eConsent

eConsent Team Members and Divisions

Business sponsor: Wong Wenjie, Ang Wei Hong, MOH Healthcare Finance

Problem Statement

How Might We digitalise the complicated consent taking process for the citizens and their family members at the medical institutions to make claims when they are seeking medical treatments?

Background

When a patient seeks treatments from one or more medical institutions, they may or may not authorise the medical institution(s) to deduct from their Medisave accounts and/or their family members' Medisave accounts. In addition, they may or may not authorise the medical institution(s) to use their MediShield Life accounts and Integrated Plan to pay for the medical bills.

Problem Formulation Process

Team carried out a user interview with our problem owner (MOH Healthcare Finance Officer), the medical institutions staff and the patients to understand the user’s pain points and challenges.

Current Process: Currently patients and their family members as payors have to fill up a physical paper form which is complicated that the hospital has to scan, safekeep, and manually update into the hospital billing system with eye-balling required to minimize mistake which could still have lapses over time (error-prone).

Current Consent Form:

Problem Formulation Process

The team carried out user interview with our problem owner, the medical institutions' staff and some patients to understand the user’s pain point and challenges. Our problem statement has been refined over few iterations with better understanding of user's pain points.

Current Process: Currently patients and their family members as payors have to fill up a physical paper form which is complicated that the hospital has to scan, safekeep, and manually update into the hospital billing system with eye-balling required to minimize mistake which could still have lapses over time (error-prone).

Key Insights Gathered from Interviews

1. Patients and family members struggle with the complicated form

• The current consent form is overly complicated, causing confusion and stress for patients and their families.
• To alleviate this, counter staff often step in to assist with form filling. However, this manual intervention is prone to errors, which can lead to:
  • Process inefficiencies,
  • Financial penalties,
  • Compliance lapses, and
  • Audit findings.

2. Patients and family members don't know what they have consented before

• Patients have no easy way to track or review what they have previously consented to.
• The only way to retrieve this information is by relying on hospital staff, which:
  • Increases the workload for staff, and
  • Can lead to disputes over billing or treatment details.

3. Modifying or revoking consent is a cumbersome process

• Changes during treatment episodes—such as updating payors, treatment schemes, treatment periods, or hospitals—require patients and their families to navigate a tedious and time-consuming process.
• This inefficiency creates frustration and delays, further burdening both patients and hospital staff.

Proposed Solution Details

Through service journey mapping and design thinking ideation process, we:

1. Simplify the consent taking process by requiring user to only approve/authorise the consent with pre-filled information.
2. Leverage SGTS to pre-fill personal information.
3. Included plan to integrate end-to-end from consent taking to billing system to patient facing app.

Transform consent form from this complicated physical form: to this simple digital form:

Proposed user journey for patients to provide consent (to illustrate eConsent simplification and leverage Singpass):

As part of the Minimum Viable Product (MVP), users can scan a QR code at the hospital front desk during their initial visit. This will direct them to log in via Singpass and land on the HealthHub consent page, where the following details are pre-filled:

• Hospital name,
• NRIC, and
• Default consent period

From here, the user simply needs to:

1. Choose whether to consent to deductions from:

• MediSave, and/or
• MediShield Life & Integrated insurance plans.

2. Optionally, add additional family members as payors if needed.

(Note: more user journey available upon request)

Impact and Value

Future Plans

We have conducted Usability Testing (UT) with users and gathered valuable early feedback. Based on these insights, our current plan is to proceed with Proof of Concept (POC) and Proof of Value (POV) phases in collaboration with selected medical institutions, such as KKH and SKH.

Once sufficient feedback is collected and initial issues are resolved, we will roll out Release 1 as a Minimum Viable Product (MVP) to all medical institutions.

In Release 2, we will focus on addressing the needs of medical institutions, including:

• Billing integration, and
• Triggers from medical institutions for consent.

Following this, Release 3 will expand the eConsent services to cover additional consent services within the healthcare sector.

Finally, in Release 4, we will explore further expansion to other government agencies, extending the eConsent services to cover other government-related services.