Healthcare Services (Outpatient Medical Service) Regulations 2023

the licensee provides any information and communication technology to the patient to enable the transmission of data related to the patient’s health status between the patient and the licensee and the monitoring of the patient’s health by the licensee; or

the licensee communicates with the patient remotely for administrative matters, including (but not limited to) the arrangement of the date of the patient’s next medical appointment.

establish, implement and regularly review policies and the appropriate processes for the training and competency assessment of the licensee’s personnel to ensure that the personnel are able to perform their work effectively, safely and in compliance with the applicable laws, guidelines, policies, processes, procedures and protocols; and

monitor and regularly review the work performance of the licensee’s personnel to ensure compliance by the personnel with the applicable laws, guidelines, policies, processes, procedures and protocols.

every equipment or facility must be installed, and used or operated properly, in accordance with the instructions of the manufacturer of the equipment or facility;

where the licensee is approved to provide the outpatient medical service using an approved conveyance, every equipment, instrument, appliance, material or facility that is necessary for the provision of the outpatient medical service is —

fit for use in the approved conveyance;

if necessary, calibrated for use in the approved conveyance; and

securely fastened or stored in a manner so as not to pose a threat or risk to the safety of any person in the approved conveyance while the approved conveyance is in motion;

where the licensee is approved to provide the outpatient medical service by remote provision — every equipment, instrument, appliance, material or facility that is necessary for the provision of the outpatient medical service by remote provision is checked regularly, and maintained properly and according to the manufacturer’s specification, so as to ensure that it is adequate, functional and effective; and

where the possession, use or operation of any equipment or facility requires any certification or licence, at all times when the licensee is in possession of the equipment or facility —

the licensee holds the valid certification or licence for the possession, use or operation of the equipment or facility; and

the equipment or facility is checked regularly, and maintained properly and according to the manufacturer’s specification, so as to ensure that it is adequate, functional and effective.

no personnel provides a service or does an act beyond his or her professional expertise and qualifications; and

the provision of any service, or carrying out of any act, that is necessary to support the provision of an outpatient medical service and requires the provision of direct care to a patient by any personnel who is not a medical practitioner, is supervised by the medical practitioner who is charged with the care of the patient.

only as a service that is incidental to the provision of an outpatient medical service;

at the licensee’s approved permanent premises or temporary premises or in the licensee’s approved conveyance, as the case may be; and

by the licensee’s personnel who is —

a medical practitioner who is trained in the conduct of ultrasound imaging;

a radiographer who is a duly qualified allied health professional; or

a sonographer.

a medical practitioner or collaborative prescribing practitioner who is the licensee’s personnel orders the test for the patient;

the testing of the specimen only involves the conduct of a simple in vitro diagnostic test; and

the testing of the specimen is provided only as a service incidental to the provision of an outpatient medical service.

using testing material in respect of which —

the expiry date has not passed; and

the personnel who is administering the test does not suspect or have any reason to suspect that the testing material is no longer fit for use; and

in accordance with the instructions specified by the manufacturer of the testing material.

ensure that adequate and appropriate facilities, equipment and drugs for the provision of any essential life‑saving measure to a patient are readily available at every approved permanent premises, temporary premises and approved conveyance; and

at all times, be capable of providing essential life‑saving measures to any patient who is at risk of death.

that only resuscitation drugs that have not passed their expiry dates and are fit for use and resuscitation equipment that is fit for use are made available for use in the provision of any essential life-saving measure;

the establishment and implementation of protocols for the rapid and accurate assessment of any patient who is in need of essential life‑saving measures; and

every personnel who provides any essential life‑saving measure to a patient is adequately trained —

to provide the essential life‑saving measure in a proper, effective and safe manner; and

in the use of the equipment that is needed to deliver the essential life‑saving measure.

the patient is in need of any essential life‑saving measure, or the patient becomes in need of any essential life‑saving measure, during the process of receiving an outpatient medical service by remote provision from the licensee; and

the licensee knows where the patient is located.

must not provide an outpatient medical service to any patient unless the approved conveyance is stationary and properly parked;

without limiting regulation 19, must ensure that at least one healthcare professional is present in the approved conveyance during the period when an outpatient medical service is provided using the approved conveyance;

must inform the patient or (if the patient is a minor or lacks mental capacity) a next‑of‑kin or carer of the patient on any follow‑up care and treatment including how the patient may obtain follow‑up care and treatment; and

if a medical practitioner who is the licensee’s personnel, is of the opinion that the patient requires a particular medical treatment or care which cannot be provided in the approved conveyance in a proper, effective and safe manner, must make alternative arrangements for the patient to receive the medical treatment or care and inform the patient or (if the patient is a minor or lacks mental capacity) a next‑of-kin or carer of the patient of the alternative arrangements.

ensure that in determining whether a particular aspect of outpatient medical service may be provided at the temporary premises in a proper, effective and safe manner, a medical practitioner (who is the licensee’s personnel) attending to the patient must take into account —

the patient’s medical condition and history;

the medical practitioner’s qualifications, experience, competency and skills; and

the facilities, equipment, medical supplies and other resources that are available at the temporary premises;

establish, implement and regularly review guidelines to assist a medical practitioner in making the determination mentioned in sub‑paragraph (a);

inform the patient or (if the patient is a minor or lacks mental capacity) a next‑of‑kin or carer of the patient on any follow‑up care and treatment including how the patient may obtain follow‑up care and treatment; and

if a medical practitioner who is the licensee’s personnel is of the opinion that the patient requires a particular medical treatment or care which cannot be provided to or conducted on the patient in the temporary premises in a proper, effective and safe manner, make alternative arrangements for the patient to receive the medical treatment or care and inform the patient or (if the patient is a minor or lacks mental capacity) a next‑of‑kin or carer of the patient of the alternative arrangements.

ensure that the following matters are completed before any outpatient medical service is provided to a patient by remote provision:

ascertaining the identity, contact information and location of the patient;

informing the patient that he or she should not seek to receive any essential life‑saving measure by remote provision;

informing the patient of the identity of the licensee’s personnel who will be providing the outpatient medical service, and his or her role or designation for which the personnel is engaged or employed by the licensee;

establish, implement and regularly review guidelines on —

the circumstances in which —

the licensee would provide an outpatient medical service by remote provision to any patient;

the licensee must not provide or must cease to provide an outpatient medical service by remote provision to a patient, and advise the patient to seek medical attention at any other place; and

the licensee must provide or cause to be provided any essential life‑saving measure to a patient who is receiving an outpatient medical service by remote provision; and

the type of patients to whom an outpatient medical service may be provided by remote provision, taking into account —

the patient’s medical condition and history;

the qualifications, experience, competency and skills of the medical practitioner who is providing the outpatient medical service; and

the patient’s ability to receive the outpatient medical service by remote provision;

where the provision of any outpatient medical service to a patient by remote provision cannot be completed for any reason, ensure that the patient is advised of the ways to seek medical attention for his or her condition;

inform the patient or (if the patient is a minor or lacks mental capacity) a next‑of‑kin or carer of the patient on any follow‑up care and treatment, including how the patient may obtain the follow-up care and treatment; and

if a medical practitioner who is the licensee’s personnel is of the opinion that a patient requires a particular medical treatment or care or a physical examination which cannot be carried out by remote provision, make alternative arrangements for the patient to receive the medical treatment or care or physical examination and inform the patient or (if the patient is a minor or lacks mental capacity) a next‑of‑kin or carer of the patient of the alternative arrangements.

document the date and time of the outpatient medical service provided, and the method of remote communication that was used, as part of the patient’s patient health record;

ensure that the patient is informed of the name and designation of the licensee’s personnel who is providing the outpatient medical service to the patient, before the outpatient medical service is provided to the patient;

where the remote provision is by means of a website or software application — ensure that all of the following information is conspicuously displayed on the website or software application at all times when the outpatient medical service is being provided to the patient:

the business name by which the licensee provides the outpatient medical service;

the email address or telephone number at which the licensee may be contacted;

the fact that the licensee is approved to provide an outpatient medical service by remote provision;

a statement that any person who needs any essential life‑saving measure should not seek to receive such measure by remote provision from the licensee; and

where the outpatient medical service is provided by remote provision using any other means — ensure that the information mentioned in sub‑paragraph (c)(i) to (iv) is conveyed to the patient before the outpatient medical service is provided to the patient.

the Internet;

the telephone or other communication device; or

any other kind of electronic or other technology for facilitating communication remotely.

the outpatient medical service is provided through real‑time 2‑way interactive audiovisual communications; or

the outpatient medical service is provided in response to an emergency or a disaster, including but not limited to, prescribing any empiric or prophylactic treatment to prevent or control an infectious disease outbreak.

the provision of the outpatient medical service is through real‑time 2‑way interactive audiovisual communications; and

to enable the outpatient medical service to be provided to the patient effectively while ensuring the confidentiality of the proceedings of the video consultation and the privacy of the patient —

only such number of personnel as is necessary for the provision of the outpatient medical service attends the video consultation; and

the personnel conducts the video consultation in a place that is closed and private.

the place at which the licensee’s personnel conducts the video consultation is equipped with sufficient lighting and other appropriate equipment or facility;

at all times when the outpatient medical service is provided, the patient has a full view of the face of the personnel who is providing the outpatient medical service; and

the patient is informed of the identity of the personnel who is providing the outpatient medical service, and his or her role or designation for which the personnel is engaged or employed by the licensee.

ensure that the fees charged by the licensee for an outpatient medical service are displayed or otherwise made available —

at every approved permanent premises, temporary premises or approved conveyance, as the case may be; and

where the licensee provides the outpatient medical service through a remote service kiosk — at the remote service kiosk; and

where the licensee provides the outpatient medical service by remote provision other than through a remote service kiosk — ensure that the licensee’s personnel informs the patient of the fees.

the consultation fee that is applicable to the patient; and

any administrative fee or any other charge that is to be imposed in respect of the outpatient medical service on the patient.

display or otherwise make available at every approved permanent premises, temporary premises or approved conveyance, the fact that the licensee is an approved institution;

display or otherwise make available at every remote service kiosk through which the outpatient medical service is provided, the fact that the licensee is an approved institution; and

where the licensee provides the outpatient medical service by remote provision and the provision is not through a remote service kiosk — ensure that the licensee’s personnel informs the patient of the fact that the licensee is an approved institution.

represent to any person or give any person the impression that the licensee is an approved institution; or

otherwise mislead any person as to whether the licensee is an approved institution.

an approved medical institution within the meaning of regulation 2(1) of the Central Provident Fund (Medisave Account Withdrawals) Regulations (Rg 17);

an approved medical institution approved by the Minister under the MediShield Life Scheme Act 2015;

an accredited clinic under the scheme established by the Government known as the Community Health Assist Scheme or any other similar public scheme providing financial assistance established by the Government.

the estimated range of fees for the claimable outpatient medical service;

the fee benchmark for the same or similar claimable outpatient medical service that is published on the website of the Ministry of Health at https://www.moh.gov.sg (if available);

whether any part of the fees mentioned in sub‑paragraph (a) may be —

deducted from any medisave account;

reimbursed under the MediShield Life Scheme; or

reduced by any subsidy or grant under a public scheme; and

any other benefit that the MediShield Life Scheme provides to the patient in respect of the outpatient medical service, if any.

to a fine not exceeding $20,000 or to imprisonment for a term not exceeding 12 months or to both; and

in the case of a continuing offence, to a further fine not exceeding $1,000 for every day or part of a day during which the offence continues after conviction.