Concerns Arise Regarding Compulsory Uploading Of Patients’ Medical Information To A Government Database

On 8 Nov, Health Minister Gan Kim Yong announced that all healthcare institutions could be required to upload their patients’ medical information to the National Electronic Health Record (NEHR).

Minister Gan Kim Yong emphasising the importance of digitalising healthcare

NEHR is a government database that stores information on individuals’ medical information uploaded by their respective doctors. By uploading patients’ data on a single network, any doctor in Singapore will be able to access information they need to decide on the best possible treatment for any patient that comes knocking at their doors.

Wouldn’t just be great to have any doctor or specialist know exactly what’s wrong with you, and even what measures have been taken to try to remedy the problem?

Except, the new initiative has even doctors up in arms, due to privacy concerns.

Concerns over patient confidentiality and privacy

A Dr Lee Pheng Soon wrote in to the Straits Times and had these few pointers to draw attention to:

First, a patient presently has the right not to mention prior illnesses when he consults his doctor.

Whether this decision disadvantages him or not is irrelevant. Under the principle of medical ethics called “autonomy”, the patient retains the right to control the information he shares with his doctor.

Dr Lee emphasises that the patients are entitled to have control over their own medical information, regardless of the sickness the patient has.

He also mentions that it is a doctor’s duty to keep information only between the patient and himself — similar to attorney-client privilege in law.

Second, the patient rightfully expects the doctor to keep private all details revealed in medical confidence.

Doctors are only allowed to disclose information regarding the patient with his or her express permission.

Therefore, when medical practitioners are obligated to upload patients medical records online, they break the terms of confidentiality that is respected by the medical society.

Taking into account the benefits of the proposed legislation

Of course, despite arguments against it, there are benefits to implementing this system to Singapore’s healthcare system.

Health Minister Gan Kim Yong emphasised that the proposed changes will pave the way for a more holistic healthcare system for patients:

MOH (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.

The database will include essential information of patients’ health records such as their medical history, drug allergies and health profiles.

In times of emergencies and uncertainty, such data will assist doctors in understanding the patient’s needs and deciding on the best possible treatment to meet them. Mr Gan said that the move would cut down on uncertainty during emergency cases.

Patients will benefit from the NEHR (National Electronic Health Records System) 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.

He then brought up the example of Tan Tock Seng Hospital’s emergency department being able to prescribe appropriate treatment to an unconscious patient with the help of NEHR.

Even Dr Lee agrees that the move will bring benefits — although he wasn’t specific on what sort.

I have no doubt that the NEHR has potential for enormous good.

What do you mean Dr Lee?

One can only question if these benefits are worth the compromise of patients losing control of their own personal information?

All things considered

With the introduction of the National Electronic Health Record, patients will have no choice but to accept that all information given to their doctors will be uploaded online. This includes medical history, drug allergies, and presumably that weird rash you don’t want anybody to know.

Those who have sensitive information which they wish not to be publicised, can only hope that the said information does not fall to people they want to keep it from.

Featured image via Facebook