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A national standard for vaccine verifications has been quietly rolling out across the country. (Photo Illustration by Pavlo Gonchar) SOPA IMAGES/LIGHTROCKET VIA GETTY IMAGES |
Published: February 24, 2022
By: Suzanne Rowan Kelleher
Even as the omicron variant loosens its grip on the world, destinations continue to require travelers to show proof of vaccination. And, increasingly, a paper CDC vaccination card is not cutting it.
While the United States government has not issued a federal digital vaccine pass, a national standard has nevertheless emerged. To date, 21 states, the District of Columbia and Puerto Rico offer accessibility to the SMART Health Card, a verifiable digital proof of vaccination developed through the Vaccination Credential Initiative (VCI), a global coalition of public and private stakeholders including Microsoft, Salesforce, Oracle, the Mayo Clinic and other health and tech heavyweights.
And very soon, at least four more states will be rolling out access to SMART Health Cards. “We've seen a notable uptick in states that have officially launched public portals where individuals can get verifiable vaccination credentials in the form of SMART Health Cards with a QR code,” says Dr. Brian Anderson, co-founder of the VCI and chief digital health physician at MITRE.
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Half of US states either already offer accessibility to SMART Health Cards or have it in the works. DATAWRAPPER |
There is already an impressively widespread availability of SMART Health Cards in the U.S. More than 200 million Americans can now download, print or store their vaccination records as a QR code. When the QR code is pulled up, only the individual’s name, date of birth and vaccination information is visible. No other medical information or personal data is shared. This code is also digitally signed to ensure that the card was issued from a verified location and to prevent forgery.
SMART Health Cards Ease Travel
For individuals, the benefits of having access to personal digital vaccine record is three-fold. First, it’s a huge plus for travel in the U.S. and abroad.
Many indoor cultural attractions and performance venues in the U.S. require proof of vaccination. “We believe it gives people peace of mind when the folks around them are unlikely to be contagious,” says Gus Warren, CEO of Bindle, a health verification app that allows venues to verify the vaccination status of patrons.
Bindle’s growing list of clients spans more than 30 states, from blue strongholds like California and New York to red leaners like Texas, Florida, Arkansas, Missouri and Georgia. At the Kennedy Center in Washington, D.C., for example, there's a Bindle lane that offers fastpass-like efficiency in scanning QR codes from a number of vaccine verification platforms used around the world.
“The SMART Health Card is such an important development and the Vaccine Credential Initiative has been phenomenal in getting this out there,” says Warren, noting that while Bindle recognizes several interoperable standards, the SMART Health Card has emerged as the most important. “Absolutely, it has become the standard across the U.S. and North America.”
“And at an international level, we are continuing to see intense interest in a coordinated international approach,” says Anderson. “And that has not diminished at all. I think quite the opposite.”
To wit: Every Canadian province has now adopted SMART Health Card verification, as has Aruba, the Cayman Islands, Singapore and Japan. And in Africa, the SMART Health Card has rolled out in Kenya and Rwanda, just the first of 32 African countries in the “Smart Africa” alliance to adopt a digital-first approach to healthcare records.
The Case For Red States
The second argument for adopting a digital vaccine verification system is the one swaying red-state governors: Having digital access to personal health records empowers the individual.
More than a dozen states have launched their own SMART Health Card-based portals. At least seven others — including Arizona, Mississippi and West Virginia — have turned to a third-party, MyIRMobile, to issue SMART Health Cards. Minnesota has chosen Docket, another third-party option.
Most right-leaning states offering SMART Health Cards do it quietly, without any fanfare. But big red South Carolina expects to roll out a portal for SMART Health Cards by the end of March, reports Politico.
“This isn’t a passport,” South Carolina’s director of immunizations told Politico. “This is essentially a Covid card that people get at their convenience because it’s their record.”
Utah was one of the first red states to get on the SMART Health Card train. For former Utah Governor Mike Leavitt, a Republican who was the Secretary of Health and Human Services in the George W. Bush administration, the issue boils down to individual rights. “There's always a question about who owns the data and the rights to access that data,” Leavitt said at a recent global forum on SMART Health Cards. “But one thing is unchallengeable. And that is, I own a right to have my own data. And to have it in a form that I can present it conveniently for the kinds of things I want to do.”
“The idea of being able to have trustworthy copies of your own health records is not a red or blue state issue,” echoes Anderson. “ It is an individual empowerment of your own health data. What we're going to see over the next month is a growing number of red states recognizing and appreciating the importance of empowering their individual citizens in their states.”
This Won’t Be The Last Pandemic
Lastly, having a vaccine verification system in place prepares the U.S. for the next coronavirus variant as well as the inevitability of a future pandemic.
Today the main threat to our health and economy remains the omicron variant, says Anderson. “But it's going to be pi in a couple months, and it's going to be the same situation. Yes, we're going to get to an endemic phase of all of this, but that doesn't change the need to continue to protect the citizens of a nation from highly transmissible and communicable diseases.”
“Vaccination verification will be increasingly important at an international level,” Anderson says. “And so if we want to enable all of our citizens from every state to be able to participate in the safe travel across international boundaries and to participate in international commerce, it'd be important for our government officials from every state to enable this.”
Where Else To Get A SMART Health Card
Given the political landscape, Anderson recognizes that some states may never get on board. “We're not going to have all 50 states leveraging this approach,” he says. “But the vast majority of the vaccinated individuals in the US – over 200 million of them – already have the ability right now to go and get one of these credentials.”
That includes anyone vaccinated at any branch of Walmart, Sam’s Club, CVS, Duane Reade, Walgreens, Costco, Kroger, Rite-Aid or any of the dozens of other companies participating in the retail pharmacy program. To access an electronic version of your vaccination record, log into the online Covid portal of the brand where you got your shots.
And whether your state is red or blue, your healthcare provider is increasingly likely to offer a digital vaccination record. More than 100 major health systems and hospital groups across the country now offer SMART Health Cards to patients. These include Kaiser Permanente, Tenet Health, Scripps Healthcare, Cerner and other healthcare heavy hitters. Big regional healthcare groups in the SMART consortium span the country, from Centra Health in Virginia to UCHealth in Colorado and from CoxHealth in Missouri to SoutheastHEALTH in Alabama and Georgia.
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The following is an excerpt from the Standard of Care website that details the legal requirement for all U.S. medical establishments to maintain medical confidentiality for all patients. This respect of privacy is legally required for all medical institutions nationwide.
To reiterate, every U.S. medical establishment and the parties therein – along with every professional business and official organization in the country – are well aware of each of these requirements. Any organization – whether corporate, official, or private – that violates these standards of medical privacy is likely to face severe legal consequences should these human-rights laws be violated.
Confidentiality and privacy in health care is important for protecting patients, maintaining trust between doctors and patients, and for ensuring the best quality of care for patients. Patient confidentiality has been a standard of medical ethics for hundreds of years, but laws that ensure it were once patchy and incomplete.The federal law called HIPAA was passed in 1996 to make sure that there would be one nationwide law to protect patient privacy. The law includes other provisions, including continuity of care, but for many individuals, the right to confidentiality is most important. There are certain rights that the law provides for that all people should be aware of so that they can advocate for privacy and for the best possible care.WHAT IS HIPAA?HIPAA is the Health Insurance Portability and Accountability Act of 1996, a law passed by Congress and signed by President Clinton. Other names for the law are the Kennedy-Kassebaum Act and the Kassebaum-Kennedy Act, for two of the leading sponsors when the law was a bill going through both houses of Congress. The law was enacted as medical records were beginning to be transferred from paper to electronic form.The transition from analog to digital records for patients left open a window of opportunity for sensitive and very personal information to be misused. At the time that HIPAA became a federal law, medical caregivers were already bound by ethical standards to protect patient privacy, but laws were inadequate to guarantee that protection.The law also set standards for using and handling electronic records in order to cut back on fraud and abuse and to make administration more streamlined. HIPAA is not just about security and protecting privacy, though. Another thing that the law guarantees is that individuals can continue to receive health insurance coverage when changing or losing a job or when adding a dependent. It improved upon the portability and continuity of health care coverage.THE FIVE TITLES OF HIPAAHIPAA includes five different titles that outline the rights and regulations allowed and imposed by the law. The titles address the issues of privacy, administration, continuity of coverage, and other important factors in the law.
- Title I. The first part of the law ensures continuity in health coverage by protecting that coverage when a worker loses or changes a job. In other words, it ensures portability of heath care coverage.
- Title II. The second title covers the administrative simplicity enacted by the law. It established nationwide standards for electronic records health care transactions. This encouraged greater simplicity in administration of health care by encouraging use of electronic records and transactions. Title II also set minimum standards and rules for protecting patient privacy.
- b This part of the law sets rules for medical spending accounts and provides for certain deductions in medical insurance.
- Title IV. Title IV sets guidelines for group health insurance plans and rules about pre-existing conditions.
- Title V. In Title V the law sets rules for life insurance and for how people who have lost U.S. citizenship can be treated.
YOUR RIGHTS UNDER HIPAAMuch of the responsibility for the law falls to medical and health care professionals, to protect personal information and to accommodate and ensure continuity in coverage of health insurance. However, it is also important for individuals to understand the law and what their rights are under the law. When you understand your health care rights, you can advocate for yourself and your loved ones. Here are some of the most important rights you have thanks to HIPAA:
- You have a right to access and get a copy of your electronic medical record. You may have to put a request in writing and wait 30 days or less.
- You have the right to check and request that information on your record is changed if you believe it is incorrect or that there is something missing.
- Even if a medical institution disagrees with an error you found in your record, you have a right to have a notation made that indicates you believe there is a mistake.
- You can send your electronic medical record to a third party, or have it sent for you.
- There are valid and legal reasons for a doctor to share your health information, but you have a right to know when, how, and with whom it is shared.
- You also have a right to indicate any specific information that you never want shared, even with other physicians or anonymously for public health records.
- You can request that a doctor or other health care worker contact you at a location other than your primary residence.
THE IMPORTANCE OF PRIVACY AND CONFIDENTIALITYIt has long been an ethical standard for physicians and other health care professionals, including medical researchers, to protect the privacy of patients and to keep interactions with patients confidential. One of the most important reasons for ensuring this privacy and confidentiality is that it is essential for a patient to trust medical professionals. Trust between a patient and doctor is important because patients put their health and their lives in the hands of their doctors. They will not get the best care if there is no trust.Patients who trust their health care professionals will not be sharing their personal information are more likely to be willing to open up and be honest about their symptoms and health habits. Doctors and other caregivers cannot do their jobs or provide the best care if they don’t get all the information from their patients.In some instances, a person may be unwilling to get a diagnosis and treatment because of stigma and the fear that someone may find out what illness they have, including friends or an employer. Mental illnesses and infections like HIV are particularly stigmatized, and to break down that barrier it is important that patients know their doctors will not be sharing this very personal information.Privacy and confidentiality are so important to individuals but are also vital to public health. Guaranteed privacy supports and encourages participation in public and community health initiatives and in important medical research. Keeping data about health private also allows government and other institutions to collect and study statistical information about public health, disease, injuries, disabilities, and other medical information.When you know what your rights are and what you are entitled to under the law called HIPAA, you are better able to advocate for yourself or for a loved one who cannot do the same because of illness or age. HIPAA protects individuals and patients and ensures that you can get good quality health care while maintaining your privacy.
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