Vaccine credentials enabling wider progress on public health interoperability

First announced in January 2021, the Vaccine Credential Initiative – co-founded by MITRE Corporation and others including Cerner, Change Healthcare, Epic, Mayo Clinic, Microsoft, Oracle, Salesforce and others – has made big progress over the past year-plus on new approaches to interoperable record-keeping.

The public and private partnership collaborated on developing a standard model for “trustworthy, traceable, verifiable, and universally recognized digital record of vaccination status” – offering individuals digital access to their vaccination records using the open and interoperable SMART Health Cards specification based on W3C Verifiable Credential and HL7 FHIR standards.

While initially developed in response to the COVID-19 pandemic, those SMART Health Cards – accessible via digital wallet apps or QR codes – were also seen as a key enabler for a larger system to more easily enable access, control and sharing of verifiable vaccination and other records.

At HIMSS22 in Orlando next month, Dr. Brian Anderson, chief digital health physician at MITRE Corporation, and Bryant Karras, chief public health informatics officer and senior epidemiologist at Washington State Department of Health, will offer an update on the progress of the Vaccine Credential Initiative, and other initiatives like it.

They’ll describe how VCI and other projects have enabled new advances in public health and patient-centered data exchange as the pandemic has progressed. They’ll explain how it’s now positioned to move beyond mere immunization status and toward a larger approach to interoperable health records. And they’ll show how, through an upcoming collaboration with the World Health Organization and the G20, those advancements can soon be expanding globally.

In a discussion – hosted by HIMSS Senior Vice President of Government Relations Tom Leary at the Interoperability Showcase – Anderson and Karras will spotlight recent progress in immunization management, and describe some specific challenges and opportunities as new approaches to interoperable patient records evolve.

“Up until this point, everything we’ve been doing within VCI has been about empowering individuals with verifiable, trustworthy copies of their vaccination records,” Anderson told Healthcare IT News.

“What we’re beginning to explore now – and certainly talking to a lot of folks in the federal government and in various state governments, as well as in the private sector – is about the additional use cases that SMART Health Cards can be used for. It doesn’t have to be just about vaccination credentials.”

For instance, VCI is working with state public health authorities about how can they use SMART Health Cards to support all vaccination records, offering individuals secure and verifiable records – not just of COVID-19 vaccination status, “but the typical vaccines that we all get,” said Anderson, who noted the potential use case of supporting streamline school enrollment.

“And then even building out beyond vaccines to diagnostic test results,” he said. “And even more broadly, enabling individuals to have portable, trustworthy secure copies to their longitudinal record.”

VCI is “looking to begin building out those use case opportunities with other interested parties at HIMSS,” said Anderson, “building the coalition and the partners that are interested in expanding into those next spaces.”

Toward that end, VCI is now planning to work with the World Health Organization and the G20 on a new international interoperability effort focused on vaccination credentials as the the initial use case – but but with plans to build out a wider interoperability framework using several data exchange specifications that exist across the globe.

VCI will participate in a technical working group convened by the Office of the Chief Scientist of the WHO. It will be co-chaired by the Global Digital Health Partnership and the Organization for Economic Co-operation and Development, in collaboration with the G20. 

“It’s essentially going to establish an international framework to the four major specifications for vaccination credentials that are in use across the world,” Anderson explained. “The SMART Health Card [used primarily in the U.S. and Canada] that is being championed by VCI; the European Union’s Digital COVID-19 Certificate, or DCC; the DIVOC standard, that’s from India; and then the ICAO-VDS standard that’s used by Australia and Japan.

“All of these organizations, representatives from, I think, 20 or 30 member states within the WHO, will be participating in this effort to build a framework for mutual recognition of vaccination credentials in any of those formats across the globe,” he said, “and building out an international registry of trusted issuers that can be referenced.”

It’s been a busy year of all-volunteer work on the Vaccine Credential Initiative, said Anderson, but the lessons learned along the way, and the progress made on new approaches to patient-centered longit interoperability, have been well worth it, said Anderson.

“One of the things that we learned is the importance of partnering with technology vendors and public health authorities is incredibly powerful, and I think has been an area I’m sure we can all appreciate has been under-invested in for quite some time,” he said.

“The opportunity space that we’ve been able to develop by taking this new technology and enabling public health authorities to directly engage residents of their states to share this kind of trustworthy health data is a wholly new thing to many states.”

Another insight, he said, is that this sort of patient-mediated approach to data sharing “creates a virtuous cycle in terms of the accuracy of that data. If an individual has the ability to go to a state and say, ‘I want my SMART Health Card,’ and for some reason that data is not there, or it’s inaccurate, it enables that individual to correct that data, or to go to their health system or to go to their pharmacy and say, ‘Hey, send in that data to the registry.’

“When we launched VCI, it was very much rooted in empowering individuals with their health records – the use case absolutely was about vaccination credentials,” Anderson added. “But the point of VCI was never about just empowering individuals with copies of their own vaccine history. It was about empowering individuals with copies of their health record and enabling them to tell the story with that vaccination credential to whomever they wanted to.”

Anderson and Karras’s HIMSS22 session, “Immunization Interoperability: Catalyzing Public Health Data Exchange Locally & Globally,” is scheduled for Thursday, March 17, from 9:30-10:30 a.m. at the Interoperability-Showcase, Hall E-Booth 8240, at the Orange County Convention Center.

Twitter: @MikeMiliardHITN
Email the writer: mike.miliard@himssmedia.com
Healthcare IT News is a HIMSS publication.