctors and other medical practitioners to have the relevant medical information for the diagnosis and treatment of patients. This is especially critical in an emergency.

Dr Charmaine Manauis of Tan Tock Seng Hospital cited the case of an unconscious patient whose medical history in the NEHR showed he was on dabigatran, an anti-coagulant that prevents blood clots. This was critical information as doctors were able to give the antidote to prevent him from bleeding profusely .

Even in a normal clinic setting, past data is particularly useful in treating elderly patients who may not remember, or even know, the medicines they are taking.

Despite the benefits, many Singaporeans were concerned that potential employers may turn them away or insurers may use their past medical conditions to refuse them a policy or impose hefty premiums.

But the proposed law states explicitly the data can be obtained only to treat patients. And doctors can access only basic information such as diagnosis, medication, laboratory reports, allergies, immunisations and the discharge report of patients who had been hospitalised.

Those who flout the rules face harsh penalties.

Ms Tin Pei Ling, a member of the Government Parliamentary Committee for Health, was all for prohibiting employers and insurers from accessing the NEHR. "The data collected should be to enhance patients' care," she said.

But the Life Insurance Association Singapore said insurers should be given access on "receiving explicit and appropriate consent from the patient when the need arises''.

Its spokesman said: "Ultimately, we believe there will be benefits from this approach for consumers in improving claims servicing."

The association will give the ministry feedback on this, she added.

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A version of this article appeared in the print edition of The Straits Times on January 06, 2018, with the headline 'Draft Bill eases privacy fears over electronic health records'. Print Edition | Subscribe