The NEHR receives and consolidates data from various healthcare institutions and national registries into a holistic health record. It includes information such as:
The NEHR is owned by the Ministry of Health of Singapore and managed by the Integrated Health Information Systems (IHiS), Singapore's HealthTech Agency.
Presently, anyone, regardless of residency or citizenship status, who has seen an authorised healthcare professional from an institution which contributes data to NEHR, will have a record in NEHR.
NEHR potentially helps you to save time and money, as it reduces the need to take duplicate tests or scans at different healthcare institutions. MOH is also helping healthcare providers to defray some of their costs of upgrading their IT systems by making available various financial support schemes. MOH will continue to monitor the situation. There are also existing schemes such as the Community Health Assist Scheme (CHAS) and Medifund to support you and ensure that healthcare remains affordable for you.
You are automatically included in the NEHR to enjoy the benefits it brings.
Access to the NEHR has to be authorised by MOH and is granted primarily to healthcare professionals who are involved in direct patient care such as doctors. In a GP clinic setting, clinic assistants would not be provisioned with an account, as they do not provide direct patient care. You can find the list of healthcare institutions participating in the NEHR here.
NEHR is intended primarily for the provision of patient care, and provides continuity of care, especially when the patient moves between institutions within the healthcare ecosystem. It provides a record of the patient's journey with each healthcare encounter, and is currently contributed mostly from public healthcare institutions. When contribution to NEHR is made mandatory for all institutions, including private healthcare institutions, your record will be viewable across the care continuum, e.g. polyclinics, hospitals, specialist clinics, or even your GP to support seamless transition of care. This will enable healthcare providers to provide more accurate diagnosis and better treatment.
Data with the identities anonymised can be used for research and population insights purposes. Additionally, NEHR data can be used for purposes of public health; fulfilment of public functions and where legislatively required, access may be granted by MOH.
After hearing feedback from the consultations sessions with both licensees and members of the public, MOH will explore if additional provisions are required to be introduced into the draft Healthcare Services bill to legally prohibit licensee access and use of the NEHR for insurance and employment purposes. However, doctors will still be able to provide their own patient notes when requested.
Permission is not needed for healthcare professionals to view your health records. However, only authorised healthcare professionals providing care to you can view your records. To prevent unauthorised access, a two-factor authentication system for access has been incorporated where necessary. There are also features to detect suspicious access and usage. For sensitive health information (SHI), safeguards are built into NEHR to ensure that access to such information is not abused or misused. For example, SHI is not routinely displayed. Authorised users who need the SHI can only do so after they validate the access with their NRIC number and the reason. All accesses are logged, subject to full audits and the reasons for access documented. Later this year, patients will be able to view a record of accesses made to their NEHR records via HealthHub so that they can report suspicious or wrongful access.
When suspicious access is detected or reported, we will carry out investigations and those found to have misused the system will be dealt with under the law, in accordance to the penalties under the Cybersecurity and Computer Misuse Act and/or the upcoming Healthcare Services Act.
To protect against cyber-attacks, the NEHR system has a rigorous and comprehensive range of security measures in place to protect the patient data in NEHR. The NEHR is built with multi-layered security defenses to provide resilience and in-depth defense against cyber-attacks. These security measures are subjected to regular independent audits, including security penetration tests. IHiS, the HealthTech agency for Singapore, also works with Cyber Security Agency and other government agencies to regularly review and enhance these security measures.
Patients have no direct access to NEHR, however they do have access to some of their clinical records, through HealthHub. At present, HealthHub provides access for patients to view the following records, which includes:
One may also view his or her children's medical records which also includes school health records, school dental records and children immunization records. In addition, caregivers may also be able to access patients' medical records with the appropriate consent granted by their parents through HealthHub.
For more information on the HealthHub, click here.
Currently, relevant health records are uploaded to the NEHR directly from the healthcare institutions. You are unable to add information directly to the NEHR. However, this may be reviewed in the future.
Yes, patients have the option to opt out. By default, all patients' summary records are sent and stored in the NEHR for seamless provision of care. Following feedback from the consult sessions, MOH is reviewing the various opt-out options, such as having records stored in NEHR under lock, or records not to be stored in NEHR. IHiS will also be exploring the setting up of a central opt-out helpdesk team to ensure an efficient opt-out process. More details of the alternative opt-out options will be announced at a later date.
However, patients should note that choosing not to have their future records stored in the NEHR would cause a permanent gap in their medical history and care may be compromised during emergency situations.
The current process for opt-out is for patients to obtain and submit the opt-out forms at any Restructured Hospitals or polyclinics. Patients who wish to opt out will be counselled, to ensure that they fully understand the implications of this decision to their care as their providers will not have access to their records. At any time, patients may choose to opt back in again.
As of April 2019, 383 patients have opted out of NEHR. Since 2011, 27 people have opted back in after being counselled on the benefits of NEHR.
Data contribution to the NEHR is voluntary for all private healthcare providers. The MOH has been reaching out to them to encourage sharing of clinical data with the NEHR.
What are your thoughts on on-boarding all healthcare providers for data contribution and access to enable better patient care?
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