Today we're pleased to announce our participation in the Trust over IP Foundation launched today by the Linux Foundation.
As the first representative of the healthcare industry on the steering committee, we see tremendous potential for the ToIP Foundation to contribute to healthcare interoperability. In confronting the challenges raised by the COVID-19 pandemic, we've seen that modern technologies can make a powerful difference when they're paired with strong governance models. The ToIP stack ensures that the way we exchange trusted healthcare information meets industry needs at a global scale.
Today’s announcement builds on important recent advances at the infrastructure level toward a new approach to exchanging trusted information on the internet — namely, the current W3C specs for both Decentralized Identifiers (DIDs) and Verifiable Credentials. Both of these standards heavily influence our approach to modern healthcare interoperability, including the opportunities they bring to ownership of sensitive health information, including personal identities, in healthcare.
While this has been a central focus for Lumedic for some time, as it bears directly on healthcare industry modernization, the recent Covid-19 pandemic has accelerated our efforts because of the social and ethical concerns raised by “health certificates.”
Why is it so important?
The way we currently share information over the internet is flawed, because it wasn’t built with an identity layer. As a result, our trusted interactions involve some kind of intermediary and account creation process. And, unfortunately, it’s pretty easy to rattle off some of the problems we face as a result: password nightmares, public breaches of secure information, fake accounts spreading misinformation on social media, the list goes on. When we apply these limitations to healthcare, see frustration, obfuscation, and waste, for patients and everyone else involved in sharing data.
With the advent of technology tools like blockchain, and the standards emerging from organizations like W3C, for the first time we have the ability to create trusted relationships and information exchange directly between two entities — without having to involve an intermediary. This new trust model uses something we call "verified digital credentials" (like a digital version of a driver’s license). The model puts patients at the center of the information exchange. Applied to healthcare, where we waste something like $400B/year, much of it related to billing and insurance related administration, the economic savings could be sizeable.
An example: Digital Insurance Card
A verifiable insurance credential could contain all the details of a patient’s specific eligibility, coverage, prior authorization, and more. We as patients would control that credential entirely, allowing us to share that data with our doctors and healthcare administrators as needed, through the tap of a button.
In that scenario, the patient’s experience of providing personal and coverage information at any point in their episode of care is greatly streamlined and made more secure. It’s simply about sharing exactly the data that’s required — and only that data — directly from their device to whoever needs to see it.
For the provider, an entire costly infrastructure — one that’s focused on maintaining lines of communication with payers (or their proxies) and continually updating and validating insurance information — is made vastly more efficient. Rather than reaching out to the payer or third-party services firm to ask questions about a given patient, the provider can go directly to that patient.
A more immediate need: COVID-19 Antibody (Immunity) Test or Vaccination Card
Once effective tests and/or vaccines have been established, a vital element of restoring healthcare (this also applies to everyday business and social routines) will be restoring trust that facilities, patients, and employees are safe. To certify that effectively, we can’t count on a laminated card or faxed letter – too slow, too expensive, too easy to fake.
Instead, let’s apply three lessons from the pandemic response to developing a digital credential:
- The importance of speed when it comes to healthcare information exchange, enabled by a new pattern of direct interoperability
- The importance of trust – trust in the data, trust in the source, trust in the right next action
- The importance of scale, putting effective tools and resources in the hands of as many people as necessary
Distributed ledger technologies solve for all three of those priorities in supporting digital credentials.
- It’s immediate – as soon as an accredited lab establishes your immunity (or, when ready, once you’ve been vaccinated), it can issue your credential electronically. From that point on, you can produce it whenever you need to, from your smartphone.
- It is extraordinarily difficult to fake, it’s more secure than other methods of interoperability, and the information is private and under the control of the individual
- Scale, equating to portability. As an industry, we talk a lot about putting people at the center. Applying blockchain technologies to digital identity actually delivers on that ambition. And that control, in the hands of the individual, means a reduction in the number of intermediaries needed to be involved.
For healthcare and beyond, it’s a fundamental rethinking about how we create and sustain trust in our digital lives. We’re excited to join the ToIP Foundation on all the work that’s ahead.