OYK tells a long story.
4h ·
Last week was significant for MOH, because we finally passed the Health Information Bill (HIB) in Parliament. It was almost eight years in the making so you can imagine how elated we are.
For those who are unaware what the HIB is about (and I don’t blame you), it requires all licensed healthcare providers to contribute summary patient information to a platform called the National Electronic Health Record (NEHR).
With this sharing of information, we can improve care.
It’s safer as all clinicians you seek care from will know your allergies and medications you are taking. We can cut down on duplicative tests and scans. We can make care more seamless and integrated.
Why did the HIB take eight years to pass? It’s quite a long story.
When MOH was about to table the HIB in Parliament years ago, we were unfortunately hit by a data breach in one of our healthcare clusters. I am not naming the cluster, because I believe for a breach of this nature, there was a systemic weakness. It was a matter of collective responsibility, not just the cluster affected.
MOH took the episode in its stride and learnt from it. We spent years investing and strengthening our cyber security. Then came COVID-19, and we had to put the HIB on the backburner.
Post-COVID, we revived the project. I decided to take some time to understand how other countries manage their patient data sharing policies. At every international meeting involving health ministers, I made it a point to meet my foreign counterparts to learn from their experiences.
I gained the following insights, which was invaluable:
Every country wants to better share patient data, to improve care.
Unfortunately, most countries were technically not ready. Their healthcare IT systems are fragmented and incompatible. We on the other hand, are in a good position because we have NEHR ready, and all public healthcare institutions and most private healthcare institutions were already onboard (thanks to Healthier SG which brought on many GPs).
A few countries from Scandinavia and the Baltics, which were at an advanced stage of implementation, gave me an important advice. They told me to avoid a system where we have to proactively seek patient consent for data sharing. Instead, make sharing the default because it is good for care delivery, but allow patients to restrict access if they have any specific concerns. Their experiences were that the number that will do so will be small, because patients understand what is best for them.
We then spent many months conducting public and stakeholder consultations on the draft Bill. We spent many meetings going through the issues, and deciding on them.
Should we allow patients to place access restrictions at all? There were many views. In the end, we decided we have to entrust this to patients. By trusting patients to do what is best for themselves, I think fewer will opt to restrict access.
How about medical information that may be deemed to be more sensitive? Let’s put it under double log-in.
What happens if a patient chose to restrict access but met with an accident and is an emergency situation? Let’s give the doctor the right to break glass and save lives.
It was one of the most complex bills I have encountered in my many years in public service. I asked SMS Tan Kiat How to take it through Parliament. Many good questions were asked, and he patiently addressed all of them. The whole House, including Opposition MPs and NMPs, supported the Bill.
Years of hard work, setbacks and overcoming setbacks culminated in a debate that was rich in substance and void of theatrics. We now move on to our next tasks, to try to make healthcare as seamless and integrated as possible.
