REVIEWING SYSTEM ENABLERS TO SUPPORT HEALTHCARE TRANSFORMATIONS - Health Information Bill

Health Information Bill

As we embark on Healthier SG, there is a need to transform the communication and sharing of data among healthcare clusters, family doctors and community care providers, to ensure a more holistic and coordinated care journey. The Ministry of Health (MOH) aims to table the Health Information Bill in the second half of 2023 to facilitate the proper collection, use and sharing of patient information across different healthcare providers and care settings in a safe and secure manner.

2. The National Electronic Health Record (NEHR) was established in 2011 as a central repository of patient summary health records drawn from and shared across healthcare providers to enhance care continuity. Since 2015, key health summaries from NEHR, such as medications and COVID-19 test results, have been progressively shared with patients and caregivers through HealthHub for their health management. As of December 2022, all public healthcare institutions and over 30% of private MOH-licensed healthcare institutions have access to NEHR. This includes over 90% of private hospitals, nursing homes and over 60% of medical clinics.

3. The Health Information Bill will benefit patients, residents and healthcare providers by:

a) Increasing the functionality of the central NEHR repository, through mandatory contribution of summary data to NEHR by licensed healthcare providers, such as hospitals, clinics, laboratories, and extending access and/or contribution to prescribed users like retail pharmacists;

b) Enhancing the legal framework to facilitate proactive data sharing across MOH entities, Healthcare Services Act (HCSA) licensees and appointed community partners to allow healthcare professionals to have a fuller picture of one’s health for better monitoring and follow-up; 

c) Putting in place safeguards for data sharing to protect patient confidentiality and respect patient autonomy; and

d) Putting in place cybersecurity, data security and data protection measures to safeguard health information.

Ensuring safe and secure data sharing

4. Since May 2022, we have consulted more than 800 residents, patients, industry experts and healthcare providers to better understand their concerns on the Bill. Most of the participants generally agreed with the benefits of data sharing and were supportive of the Bill. However, there were some concerns on medicolegal liabilities, cybersecurity and data security. 

5. To address these concerns, we will provide guidance for healthcare professionals: 

a) On the cybersecurity front, we will be setting out cyber and data security requirements for healthcare entities. Data intermediaries including Clinic Management System (CMS) vendors will need to ensure that their IT systems and services maintain good cyber hygiene (e.g. protected with anti-malware, implementation of proper access controls) Data and systems will also have to undergo regular backups and updating of software and security patches. In addition, healthcare staff will be adequately trained in cybersecurity. 

b) In addition to putting in place safeguards such as the need for data security classification, and requirements for proper data storage, transmission and disposal, we will also align data security and protection with prevailing policies and standards under the Personal Data Protection Act. Only authorised personnel will be allowed to access the relevant patient health data, which will be limited to what is necessary for their work. Healthcare providers or system vendors must meet these requirements and are expected to report any suspected incidents or breaches to MOH in a timely manner. 

6. Health information is personal and we respect patient autonomy. As such, we are reviewing ways to allow patients greater control over access to their records, while ensuring that should the patient decide to opt back in after initially opting out, he would still have a complete set of information for his healthcare needs. 

7. We will continue to engage stakeholders to gather their concerns and feedback as we design the Health Information Bill. 

MINISTRY OF HEALTH 
3 MARCH 2023