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Internet separation has lengthened waiting times for patients

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Internet surfing separation imposed after June's cyber attack may be made permanent, but advisers warn of longer waiting times, staff fatigue

Cutting Internet access in public healthcare institutions here has caused a variety of difficulties, such as longer waiting times for patients, declined productivity and increased staff fatigue, and had led to new cyber-security risks.

The Ministry of Health's (MOH) chief data adviser, Associate Professor James Yip, yesterday outlined these difficulties before a Committee of Inquiry (COI) looking into Singapore's worst cyber attack.

In June, the personal data of 1.5 million SingHealth patients and the outpatient prescription information of 160,000 people, including Prime Minister Lee Hsien Loong, were stolen.

Temporary Internet surfing separation (ISS) was imposed on SingHealth on July 19, followed by the National University Health System (NUHS) and the National Healthcare Group (NHG) on July 22, as a move to safeguard IT systems and confidential patient data after the cyber attack.

Health Minister Gan Kim Yong told Parliament in August that the Government was studying ways to make ISS a permanent measure in some parts of the public healthcare system.

But since the implementation of the ISS, Prof Yip said the healthcare clusters, which comprise largely hospitals, polyclinics and medical centres, have had problems with patient care.

Healthcare staff have had to take additional steps to book screening appointments and upload test results for patients.

Frontline patient administration has been affected too.

According to Prof Yip, staff now have to use separate, shared devices to retrieve patient information like insurance details, work permit status and Medisave balances.

This increases waiting time for patients.

As a result, hospital staff have to use their personal mobile phones for work. But the use of separate Internet enabled devices also opens up the system to new cyber-security risks, pointed out Prof Yip.


Prof Yip acknowledged that following the SingHealth attack, public healthcare staff have accepted the challenges of temporary ISS, and that patients have accepted poorer service delivery standards, delays and inconveniences.

But the current situation is not sustainable, he added.

"The operational challenges highlighted above will inevitably translate into tangible manpower and financial costs, and reduced employee and patient satisfaction," he said. "Ultimately, healthcare costs for the general Singapore public will rise."

Testifying before the Committee of Inquiry (COI), former director of the United States' National Security Agency Keith Alexander also warned that cyber criminals can find vulnerabilities and breach any organisation's IT system, given enough time, and current protection measures are insufficient.

To counter this, the Government and industry players need to work together on collective systems that share information to continually learn and prepare defences.

"The threats we face exceed the defences that we have... We need to up the game on the defence, and the defences have to grow quickly," Mr Alexander, now chief executive officer of IronNet Cybersecurity, said yesterday.