About NEHR

What is the National Electronic Health Record (NEHR)?

​The National Electronic Health Record (NEHR) is a key enabler of Singapore’s strategic vision for “One Patient, One Health Record” where patients move seamlessly across the national healthcare network, receiving coordinated patient-centric care at the most appropriate settings. It provides secure access to a patient’s health record by authorised clinicians and healthcare professionals to:

  • Enable greater coordination and informed decision-making,
  • Support more accurate diagnosis, better treatment, and patient-centric integrated care.

It is a patient data exchange system that manages the patient’s health record by capturing clinically relevant information from their encounters with clinicians and healthcare professionals across the national healthcare network throughout their life. The goal of the NEHR is for patients to enjoy hassle-free healthcare delivery, higher quality of care, fewer duplicate or unnecessary tests and/ or referrals, reduced medical errors and adverse drug events. To ensure security and confidentiality of patient data while the best care is provided, the NEHR enforces measures to authenticate, authorise and audit healthcare institutions and users' access to patient’s health record.


What information is shared through the NEHR?

Which healthcare institutions have access to the information in the NEHR?

Who owns the information in the NEHR?

Is the NEHR applicable to non-Singaporean Citizens or non-Permanent Residents?

How can I be sure information in NEHR system is accurate?



Security

Is the NEHR system secure?

What are the safeguards to ensure the confidentiality and security of patient data in the NEHR?



Patient's concerns about the NEHR

Will my healthcare costs increase because of NEHR?

Am I included in the NEHR?

Who can access my medical records on the NEHR?

What will my health record in the NEHR be used for?

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.

The NEHR may not be used by doctors when writing medical reports for pre-employment medical screening and insurance claims. They will have to rely on their own patient notes.

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.



Opting back in/out of the NEHR

Can I choose to opt out of the NEHR? What will happen if I do so?

Yes, you have the option to opt out of the NEHR.

By default, all patients' summary records are sent through systems that are integrated with the NEHR for seamless provision of care. Following feedback from the consult sessions conducted in 2018, MOH is reviewing the various opt-out options. 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 when ready.

The current opt-out process available is 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.

Once you have opted out, your past and future records in the NEHR will be blocked from view to healthcare providers authorised with NEHR access, including those providing care to you. You will also not be able to see your summary health records via HealthHub.

At any time, you may choose to opt back in again.

Where can I request to opt back in/out of the NEHR?

To opt back in/out of the NEHR, please approach the frontline staff of any restructured hospital or polyclinic.

It does not have to be an institution that has your records. They will validate your identity in person and facilitate the process.

How many patients have opted out of NEHR?

Since 2011, over 400 patients have opted out of NEHR and more 30 have opted back in after being counselled on the benefits of NEHR.



Access to records in the NEHR

Who can access my medical records on the NEHR?

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. All clinicians and healthcare professionals accessing the NEHR are also bound by law and professional ethics to keep patient health record strictly confidential.

Employers, insurers and patients are not granted with NEHR access.

Will Government agencies, health researchers, insurance companies and people other than those delivering healthcare be able to access my health record in the NEHR?

Unless you have opted out of the NEHR, only the clinicians and healthcare professionals authorised to access the NEHR who are managing your care could access your health record to provide you with the best care possible. Your health record will not be accessed for other purposes unless access is allowed or required by law.

Will healthcare professionals ask for my permission to view my health record in the NEHR?

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.

Can I view my own, my parent's and children's healthcare record and medication list? If yes, how can I view it?

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:

  • Immunisation records
  • Laboratory results
  • Screening records
  • Discharge information
  • Vital health tracking
  • Appointment information
  • Medications

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.

Can I add or update information to my health record?

Currently, relevant health records are uploaded to the NEHR directly from the healthcare institutions. You are unable to add information directly to the NEHR.





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