6/18/21 11:39 AM 11 min read

5 Questions on Health Passes, Answered

Did you know that health passes started back in the late 1800s for the smallpox epidemic? Although not a novel concept, what is new this time around is figuring out how to securely digitize and uniquely identify individuals health status through an interoperable app between entities. 

Fortune recently hosted an event with Jonathan Dordick of the Rensselaer Polytechnic Institute, Dakota Gruener of ID2020, Eric Piscini of IBM, Sharon Pinkerton of Airlines for America, to share their unique insights on the future of health passes.

In the following sections, we summarize their ideas to better understand health passes, the great benefits they can provide to society, why they struggle to gain traction, and how an individual’s information is secured.

Main Questions

What actually defines a “Health Pass”? Why would it be beneficial for societies to implement have a health pass?

“Vaccine Passport”, “Vaccine Pass”, “Health Pass” have all been used interchangeably to describe the same idea.

A “health pass” is a trusted indicator for certain entities to verify your health records, typically utilized for entry into particular areas.

Health passes are not a novel idea, and have been implemented for decades in different mediums.

For example, all 50 states in the U.S. require chickenpox, diphtheria, tetanus, pertussis (DTaP), measles and rubella, and polio vaccinations in order to attend schools. However, those verification systems are typically handled either by state immunization systems or primary healthcare providers, and are not readily accessible to individuals. 

Creating a health pass that is readily accessible by individuals presents great benefits. For one, in many emergency situations, people’s smartphones can display medical records so that EMTs can properly take care of individuals, with knowledge of medical conditions and allergies. Secondly, being able to readily present vaccinations or health status in a verifiable manner will significantly help accelerate processes of entry for travel, schools, and many more places. 

What are the main issues preventing health passes from taking a foothold?

There are three issues that prevent health passes from becoming widespread throughout society.

  1. Safety and privacy of data. Even though it is understood anything digital is not 100% secure, people’s personal health information is incredibly private information. It is crucial that the backend systems storing all of this information are secure with multiple layers of authentication.
  2. Interoperability with multiple different entities. All 50 states have varying public health requirements, alongside diverse sentiments towards vaccinations and public information. You see the stark contrast between NYC and Florida, where many establishments in NYC require proof of vaccination for entry, whereas Florida signed into law banning any form of vaccination verification system. The disparity exemplifies the interoperability issue solely on a national level, without even getting into the conversation on an international level.
  3. Public adoption and skepticism. Interplaying with similar ideas as the privacy concerns, many in the public are skeptical of the role governments and other healthcare entities play in their own personal information. Many feel that health passes are an infringement upon their rights, as exemplified by the differences in the terminology surrounding health passes. Americans polled show that 40% are in favor of some form of vaccine “verification” system, but only 11% are in favor of some form of vaccine “passport” system

Where are health passes applicable? How do entities enforce health passes?

Questions surrounding the applicability of health passes will be determined by established public entities and what they decide to enforce. Given that schools choose to enforce vaccinations for the greater health of children, state medical registries are monitored closely to communicate with schools to verify the vaccination status of those children.

The school (public entity) enforces vaccination, and as such vaccination verification systems are implemented. Another example - airport TSA (government entity) enforces a security check & scan of boarding passes in order to access gates, and as such security measures are implemented.

The same methodology applies to health passes - local, state, or federal entities need to enforce a proof-of-status requirement, whether that means a vaccination or negative test, through a verified entity in order to accelerate the adoption health passes. More commonplace areas within communities will most likely not enforce health passes, but there are applicable use cases beyond schools and travel.  Nursing homes present an ideal target for implementing health passes to ensure its community members stay safe from potentially deadly viruses. 

How do you ensure an individual's health data is secure? 

There are valid concerns surrounding the privacy and security of one’s personal health data. As mentioned earlier, different government and private entities have rolled out different versions of a health pass. All of these different health passes have varying degrees of individual ownership over health information. However, there are three main characteristics that can be implemented in order to ensure safety and privacy. 

  1. One is to ensure users are safely accessing their own information is by implementing Two-Factor Authentication systems to verify that individuals attempting to sign in are them. 
  2. Another is to ensure that administrators do not have access to private information beyond health status. There are mechanisms to strip down a users information to just their name and health status, so that administrators do not have access to a whole host of other private information to the user.
  3. Finally, Blockchain technologies also provide another great solution for privacy issues, in decentralizing all of the information such that it cannot be traced back to an individual. IBM has been developing a health pass centered around blockchain technology that ensures the privacy of individuals first. 

Is there a place for a health pass beyond the pandemic?

The pandemic has changed society in many different ways, many of which are permanent. The future of health passes has the potential to fall into that category, provided that public institutions take to adopting a standardized system. Before the pandemic, the healthcare industry was one of the last industries to create digitized systems for patient-provider communications. Tele-health appointments, digital accounts, and other systems were implemented throughout the course of the pandemic, and will continue to be here long after the pandemic. 

Conclusions

The pandemic has permanently impacted the way that societies view health and healthcare systems. Undoubtedly there will be permanent changes that derive from the pandemic, and health passes will likely be one of those changes. Depending upon public entities adopting health pass systems for entry into particular areas, the use cases for health passes can either be limited to particular areas, or more widespread between countries and industries. Overall, the pandemic has revealed the public demand for digitized and secure verification of health information.