Greater protection of patient data when national electronic medical records become mandatory

When the new law comes into effect under the proposed Healthcare Services Bill, those who violate it could be fined up to $100,000 and jailed for a period not exceeding 24 months.
When the new law comes into effect under the proposed Healthcare Services Bill, those who violate it could be fined up to $100,000 and jailed for a period not exceeding 24 months.PHOTO: ST FILE

SINGAPORE - Employers and insurers will be prohibited from accessing a person's medical history in the National Electronic Health Records (NEHR) once the new Healthcare Services Bill comes into effect.

This move should allay concerns that have surfaced repeatedly during feedback sessions on the Ministry of Health's (MOH) announcement that all healthcare institutes must input patient details into a central database that all doctors and other medical practitioners will have access to.

Many people were concerned that their past medical conditions might be used against them by insurance companies when they want to buy a new policy, or by potential employers.

When the new law comes into effect under the proposed Healthcare Services Bill, those who violate it could be fined up to $100,000 and jailed for a period not exceeding 24 months.

People who do not want to have any of their medical data in the NEHR will be given two options. They can have their data included but not made available to any doctor accessing the database. If they change their minds later, their medical history can be uploaded.

Alternatively, they can choose not to have any of their medical data in the system. In this case, no historical data will be available.

The idea behind the NEHR is to enable any doctor treating patients to have relevant medical information that could help in treatment and diagnosis. It will also prevent data from being lost should a doctor retire.

 
 
 

This is especially critical in emergency situations. Dr Charmaine Manauis of Tan Tock Seng Hospital's (TTSH) emergency department gave an example of a patient who was brought in unconscious. Doctors found out from the NEHR that the patient was on Dabigatran, an anticoagulant that would have affected treatment if they had not been aware of it.

Historical medical information is also useful in a normal clinic setting, especially for elderly patients who might not remember, or even know, the medications they are taking.

While substantial medical details may be put into the system, doctors can access only basic information, such as diagnosis, medications, laboratory reports, allergies and immunisations, and, if the patient was previously hospitalised, the discharge report.

So far, all public-sector medical institutions are inputting patient information, but very little is coming in from the private sector.

Last year, Health Minister Gan Kim Yong announced plans to make it compulsory for all to input data. To help them get started, MOH has put aside $20 million in grants - ranging from $2,400 for clinics to $200,000 for hospitals - for those who join the scheme early, before it becomes mandatory.

Ms Tin Pei Ling, a member of the Government Parliamentary Committee for Health said it was good to broaden the regulations to include non premises-based services.

She said: “With ageing, there is increasing need for mobile care services such as home nursing. Already, there are companies operating in this area of need where they match supply of professional freelance nurses to home- or bed-bound patients.”

There may be further changes to the final Bill, depending on feedback the ministry hopes to receive over the next six weeks. It has uploaded the complete draft Bill on the Internet and is asking for feedback before finalising it.

There will also be two public consultations on Jan 24 from 6pm to 9pm and on Feb 10 from 2pm to 5pm. Those interested can sign up at www.HCSA.sg