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Analysis: Digitisation matters

Gan Kim Yong, Singapore’s minister for health, explains why the private sector needs to get behind the National Electronic Health Record System.

The care needs of Singaporeans have grown rapidly in recent years due to our ageing population, higher chronic disease incidence and rising public expectations. On the other hand, medical knowledge and technologies are also advancing, bringing about new possibilities in how we prevent, diagnose and treat diseases.

When we work on transforming healthcare to provide better care to Singaporeans, one key enabler is the use of IT through digitisation and closer connections among healthcare providers. In 2011, we introduced the National Electronic Health Record System (NEHR) to bring together clinical summary records from different care providers, enabling information to be shared across providers for enhanced patient safety and facilitate care integration.

Today, this is even more important with an increasing number of patients suffering from multiple medical conditions requiring team-based care. Patients will benefit from the NEHR when their doctors and care teams are able to access their key medical history when necessary and, work across settings to provide them with coordinated, holistic and safer care. This is particularly important during emergencies.

There was a case where an unconscious man was brought in by ambulance to the Tan Tock Seng Emergency Department. A CT scan revealed bleeding inside his brain. The patient was unable to communicate and no family contact information was available. The attending doctor – Charmaine Manauis – pulled up his medical records in the NEHR. She found that he was recently prescribed an anticoagulant for his heart condition. This drug has the effect of reducing the ability of a person’s blood to clot. With this information, Dr Charmaine was able to prescribe the appropriate treatment that helped the patient recover quickly.

This is just one of many examples. The NEHR has the potential to save lives, and enables significantly better integrated care across the various healthcare institutions. Today, over 1,100 healthcare providers across public and private care settings have access to the NEHR. Last month alone, over 1 million patient searches were made on the NEHR. While access has been growing significantly over the years, however, more can be done, especially in encouraging private healthcare providers, GPs, private hospitals and specialists to contribute data to the NEHR.

Patients can only realise the full potential of the NEHR if the data is comprehensive. And for the data to be comprehensive, every provider and healthcare professional needs to contribute relevant data to it.

The ministry of health therefore intends to take the next major step for the NEHR, to require mandatory data contribution by all licensees, such as healthcare providers and laboratories, so as to improve data comprehensiveness for better patient care. We plan to introduce legislation next year to do this.

We have consulted many in the healthcare sector on this. Healthcare professionals and patients alike are supportive as it enables care continuity and patient safety. However, we recognise that some care providers may face challenges and they may have concerns. MOH will help them.

The ministry will be increasing support for contributions to the NEHR. We will provide clinical and technical expertise, as well as financial support, to help healthcare providers make the transition.

First, we will organise workshops and focus groups among different stakeholders over the next few months, better to understand their concerns and how we can help them contribute to the NEHR. We will also run a series of technical workshops for IT vendors of clinic management or medical record software to help them meet the data requirements.

Second, we will make online resources available for providers and vendors to get advice on how to contribute data, where to seek assistance and how to access the support provided.

Third, we will provide an Early Contribution Incentive to encourage early adoption before the legislative requirement takes effect. This will help healthcare providers and labs defray part of the costs associated with enhancing their IT systems. As this is an incentive to encourage early adoption, only early birds that start contributing medical data to the NEHR will receive the funding. We have set aside a budget of S$20 million (US$14.7 million) for this. Our healthtech agency, the Integrated Health Information Systems (or IHiS), will work with healthcare providers and labs to provide this support and funding.

Healthcare providers and professionals have also given other feedback such as system security and safeguards. We will certainly work with healthcare providers, professionals and other stakeholders in the coming months to see where we can further strengthen and refine.

The transformation of our healthcare ecosystem and workforce is a journey. It is a journey that we need to take together – as leaders, educators, researchers, industry partners, healthcare workers, patients, caregivers as well as individuals. Only if we share the same vision of future health, can we lay a strong foundation for better skills and better work for our healthcare professionals, and deliver better care for Singaporeans.

This article is an edited version of a speech given in Singapore at the FutureHealth 2017 conference on 8 November.

Posted on: 13/11/2017 UTC+08:00


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