Digital Health Passports: Key Considerations for Interoperability and Data Exchange

Introduction

The HIMSS Interoperability & HIE Committee focuses on advancing standards-based interoperability and emerging health information technologies that lead to impactful health information exchange (HIE). The committee members consist of top industry experts who are leading efforts in thought leadership and key initiatives advancing interoperability. Building on the group’s crucial work, the HIMSS Interoperability & HIE Committee authored a white paper on the highly relevant and current topic of digital health passports, taking a look at vaccine passports amidst the COVID-19 pandemic. The members of this group tackled what they felt are the most pressing considerations when developing and implementing digital health “passports” (e.g., digital credentials or passes that include such information as vaccination and infection testing status).

This white paper and attached summary table are intended to level-set the definition, purpose, technological approaches, and functionality of digital health passports. The paper also explores challenges related to policy, regulation, privacy, interoperability, and global health equity. This succinct resource seeks to highlight and promote leading practices on what is being developed and implemented by focusing on specific use cases within the U.S. and internationally. By exploring varied digital health passport initiatives such as the Vaccination Credential Initiative (VCI), European Union Digital COVID Certificate, World Health Organization (WHO) Smart Vaccine Certificate, as well as leading practices in diverse geographic areas, this white paper will enable HIMSS’ audiences to better understand the opportunities and challenges relevant to current solutions and those under development.

Why Does This Matter?

Public and private organizations have turned to the concept of digital health passports in an effort to safely and securely restore certain activities currently impeded by the COVID-19 pandemic. This topic is particularly pertinent because it affects people outside of care delivery systems and has been implemented in workplaces, restaurants, country borders, and beyond. With multiple U.S. and global entities seeking to create their own version of a digital health passport, there is an increased risk of creating numerous disparate systems that are not interconnected and thus have no universal applicability. Incompatible standards along with solutions that are not designed for interoperability will likely lead these efforts to create a fragmented system that undermines both the adoption and the utility of digital health passports.

In addition to the technical considerations needed to develop solutions, there are several important policy and ethical considerations for effective implementation. These include equity, privacy, and civil liberties, including consideration of the needs of those who are medically or otherwise ineligible for vaccination. All of these interests and values must be protected and enhanced in this effort to restore intra-national and cross-border mobility in the face of the COVID-19 pandemic and as these digital credentials are more widely applied to other use cases.  As emerging digital health passports are developed and implemented, guidance on best practices, and a better understanding of the technical, ethical and policy considerations in the U.S. and globally will help the industry with meaningful, scalable adoption.