Electronic Medical Record - Singapore

MOH Budget Speech (Part 2) - Transforming Healthcare

06 Mar 2007
By Mr Khaw Boon Wan, Minister for Health
Venue: Parliament

Electronic Medical Record

7. First: an important infrastructure is the Electronic Medical Record (EMR). I have coined the slogan, "One Singaporean, One EMR" to catalyse this initiative. Right now, it is one Singaporean, multiple medical records, stored away in different clinics and hospitals in different formats, and not connected or consolidated. As a result, when patients visit different doctors, they have to have tests repeated and scans redone. This adds to unnecessary cost.

8. We are moving towards this target of "One Singaporean, One EMR". Because of legacy systems, we cannot achieve it in one step. But we have made progress. As pointed out by Dr Lam Pin Min, public hospitals now have the EMR eXchange (EMRX). We achieved a first but important psychological step in 2004 when public hospitals began to electronically exchange their Hospital Inpatient Discharge Summaries. Since then, we have made the EMRX more comprehensive, by adding other patient records such as laboratory tests, radiology reports and medication information. The electronic volume of laboratory results exchanged has grown 7 times in 2 years. Thousands of patients benefit from EMRX every month.

9. Our doctors' feedback is that EMRX has made their work easier. In particular, our Emergency Department doctors have said that the EMRX gives them greater reliability and confidence in treating patients, especially those with long and complicated medical histories. Extending EMRX to private doctors will be a natural step and is the objective. As Dr Lam pointed out, a National EMRX will minimise unnecessary medical investigations. More importantly, I see EMRX playing a critical role in the integrated delivery of care to patients.

10. However, this is a complex national project - very few if any countries have successfully implemented a system that links up public, private and the charity sector. This is because there are many issues such as data protection, regulation and audit to be addressed. We need to take a measured approach, to pilot and put together a comprehensive framework that takes care of these issues. This will begin with common data standards. We will do this within the public sector, and extend this to the step-down institutions. We have started to build the linkages to the private sector GP clinics by helping them to set up their IT systems under the Chronic Disease management effort. I am confident that we will get there.