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An Online Gateway To Eldercare In Singapore ~ By Caregivers, For Caregivers

National Electronic Health Record

NEHR : In Layman’s Terms

The reason for embarking on the electronic health record journey in Singapore is the stark recognition that by 2030, 1 in 5 Singaporeans will be over the age of 65.By 2050, Singapore will be among the world’s demographically oldest countries with a median age of 54 years.

This means having to adopt a different pattern of healthcare.

What Patient Medical Info Is Shared ?

Types of Patient Medical Information Shared

Fundamental to this transformation, our government has recognized that the healthcare system needs to be better integrated with the ability to seamlessly exchange health information.

Although Singapore has been investing in healthcare IT for years,SingHealth Cluster and National Health Group (NHG) Cluster have both developed their Electronic Medical Record (EMR) systems independently, and this led to problems when patients moved across clusters.

Geek Speak : What Type of IT Systems ?

In 2004, an interim system called Electronic Medical Records Exchange (EMRX) was implemented to allow secure exchange of patient data between clusters,where unstructured documents such as lab investigation reports,discharge summaries etc can be viewed.However, there were drawbacks to the EMRX system – it is essentially a document-level exchange with no standardised or structured data.

Geek Speak : Difference Between EMR & EHR

In order to realize the vision of “One Patient – One Medical Record” and support the delivery of integrated care across the healthcare continuum, Singapore is promoting IT adoption by its public and private healthcare providers and implementing a National Electronic Health Record (NEHR) for health information exchange.

The EHR is an integrated healthcare record centered on each person. It extracts and consolidates in one record, all clinically relevant information from their encounters across the healthcare continuum throughout his/her life.

Journey Towards One Health Record

The Journey Towards NEHR Phase 1
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In June 2010, MOHH awarded the US$144 million NEHR contract to a consortium made up of Accenture, Oracle,Orion Health, Initiate (an IBM Company) and Hewlett Packard. The go-live is the first phase of the effort and was deployed 10 months later in April 2011.

The first phase implementation is expected to last until June 2012.

Planned Implementation Footprint - NEHR Phase1

Implementation Footprint – NEHR Phase 1

By June 2012, all public healthcare institutions (restructured hospitals,specialist centres,polyclinics), selected community hospitals and selected GPs will be on the NEHR system.

Fundamental to the development of the NEHR has been clinician involvement via advisory groups and taskforces. Over 200 clinicians were involved in developing the business and clinical requirements for the system.

Geek Speak : Interoperability - Standards

A national standards-based enterprise architecture is in place to support the NEHR deployment. While its deployment will be purpose-built to suit an integrated Singapore healthcare system, it reflects the same tenets as Canada’s Infoway architecture – international standards based to enable secure data exchange and data sharing among local and enterprise clinical systems. In fact, the vendors implementing the NEHR are all very familiar to the jurisdictions in Canada, namely Accenture, Orion Health, Oracle, Initiate (an IBM Company) and HP.

Current Distribution Of Healthcare Services

Current Distribution Of Healthcare Services
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Like Canada,Singapore has a low rate of IT adoption and use in primary care – about 15% to 20% of GPs have an electronic medical record (EMR) system. As a result, this sector, together with intermediate and long term care, will receive focused IT enablement with linkages to the NEHR.

The Ministerial Committee for Ageing aim to build up on integrated care for the chronically ill, so their treatment will be managed on an ongoing, rather than episodic basis. To do this, the Health Ministry will further exploit technology to make it easier for patients to move seamlessly between providers.

One of the technologies introduced is the CLEO system (Clinic Electronic Medical Record and Operation System) which will facilitate the sharing of patient information among GPs.

With the CLEO system, GPs will have have access to the NEHR system which will provide them with an array of patient data. These include their current care received at other healthcare institutions, medication histories, drug allergies, laboratory investigations, clinical diagnoses and X-ray reports.

In mid-2011,MOHH awarded the contract for the GP clinical information management and electronic medical record system to SingTel. About 50 general practitioners will be equipped with a standardised IT system during the first phase of implementation.

The system will start rolling out by the second quarter of 2012 and by 2013, some 50 GP clinics will be equipped with it

NEHR : Deep Dive

Capability Map - NEHR Phase 1

Capability Map – NEHR Phase 1
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NEHR Conceptual View

Conceptual View – Master Index
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EHR Clinician Portal - Summary View

Clinical Portal of NEHR – Summary View
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NEHR Architecture

NEHR Architecture
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Geek Speak : Product Suite - NEHR Phase 1

NEHR Phase1 (2009 to 2011)

Sources,Data,Capabilities & Deployment – NEHR Phase 1
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NEHR Functional Diagram

Functional Diagram
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Moving Forward : Beyond 2012

NEHR_MovingForward

NEHR Phase2 - Strategy And Approach

NEHR Phase 2 – Strategy & Approach
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The Next Wave

The Next Wave – Transforming Healthcare Through Innovative Use of Technology
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Sources :
NEHR Brochure By MOH
NEHR Perspectives:Singapore By Dr Sarah Muttitt, CIO MOHH Mar 2011
MOH To Keep Healthcare Affordable, Expand Infrastructure – ChannelNewsAsia.com
HIMSS12 – S’pore’s NEHR The Journey to 2012 & Beyond By Dr Sarah Muttitt , CIO MOHH
Singapore’s National EHR Roadmap By Dr Sarah Muttitt, CIO MOHH Oct 2011

About MOHH :
MOH Holdings is the sole holding company of Singapore’s public healthcare assets & other wholly owned corporate entities :
MOH Holdings

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