The Health Information Bill (HIB) introduces significant changes to how health information is collected, accessed, and shared in Singapore. A central component of this bill is the National Electronic Health Record (NEHR), a secure, centralized repository established in 2011 to streamline health information management across public and private healthcare institutions.
Mandating Data Contributions
Under the new bill, all healthcare providers licensed under the Healthcare Services Act (HCSA) are required to contribute selected health information to the NEHR. This mandate also extends to other approved contributors, such as retail pharmacists, who will be required to provide specific types of health data to enhance the completeness of the NEHR.
Types of Health Information Required
Only certain types of health information will be mandated for contribution to the NEHR. This includes:
Patient Demographics: Basic personal details like name, address, and contact information.
Visits: Records of hospital admissions, general practitioner visits, and other healthcare interactions.
Medical Diagnoses and Allergies: Information on patient diagnoses and known allergies.
Medical Procedures and Treatments: Details of surgeries, treatments, and other procedures performed.
Discharge Summaries: Summaries provided upon a patient’s discharge from a healthcare facility.
Medications: Information about prescribed medications.
Investigation Reports: Results of laboratory tests and radiological investigations, such as X-rays.
Exclusions and Considerations
Detailed clinical notes and day-to-day progress reports are not required to be contributed to the NEHR. This decision is based on the need to keep the system user-friendly and relevant. Healthcare providers will only need to contribute information generated during their interactions with patients. For instance, a general practitioner (GP) who does not prescribe medication does not need to enter prescription data. Similarly, if a clinical laboratory conducts a test, the lab, not the referring GP, is responsible for contributing the test results to the NEHR.
Certain groups, like short-term visit pass holders, are excluded from the data submission requirements. These individuals, such as tourists receiving temporary care, do not benefit significantly from long-term data storage in the NEHR, making the cost of inclusion outweigh the potential benefits.
Regulating Access to the NEHR
A. Controlled Access for Healthcare Providers
Access to the NEHR is strictly regulated under the new bill. Healthcare licensees and approved users must obtain authorization from the Ministry of Health (MOH) to access the system. Licensees are typically granted access through their HCSA license, while non-HCSA licensees must apply separately to the MOH.
B. Purpose-Based Access
Access to patient records in the NEHR is limited to direct patient care or other uses explicitly authorized by the Minister for Health. These purposes can include clinical care, administrative tasks directly related to patient care (like scheduling appointments or arranging transfers), or statutory requirements under other laws (such as medical examinations related to the Enlistment Act).
To protect patient privacy and autonomy, even authorized healthcare providers cannot access records for individuals who have restricted access to their data unless they have obtained explicit consent from the patient.
Conclusion
The Health Information Bill represents a transformative approach to managing health data in Singapore. By mandating contributions to the NEHR and regulating access, the bill aims to create a comprehensive, secure, and accessible health information system that benefits both patients and healthcare providers.
Are you prepared for the changes introduced by the Health Information Bill? Ensure your organization is compliant and ready to leverage the NEHR by staying informed about these new regulations and provisions.
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