Digital healthcare passports vs. digital vaccine certificates or passports
A digital healthcare passport is a digital tool (app or online platform) designed to register patients’ healthcare history. This information can in turn, then be accessed by their carers or healthcare providers.
In our view, the digital healthcare passport is an umbrella term which also includes the digital vaccine certificate. Digital vaccine certification tools are being implemented in several countries to display a COVID-19 test result or vaccination record, but in most cases do not include the complete medical history of the users.
The digital healthcare/health passport term is currently used by many media outlets to describe digital vaccine certification. A distinction should be made between the two terms since they offer different services and pose different regulatory, ethical and technical challenges.
Thus, a digital vaccine certificate or passport should not be confused with a digital healthcare passport.
Below is our categorisation of the digital healthcare and vaccination passports that have risen to prominence in the past year.
Digital healthcare passports:
Digital vaccine certification/passports:
- IBM, Ubirch, Bechtle and Govdigital – Digital Health Pass
- Lumedic
- CoronaPass
- CommonPass
- IATA (International Air Transport Association) Travel Pass
- Mvine-iProov passport
- VeriFly
- V-Health Passport
- Passport for COVID
- CCI (COVID Credential Initiative) Linux
If you have been following the COVID-19 news, you will have seen that many airlines are in various stages of developing tools allowing for online vaccination results to be embedded into booking confirmations.
Due to the COVID-19 pandemic setbacks, there is an ever-increasing urgency in the need for the global economy to recover. With the travel industry being one of the most impacted, their dedication to develop digital vaccine passports is understandable.
Most digital passports are being developed to address the need to normalise travel during and after the COVID-19 pandemic. Some digital vaccine passports may evolve to include certification for vaccinations such as yellow fever, malaria and polio in addition to COVID-19. An interesting prospect that remains to be seen.
How do digital healthcare and vaccination passports work?
In order to access a digital vaccine passport, travellers will be instructed to download an app to their smartphone. The app will then be connected to their travel provider via a web platform or another app, where uploading their vaccination itinerary will be required. In turn, the travel provider would offer guidance on what verifications are mandatory for travel.
A digital healthcare passport is designed specifically to contain information of someone’s full medical history, which can easily be connected to an electronic medical record for instant verification. A digital healthcare passport can be compatible with one or more unified databases.
The information can be accessed by patients through a smartphone app or web platform, and we are beginning to see in some cases HCPs (healthcare providers), also having access to the patient information.
Why is there hesitation in adopting this new technology?
Privacy and security
According to the global head of privacy for the management company CWT, companies should avoid requiring or asking employees to adopt digital travel health passports until thorough data-privacy impact assessments are conducted.
Some apps could track user location and activities which may not resonate well with members of the public.
Simultaneously, questions are being raised on how adequately digital healthcare passport providers can protect sensitive data.
Data ownership
Who owns the data? The public may be weary of providers selling user data to third-party companies without explicit consent, or awareness of what data are transferred and what they will be used for.
We anticipate digital solutions will give users and patients more ownership of their data, but to what extent? Will patients be able to choose who has access to their data as well as how, and when it is accessed?
Uncertainty
If digital healthcare and vaccination passports are made mandatory by government decree at large scale, will they lead to potential discrimination or categorisation of employees, travellers, or the general population?
Could third-party providers having access to your healthcare data affect your chances of getting a loan, life insurance or a mortgage? We must consider how different political systems and cultures could directly impact where the “privacy line” should be drawn.
As the concept of digital healthcare passports continues to evolve, it remains unclear what frameworks will be developed globally and how the information will be exchanged amongst them. Similarly, there is uncertainty in what transcontinental travel with a digital vaccine passport will look like since GDPR (General Data Protection Regulation) is not regionally standardised outside of the EU.
What will the future look like?
In March 2021, the EU Commission proposed a Digital Green Certificate (DGC) to facilitate the safe free movement inside the EU during the COVID-19 pandemic. The DGC will act as evidence that a person has been vaccinated for COVID-19, received a negative test result or recovered from COVID-19. The certificate will be available free of charge in digital (QR code) or paper format.
To ensure data security, the DGC and other similar tools could be supported by blockchain technology where each record could be stored on a blockchain ledger. Perhaps, the DGC could adopt a similar structure to AOKpass, where the tool manages the signatures on blockchain rather than the information itself, therefore providing the authentication backbone of a digital certificate while respecting data privacy.
We believe digital vaccine certification/passports are the precursor to digital healthcare passports. The two will inevitably be integrated within the next 5 years, however there are many questions which remain unanswered regarding data security, data privacy and data ownership.
A successful digital healthcare or vaccine passport needs to be created via cross-industry collaboration between public and private entities, led by the former, with a strong focus on user-centricity and data privacy.
So… are we ready for digital healthcare passports? Yes and no. We have the technology to enable widespread development and use of such tools but we still need to address fundamental regulatory, ethical and technical challenges, which differ across regions.
