The

importance of
NEHR
integration
Last updated on: 30 Sept 2022

What is National Electronic

Health Records (NEHR)

NEHR is a national consolidated view of

:
 health records. Jointly contributed by
healthcare professionals, patient data in
NEHR can help to provide a continuous
view of a patient’s health for better
diagnostics and treatments.

The National Electronic Health Record

(NEHR) was deployed rapidly in both
private and public healthcare
institutions across Singapore in 2011 to
realise the Ministry of Health’s vision for
‘One Patient, One Health Record’. As of
January 2021, there are 1,632
participating healthcare institutions in
the NEHR. NEHR is operated by
Integrated Health Information Systems
(IHIS) which is a subsidiary of The
Ministry of Health Holdings (MOHH). The
NEHR has 4 main aims: 

• Connecting healthcare
professionals to deliver patient-
centered care 

• Achieving better health outcomes 

• Raising patient safety 

• Enhancing the patient experience

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 with seamless care 

NEHR – One patient, One

health record

Impr Impr Incre

oved oved ased
Coor Patie Effici
dinat nt encie
ion & Safet s
Care y.
Bette
r
Healt
h
Outc
omes

The NEHR ‘C.A.R.E’

Collectively, these 4 aims, dubbed as

‘CARE’, have transformed the patient
journey from a fragmented one to a
:
 seamless and comprehensive one.
Indeed, the NEHR receives and collates
data from multiple healthcare providers
at various levels (i.e., primary care,
specialist care, allied health care, etc.)
and displays them to healthcare
providers in a systematic and user-
friendly manner. The NEHR consists of
the following healthcare-related
information: 

• Admissions and Visit History 

• Hospital Inpatient Discharge

Summaries 

• Laboratory Results 

• Radiology Results 

• Medication History 

• History of Past
Procedures/Surgeries 

• Allergies and Adverse Drug

Reactions 

• Immunization History 

During the COVID-19 pandemic, NEHR

was enhanced in 2021 to include COVID-
:
 19 SWAB tests and vaccination
information. Healthcare personals can
access NEHR for a patient’s COVID-19
test results and existing medical
conditions before vaccination.

Centralized Healthcare Data

Electronic health records (EHRs) and

clinic management systems (CMS)
consolidate patients’ health history and
information to improve coordination of
care and enhance patient safety.

NEHR bridges protected health

information (PHI) from patients who are
managed by institutions from different
healthcare groups and provides
physicians with a longitudinal view of
the patients’ medical history. This
enables them to make better informed
clinical decisions and improve patient
care. 
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 Access to NEHR

For confidentiality and privacy reasons,

access to NEHR is only granted
to healthcare professionals involved in
direct patient care, such as doctors.
Every single access is logged and
tracked for strict confidentiality and
privacy protection. 

Any unauthorised access or

modification to NEHR data is
a chargeable offense under the
Computer Misuse Act. 

In Singapore, all registered physicians

are allowed to access, review, and even
upload patient data. All patients in
Singapore (citizens and non-citizens
alike) who have been managed by an
authorised healthcare professional from
a NEHR-contributing institution/clinic will
have a record in NEHR. In 2018, the
Healthcare Services Bill was introduced
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 and mandated all healthcare providers
to contribute patient data to the NEHR.  

Patients’ NEHR records are confidential,

and can only be accessed for the
purposes of patient care. NEHR
records must not be accessed for other
purposes such as insurance or
employment.  

MOH has implemented safeguards to

ensure that NEHR data is not
inappropriately accessed; access logs
to patients are routinely checked, and
regular audits are instituted to prevent
illegitimate access. Unauthorised
access to NEHR results in significant
penalties which are imposed by MOH. 

Patients who do not wish to participate

in NEHR can opt-out of the service.
Physicians should explain the
implications and process to patients in
detail: 

• During emergency situations,

healthcare providers will not be
able to access past healthcare
:
 information 

• Patients who opt out will

continue to have their information
transmitted to NEHR, but access to
this data will be blocked to all
healthcare providers 

• Past information can be unlocked if

patients wish to opt back into NEHR
at a later time 

NEHR security measures

Security was one of the major concerns

when doctors submit their patient’s
data onto NEHR. Dr. Puthucheary, Senior
Minister of State of Singapore, said that
‘Data security remains a key priority for
NEHR. 

The NEHR is built with stringent access

control features and multi-layered
security defences to provide resilient,
all-rounded cybersecurity measures.
These security measures are subjected
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 to regular independent audits, including
security penetration tests.

IHiS also works closely with CSA and

other government agencies to regularly
review and enhance these security
measures. These measures are
constantly evolved and enhanced. 

In order to be vigilant against potential

cyber-attacks, clinics are advised to
practice good cybersecurity measures.  

It is recommended for clinics to: 

• Use complex passwords 

• Two-factor authentication (2FA) 

• Update security software regularly  

• Engage with a trustable and

reliable clinic system 

How to prepare for NEHR

contribution

In order to contribute data to NEHR, you’ll

:
 need a clinic software that’s NEHR ready
and licensed by NEHR. (eg. UNO Clinic
Management System) 

You will also need to master the clinic

system functionality and workflows to
effectively and
efficiently contribute records. 

If your existing clinic system is not NEHR-

ready, you will not be able to contribute
to NEHR. You might want to consider
switching vendors. 

NEHR ready clinic

Since contribution to NEHR is done

through a NEHR ready clinic system,
clinics using a NEHR system are
automatically NEHR ready.

As for clinics currently not using any

clinic system or the system is not NEHR
ready, you will have to switch vendors.
:
 NEHR contribution

Data Contribution to NEHR only focuses

on patient’s health record summary. No
other information required.  

Patient data are transmitted from the

healthcare professional’s electronic
system, such as a clinic management
system (CMS) or Electronic Health
Records (EHR).  

Depending on the healthcare sector

involved, patient data required for
contribution will fall into the following
category: 

• Patient demographics 

• Patient visits 

• Diagnosis 

• Discharge Summary 

• Medications 

• Laboratory Reports 
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 • Radiology Reports 

• OT Notes / Procedure / Treatments 

• Immunisation 

• Allergy 

For a typical GP to contribute to NEHR,

the data will be: 

• Patient profile (Mandatory fields

Name, Date of Birth, Gender and ID) 

• Patient visit 

• Diagnosis 

• Immunisation 

• Allergy 

• Medications 

Contribution to the NEHR is not

mandatory at the moment, but may
subject to further reviews by the MOH. 

Benefits of NEHR to private

:
 General Practitioners in
Singapore

For GP clinics in the

private primarycare sector, NEHR can be
very beneficial for both the Doctor and
patient. 

• Instant access to patient health

records  

• Better informed diagnosis and

prognosis, overall better health
outcome 

• Better patient safety 

• Enhanced patient experience with

more personalised care. 

NEHR integration

UNO Technologies
When doctors select CMS vendors with
NEHR integration, please take note of the
following: 

• Compliance with MOH’s security

:
 requirements (i.e HIPAA and MTCS) 

• Provide the necessary support for

MOH’s audit 

• Vendor’s credibility and reputation 

• Provide dedicated
customer/technical support

• Familiarity with Singapore’s laws

and legislations, the various
healthcare practices, and best
practices in the industry 

• Relationship with MOH and IHiS 

NEHR and Healthier SG (HSG)

The MOH Healthier SG initiative (HSG)

was announced in mid 2022. It will be a
major transformation of the Singapore
healthcare system toward population
health.

Every Singapore resident will be

assigned a GP Doctor of their choice to
manage their long-term health.
:
 The GP Doctors assigned will have the
duties to:

1. Manage and deliver preventive

health to the residents

2. Develop health plans for lifestyle

adjustment, health screening, and
vaccinations

Healthier SG is expected to start by mid

2023. HSG enrolment for Singapore
residents aged 60 and above will start in
the second half of 2023. For ages 40 –
59, enrolment will start in 2024.

Resumption of NEHR
contribution for private GPs

Under the Healthier SG initiative, family

Doctors, both private and public, will
need to work together in their
healthcare clusters to coordinate
patient care together as a team. Patient
data submission and sharing will be
:
 critical to keeping Singapore residents
healthy.

Hence, private GP clinics and family

Doctors will resume NEHR contribution.
Private GP Clinics simply have to
onboard a NEHR-ready Clinic
Management Software to begin NEHR
contribution.

The resumption of NEHR contribution will

be around the corner.

NEHR opt-out

The NEHR gives all patients privacy and

confidentiality for their own
data, an opt-out option is given to all
patients.  

When a patient has opted-out from

NEHR, their data will continue to be sent
to NEHR, but completely blocked from
anyone’s view. Should the patient wish
to opt back into NEHR, their data can be
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 restored quickly without any data gap. 

In the case where the patient wants

further confidentiality and
anonymity, they may have the option to
not have any data contributed to NEHR.
An acknowledgment slip will be signed
for them to understand the
consequences.  

Troubleshooting NEHR 

Healthcare providers who are facing

problems with access or usability can
contact 1800-6644-347 for assistance.
Alternatively, you may send an email
to nehr.feedback@ihis.com.sg  
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source:

www.ihis.com.sg/nehr/about-nehr

https://www.channelnewsasia.com/new
s/singapore/national-electronic-
health-records-cybersecurity-
enhancements-14340748

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