Blockchain for Decentralized Identity — dApp — Healthcare
There is friction in business processes within healthcare with opportunities for efficiencies and cost reduction. Covid-19 triggered healthcare innovation to enable users to control their Covid vaccination data as verifiable credentials (explained in the fifth blog). Organizations like the Linux Foundation Public Health (LFPH), Decentralized Identity Foundation (DIF), W3C, World Health Organization (WHO), and the Common Check Foundation worked together with the private sector like Affinidi to innovate. The WHO and LFPH defined specifications for countries to implement and open up travel. There were four specifications that countries developed1:
· Digital Infrastructure for Vaccination Open Credentialing (DIVOC) is an open-source platform for countries to implement health processes
· EU Digital Covid Certificate (EU-DCC) — a digital health certificate for EU citizens
· Smart Health Card (SHC) — open standards to connect users with their health data
· International Civil Aviation Organization — Visible Digital Seal (ICAO-VDS) — a travel document through aviation
New experiences beyond Covid will be possible like the ones described below.
Let us imagine what experiences using a smartphone in healthcare could be someday? Contactless and paperless. (These are specific for healthcare in the USA. The experiences vary in other parts of the world).
1. You explore medical benefit options and do comparative shopping for the best provider and healthcare plan for you in your area. Next, you sign up for medical benefits using your credentials and a portal. There is no need to fill out forms in this process. Instead, your identity verifiable credentials from your digital wallet (described in the fourth blog) are automatically entered to fill in the online forms — for example, your name, date of birth, etc., from your driver’s license.
2. Verifiable credentials store insurance details, and only relevant claims are used for presenting attestation proofs when needed. It is the principle of zero-knowledge proofs (explained in the first blog).
3. Before visiting a doctor, you use your phone to check eligibility for services required.
4. Next, you manage appointments and save them in the calendaring application.
5. Upon arrival at the doctor’s office, the location application informs a business rule to execute the creation of a compound proof (explained in the fifth blog) with the name and insurance card information needed for check-in. Next, you accept and provide the same using a QR code. Then, a financial instrument in the digital wallet makes the co-payment.
6. You fill out the patient screening form using verifiable credentials (explained in the fifth blog) from your wallet that has your past medical history. There is no need to spend time filling out forms during each visit.
7. The doctor’s orders for lab tests provided as verifiable credentials are stored in your wallet and used to schedule and request lab tests.
8. After the doctor’s visit, the visit summary and lab test results are delivered to you and stored as verifiable credentials.
9. Over the years, medical procedures conducted are recorded and sent to you as VCs (verifiable credentials). Once you accept, the digital wallet stores them. You track medical history trends from your smartphone.
10. Prescriptions are stored as VCs and used with the insurance information above at any authorized pharmacy to refill. Location information can execute a business rule upon arrival at the regular pharmacy. The rule automatically generates a compound proof created with claims needed at the pharmacy, for example, name, date of birth, address, and prescription name. It is provided to the pharmacist using a QR code. Financial Instruments in digital wallets make co-payments. Business rules also generate requests for auto-refills over a period of time.
11. Immunization records over your lifetime get stored as verifiable credentials and used to provide proof to complete transactions.
12. Information and records of allergies and related medications are available as verifiable credentials.
13. If you wear any IoT devices that collect medical data, those can also be sent at a pre-defined interval and stored as VCs. Over time you can visualize and measure trends and progress.
14. If you decide to change a doctor, these medical records can be shared securely with any medical professional by creating an attestation proof delivered via a QR code. Again, you control your data.
15. In a medical emergency, messages go to emergency services for help with your location. In addition, past medical history can be shared for immediate treatment, saving time and possibly lives.
16. If an educational institution requires proof of vaccinations for children, parents can hold their immunization records as guardians and provide the same securely. Once children reach adulthood, parents/guardians transfer the records to the child’s digital wallet.
17. Insurance claims from the medical provider to the insurance company can also be automated efficiently. Billing errors are reduced when the right information is shared across healthcare providers.
The above description outlines frictionless experiences, cryptographically secure with privacy and immutable. As a result, it improves efficiencies while reducing costs. For example, imagine reducing paperwork, time, and personnel costs? The patients’ health information is stored privately in their digital wallets. It allows the patient to control what to share with whom and when. It improves their journey in managing their health. Privacy is at the root of a trusted relationship between a patient and a healthcare provider. HIPAA2 (Health Insurance Portability and Accountability Act) legislation in the US is a federal law that led to the creation of national standards to protect sensitive patient health information and prohibits it from being disclosed without their consent. We can expect more regulations in the coming years.
In the United Kingdom, the government uses Verifiable Credentials (explained in the fifth blog) as staff passports to manage 1.4 million staff members across more than 1200 hospitals for the National Health System (NHS). It builds employee portability within the NHS ecosystem. It also streamlines the process of hiring and mobility, especially in a pandemic where speed in the hiring and onboarding process saved lives and reduced about twenty-two million pounds of savings in lost hours4. The efficiencies included eliminating repeated employment checks and data requests with increased flexibility. A Gravity Digital ID5 solution enables vulnerable migrants to receive consistent healthcare services in Kenya. The SSI solution delivers services to patients with a smartphone, feature phone, or no phone (using a QR code on paper). Patients at healthcare service points have their medical history available to share for treatment. It promotes dignity for Kenyan migrants while balancing their need to reveal information about themselves and receive medical care. In Myanmar, Thailand, and the Philippines, people use the Zada verifiable credential system to obtain and manage their vaccination records throughout their digital life. With Covid 19, various other countries too provide this capability. For example, Immunodex in Hong Kong, NY Excelsior Pass in NY, USA, and Lumedic in the USA. Some are in pilot. The Good Health Pass6 is an open inclusive initiative with over 125+ organizations to develop interoperable standards for international health passes during Covid. The future dApps in Web 3.0 will give consumers scale to manage complexity in their lives. A community of healthcare providers is working with the Trust Over IP3 foundation to define use cases, technical standards, and governance frameworks for exchanging information and building trust in the ecosystem.
In the next post, I will cover RegTech.
To reference previous posts refer to this link. Again, I would suggest reading the posts in succession.
Glossary
Digital Wallet
A digital wallet is a software used to digitally store (usually in a smartphone) the contents of a wallet, like IDs, loyalty cards, and financial instruments used for payments. In essence, it is a digital version of a physical wallet.
Presentation or Proof
The proof attests a claim or compound claims from the holder to the verifier to prove some form of identification to complete a transaction. All are achieved without making contact with the issuer.
Self-Sovereign Identity (SSI):
A decentralized way to manage the identity of an entity, built on the principles of transparency, interoperability, portability, and consent from the owner who controls what they own, know and have.
Verifiable Credential
A credential is an attestation of authority, competence, or qualification given by an authorized party (issuer) to an entity (holder). It consists of metadata, claims, and proofs and has one or many claims related to an entity’s identity. It is to respond to attestations for proof of a claim. Claims from multiple verifiable credentials consolidated to respond to a request for proof are called a compound verifiable credential.
Zero-Knowledge Proof
A zero-knowledge proof is a method of authentication using cryptography that allows an entity to prove to another that specific requirements for a transaction are met instead of disclosing all the data (selective disclosure).
References
1. Unlocking the Value of Verifiable Credentials in the Health Sector; Neeraj Jain, March 2022
4. Lacity, Mary, Carmel, Erran, 2022, Implementing Self-sovereign Identity (SSI) for a digital staff passport at UK National Health Service (NHS)
6. https://www.goodhealthpass.org
Contact
Linkedin https://www.linkedin.com/in/anitarao/,
Twitter @anitaprao,
Blog https://rao-anita.medium.com/
#SSI; #decentralizedidentity; #blockchain; #digitalidentity; #selfsovereignidentity; #identity; #dlt; #web3; #web3.0; #dApps; #digitalwallets; #distributedledger
Contents distributed by Learn.Block6.tech
👉 Discord — Live Talks
👉 Twitter — Latest articles
