The National Electronic Health Record (NEHR) is a key enabler of Singapore’s vision towards an integrated care system where patients are able to move seamlessly within the healthcare system. Our vision is “one Singaporean, one health record.”
It is a system that manages an individual’s electronic health records. The NEHR builds on the existing Electronic Medical Record Exchange (EMRX) which is a digitised version of medical information recorded by each healthcare institution a patient visits. Specific to individuals, the NEHR further captures key information from multiple health care providers and provides this information electronically to authorised healthcare providers.
Designed to facilitate the sharing of data across healthcare providers in different locations, the result is greater enhancement of the continuum of care. The NEHR is a robust, patient-centred system that builds upon existing systems and allows extensions beyond the current provider coverage.
With the NEHR, patients will benefit from having their clinical records available to the providers in charge of their care regardless of geographic boundaries and care settings. As a result, there will be cost savings as we eliminate duplicate or unnecessary tests, and improve the quality of care through, for example, helping to reduce medication errors and adverse drug events as well as facilitating care integration.
The public sector healthcare institutions have been practicing electronic records exchange since 2004 under the name “Electronic Medical Record Exchange” (EMRX). The NEHR builds on this foundation and has the potential to extend beyond the current provider coverage of EMRX. This will allow seamless transition of patients across the care continuum with minimal disruptions.
The NEHR will be rolled out in phases. At the current phase of implementation, key medical information will include patient demographics, allergies, clinical diagnoses, medication history, x-ray reports, laboratory investigations and discharge summaries. This information is already captured in the existing electronic medical records maintained by the public healthcare sector (ie. the public hospitals and polyclinics).
Plans are underway to include information sources beyond the public healthcare sector such as community hospitals, and General Practitioners over time.
Healthcare teams would be better equipped to provide more effective care as the NEHR will enable more timely access to health records including diagnoses, prescriptions and allergies.
There will also be cost savings as healthcare staff will be able to obtain a more complete and accurate picture of your health history and therefore avoid ordering duplicate or unnecessary tests.
While you can choose not to be on the NEHR system, we would strongly discourage you from doing so. The NEHR system allows your healthcare providers to have an overview of your medical history as you move from one institution to another.
An example of this would be if a patient who is not on the NEHR is taken to an A&E, the staff at the A&E may not be able to access that patient’s current medication records, allergies history, or notable reactions to medicines, etc.
However, if you still wish to opt-out of the NEHR, please speak to any of our healthcare providers or service staff who would be happy to help you arrange a meeting with our counsellors. They will be able to tell you more about the NEHR and your opt-out options.
All medical staff accessing the NEHR are bound by law and professional ethics to keep your medical information strictly confidential. In addition to existing laws already in place to protect your physical medical records, unauthorised access and modification of your electronic health record is also an offence under the Computer Misuse Act. Under this Act, healthcare institutions are treated as “protected computer” installations and the enhanced punishment for offences covered under the Act attracts fine not exceeding S$100,000 and/or jail of up to 20 years. Provisions under the Private Hospitals and Medical Clinics Act require licensees of healthcare institutions to ensure that there are systems and processes in place to safeguard patient data. This includes staff training so that they understand their duty of confidentiality and what it means in practice.
Private healthcare providers must also follow the same policies and use the same controls as their public healthcare counterparts.
Anyone who accesses your records under NEHR will have their details recorded. If someone has deliberately accessed your records without permission or good reason, action will be taken. This can include disciplinary action, ending a contract, firing an employee or bringing criminal charges. The security measures implemented in the NEHR follows industry best practice.