SMART Health Card

Last updated
SMART Health Card
SMART Health IT logo.png
Type of project Immunity passport
OwnerSMART Health IT (Boston Children's Hospital)
FounderKenneth Mandl, Isaac Kohane
CountryUnited States
Established2010
Website https://smarthealth.cards/en/

The SMART Health Card framework is an open source [1] immunity passport program designed to store and share medical information in paper or digital form. [2] It was initially launched as a vaccine passport during the COVID-19 pandemic, but is envisioned for use for other infectious diseases. [3] SMART Health Cards include a QR code which can be scanned and verified using the official SMART Health Card Verifier mobile app, supported by Apple and Android. [4] [5] It was rolled out by the Vaccination Credential Initiative (VCI) based on technology developed at Boston Children's Hospital, [6] and standards set by Health Level Seven International (HL7) and the World Wide Web Consortium (W3C). [7] It is recognized by the International Organization for Standardization. [5]

Contents

History

Founding

In February 2009, United States president Barack Obama signed an economic stimulus package which included $19 billion in funds for investment in health information technology. The following month, researchers from Boston Children's Hospital and Harvard Medical School, Kenneth Mandl and Isaac Kohane, published an article in The New England Journal of Medicine calling for the modernization of electronic health records through API integrations on mobile devices. [8] In April 2010, the pair secured a $15 million grant through the Office of the National Coordinator for Health Information Technology's Strategic Health IT Advanced Research Projects (SHARP) program. [9] With this federal funding, the researchers began development of an interoperable healthcare IT platform they called "Substitutable Medical Applications and Reusable Technologies" (SMART). The first iteration of the platform API was previewed later that year, [10] and "SMART Classic" was released in 2011. [11]

In 2013, SMART adopted the open-source Fast Health Interoperability Resources (FHIR) standard developed by Health Level Seven International (HL7). The newly named SMART on FHIR platform was debuted in February 2014 at the Health Information Management Systems Society conference. [11]

21st Century Cures Act

According to SMART Health IT, Mandl successfully lobbied for the inclusion of a universal API requirement in the 21st Century Cures Act, signed into law on December 13, 2016. [9] [12] The team also advocated for a federal rule establishing SMART as the universal API. [13] In 2019, the Office of the National Coordinator for Health Information Technology published the "final rule" specifying the SMART framework as the standard to satisfy the requirements of the 21st Century Cures Act; the rule was implemented in June 2020. [14]

COVID-19

The SMART Health Card framework was deployed as a "de facto standard" for vaccine passports in the COVID-19 pandemic in the United States and other international jurisdictions. [6] [15] [16] [17] On January 14, 2021, the Mitre Corporation announced the launch of a new public–private partnership called the Vaccination Credential Initiative (VCI) alongside the CARIN Alliance, Cerner, Change Healthcare, The Commons Project Foundation, Epic Systems, Evernorth, Mayo Clinic, Microsoft, Oracle, Safe Health, and Salesforce. [18] VCI's purpose was to employ the SMART Health Card framework in order to create a unified proof-of-vaccination system for COVID-19 vaccines. [19]

Sample proof of vaccination from British Columbia using SMART Health Card framework Federal proof of vaccination example British Columbia.png
Sample proof of vaccination from British Columbia using SMART Health Card framework

The California Department of Public Health introduced a Digital Covid-19 Vaccine Record portal in June 2021, allowing individuals to verify their vaccination status using the SMART Health Card reader. [16] [20] [21]

On August 5, 2021, New York Governor Andrew Cuomo announced the introduction of the "Excelsior Pass Plus" which would expand its Excelsior Pass program into other states and internationally by connecting it to the SMART Health Card system. [15] [22] As of August 27, 2021, 415,000 citizens of Louisiana had added their COVID-19 vaccination status to their state-run, SMART Health Card enabled LA Wallet. [23] On September 8, 2021, Hawaii governor David Ige announced the rollout of the state's Hawaiʻi SMART Health Card. [24] [17] County-level health departments across the United States partnered with VaccineCheck to issue SMART Health Cards by verifying vaccine cards provided by the Centers for Disease Control and Prevention. [25] [26] [27]

The Government of Canada spent CAD$4.6 million to develop a proof-of-vaccination credential on the SMART Health Card framework, enabling its ArriveCAN travel application to store, recognize and verify credentials from every province, territory and foreign country. [28] [29] [5] Since October 2021, [30] Canadian provinces and territories used the SMART Health Card format as a requirement by the federal government, including British Columbia, [31] Newfoundland and Labrador, the Northwest Territories, Nova Scotia, Nunavut, [5] Ontario, [32] Quebec, [5] Saskatchewan [33] and the Yukon. [34]

On October 13, 2021, the American Immunization Registry Association (AIRA) published a statement encouraging adoption of SMART Health Cards as a common standard "where allowed by local law and policy." [35] "SMARTHealth.Cards" was listed as a supporting member of AIRA through the VCI. [36]

A SMART Health Cards Global Forum was held on October 28, 2021. [37] The event featured keynote speakers Andy Slavitt (former Senior Pandemic Advisor to President Joe Biden’s COVID-19 pandemic response team) and Mike Leavitt (former United States Secretary of Health and Human Services). [38] [25]

On December 20, 2021, Japan's Ministry of Health, Labour and Welfare launched its COVID-19 Vaccination Certificate Application using the SMART Health Card. [39] [40]

By January 2022, about 80% of Americans who had received a COVID-19 vaccine had access to a SMART Health Card through their state governments, local businesses, universities and healthcare systems. [16]

Participants

Developers

SMART Health IT is based out of the Computational Health Informatics Program (CHIP) at the Boston Children's Hospital. CHIP's related projects include Apache cTAKES, Genomic Information Commons, HealthMap, and VaccineFinder. [41]

The SMART Health Card's project sponsor is HL7 International's Public Health Work Group, [42] consisting of representatives from Allscripts, the Altarum Institute, Tennessee Department of Health and Washington State Department of Health. [43]

Issuers

Official registries of authorized SMART Health Card issuers are maintained by SMART Health IT, the Vaccination Credential Initiative, and the CommonTrust Network. Authorized issuers include: [44] [45] [46]

See also

Related Research Articles

<span class="mw-page-title-main">Vaccination</span> Administration of a vaccine to protect against disease

Vaccination is the administration of a vaccine to help the immune system develop immunity from a disease. Vaccines contain a microorganism or virus in a weakened, live or killed state, or proteins or toxins from the organism. In stimulating the body's adaptive immunity, they help prevent sickness from an infectious disease. When a sufficiently large percentage of a population has been vaccinated, herd immunity results. Herd immunity protects those who may be immunocompromised and cannot get a vaccine because even a weakened version would harm them. The effectiveness of vaccination has been widely studied and verified. Vaccination is the most effective method of preventing infectious diseases; widespread immunity due to vaccination is largely responsible for the worldwide eradication of smallpox and the elimination of diseases such as polio and tetanus from much of the world. However, some diseases, such as measles outbreaks in America, have seen rising cases due to relatively low vaccination rates in the 2010s – attributed, in part, to vaccine hesitancy. According to the World Health Organization, vaccination prevents 3.5–5 million deaths per year.

<span class="mw-page-title-main">Vaccine hesitancy</span> Reluctance or refusal to be vaccinated or have ones children vaccinated

Vaccine hesitancy is a delay in acceptance, or refusal, of vaccines despite the availability of vaccine services and supporting evidence. The term covers refusals to vaccinate, delaying vaccines, accepting vaccines but remaining uncertain about their use, or using certain vaccines but not others. Although adverse effects associated with vaccines are occasionally observed, the scientific consensus that vaccines are generally safe and effective is overwhelming. Vaccine hesitancy often results in disease outbreaks and deaths from vaccine-preventable diseases. Therefore, the World Health Organization characterizes vaccine hesitancy as one of the top ten global health threats.

<span class="mw-page-title-main">Vaccination schedule</span> Series of vaccinations

A vaccination schedule is a series of vaccinations, including the timing of all doses, which may be either recommended or compulsory, depending on the country of residence. A vaccine is an antigenic preparation used to produce active immunity to a disease, in order to prevent or reduce the effects of infection by any natural or "wild" pathogen. Vaccines go through multiple phases of trials to ensure safety and effectiveness.

A vaccine adverse event (VAE), sometimes referred to as a vaccine injury, is an adverse event believed to have been caused by vaccination. The World Health Organization (WHO) knows VAEs as Adverse Events Following Immunization (AEFI).

<span class="mw-page-title-main">Houston Methodist Hospital</span> Hospital in Houston, Texas, USA

Houston Methodist Hospital is the flagship quaternary care hospital of Houston Methodist academic medical center. Located in the Texas Medical Center in Houston, Texas, Houston Methodist Hospital was established in 1919 during the height of the Spanish influenza epidemic as an outreach ministry of Methodist Episcopal Church. Houston Methodist comprises eight hospitals, an academic institute, a primary care group, and more than 300 locations throughout greater Houston.

A vaccination policy is a health policy adopted in order to prevent the spread of infectious disease. These policies are generally put into place by state or local governments, but may also be set by private facilities, such as workplaces or schools. Many policies have been developed and implemented since vaccines were first made widely available.

Homeoprophylaxis, or homeopathic prophylaxis, is the use of homeopathy as a preventive medicine or immunisation against serious infectious diseases.

<span class="mw-page-title-main">Health in the United States</span> Overall health of the population of the United States

Health may refer to "a state of complete physical, mental and social well-being and not merely the absence of disease and infirmity.", according to the World Health Organization (WHO). 78.7 was the average life expectancy for individuals at birth in 2017. The highest cause of death for United States citizens is heart disease. Sexually transmitted infections impact the health of approximately 19 million yearly. The two most commonly reported infections include chlamydia and gonorrhea. The United States is currently challenged by the COVID-19 pandemic, and is 19th in the world in COVID-19 vaccination rates. All 50 states in the U.S. require immunizations for children in order to enroll in public school, but various exemptions are available by state. Immunizations are often compulsory for military enlistment in the United States.

A vaccine-preventable disease is an infectious disease for which an effective preventive vaccine exists. If a person acquires a vaccine-preventable disease and dies from it, the death is considered a vaccine-preventable death.

<span class="mw-page-title-main">Ministry of Health (Saudi Arabia)</span> Saudi Arabian ministry of Health

The Ministry of Health, commonly abbreviated to MoH, is the ministry overseeing the health care and health policy of Saudi Arabia. The ministry is tasked with formulating strategies to ensure public health in the country, while also managing crucial health infrastructure.

This article summarizes healthcare in Texas. In 2022, the United Healthcare Foundation ranked Texas as the 38th healthiest state in the United States. Obesity, excessive drinking, maternal mortality, infant mortality, vaccinations, mental health, and limited access to healthcare are among the major public health issues facing Texas.

<span class="mw-page-title-main">Vaccination policy of the United States</span> Overview of the vaccination policy in the United States of America

Vaccination policy of the United States is the subset of U.S. federal health policy that deals with immunization against infectious disease. It is decided at various levels of the government, including the individual states. This policy has been developed over the approximately two centuries since the invention of vaccination with the purpose of eradicating disease from the U.S. population, or creating a herd immunity. Policies intended to encourage vaccination impact numerous areas of law, including regulation of vaccine safety, funding of vaccination programs, vaccine mandates, adverse event reporting requirements, and compensation for injuries asserted to be associated with vaccination.

Hackensack Meridian Health (HMH) is a network of healthcare providers in New Jersey, based out of Edison. Members include academic centers, acute care facilities, and research hospitals. Hackensack Meridian Health aims to create one integrated network that changes how healthcare is delivered in New Jersey. The HMH network was formed in 2016 by a merger between Hackensack University Medical Center and Meridian Health. Hackensack Meridian Health is affiliated with the Hackensack Meridian School of Medicine and maintains active teaching programs at its hospitals. After the acquisition of JFK Medical Center in Edison, HMH is now the largest healthcare provider in New Jersey.

<span class="mw-page-title-main">COVID-19 pandemic in California</span>

The COVID-19 pandemic in California began earlier than in some other parts of the United States. Ten of the first 20 confirmed COVID-19 infections in the United States were detected in California, and the first infection was confirmed on January 26, 2020. All of the early confirmed cases were persons who had recently travelled to China, as testing was restricted to this group, but there were some other people infected by that point. A state of emergency was declared in the state on March 4, 2020. A mandatory statewide stay-at-home order was issued on March 19, 2020; it was ended on January 25, 2021. On April 6, 2021, the state announced plans to fully reopen the economy by June 15, 2021.

<span class="mw-page-title-main">COVID-19 vaccine card</span> Medical record for COVID-19 vaccination

A COVID-19 vaccine card is a record often given to those who have received a COVID-19 vaccine showing information such as the date(s) one has received the shot(s) and the brand of vaccine one has received, sometimes including the lot number. The card also contains information identifying the recipient and the location where the shot was given. Depending on the country, it could serve as an official document verifying one has received vaccination, which could be required by some institutions, such as a school or workplace, when boarding a cruise ship, or when crossing an international border, as proof that one has been vaccinated.

<span class="mw-page-title-main">CoWIN</span> Indian Government COVID-19 vaccination portal

CoWIN is an Indian government web portal for COVID-19 vaccination registration, owned and operated by India's Ministry of Health and Family Welfare. It displays booking slots of COVID-19 vaccine available in the nearby areas and can be booked on the website. The site also provides vaccination certificates to the beneficiaries, which act as Vaccine Passports during the COVID-19 pandemic for the beneficiaries and can be stored in Digilocker. Users can access the platform via desktop, tablet, and mobile phones.

<span class="mw-page-title-main">COVID-19 vaccination mandates in the United States</span> Mandates for people to receive the COVID-19 vaccine in the U.S.

Over the course of the COVID-19 pandemic, COVID-19 vaccine mandates have been enacted by numerous states and municipalities in the United States, and also by private entities. In September 2021, President Joe Biden announced that the federal government would take steps to mandate COVID-19 vaccination for certain entities under the authority of the federal government or federal agencies. Most federal mandates thus imposed were either overturned through litigation, or withdrawn by the administration, although a mandate on health care workers in institutions receiving Medicare and Medicaid funds was upheld. All federal mandates were lifted when the national emergency was declared to have ended in May 2023. A small number of states have gone in the opposite direction, through executive orders or legislation designed to limit vaccination mandates.

<span class="mw-page-title-main">Vaccine passports during the COVID-19 pandemic</span> Use of immunity passports for COVID-19 vaccination

A vaccine passport or proof of vaccination is an immunity passport employed as a credential in countries and jurisdictions as part of efforts to control the COVID-19 pandemic via vaccination. A vaccine passport is typically issued by a government or health authority, and usually consists of a digital or printed record. Some credentials may include a scannable QR code, which can also be provisioned via mobile app. It may or may not use a COVID-19 vaccine card as a basis of authentication.

COVID-19 vaccination mandates in Canada are the responsibility of provinces, territories, and municipalities, and in the case of federal public services and federally-regulated transportation industries, the federal government. COVID-19 vaccines are free in Canada through the public health care system. The federal government is responsible for procurement and distribution of the vaccines to provincial and territorial authorities; provincial and territorial governments are responsible for administering vaccinations to people in their respective jurisdictions. Mass vaccination efforts began across Canada on December 14, 2020. As the second vaccinations became more widely available in June 2021, Manitoba became the first province in Canada to offer a voluntary vaccine passport.

<span class="mw-page-title-main">19 to Zero</span> Canadian communications initiative

19 to Zero is a not-for-profit behavioural sciences initiative based in Calgary, Alberta, Canada. Hosted at the University of Calgary, the public–private partnership is made up of around 500 members including public health specialists, academics, behavioural psychologists, marketers and multimedia creators. Its purpose is to increase confidence in vaccines for COVID-19 and other diseases by tackling vaccine hesitancy. The group publishes materials on its website and through partner organizations, including videos, billboards, presentations, brochures and in-person events.

References

  1. ↑ The Commons Project (10 January 2022). "VCI Directory". GitHub . Retrieved 10 January 2022.
  2. ↑ "Home". SMART Health Cards. Archived from the original on 2023-06-01. Retrieved 2023-12-26.
  3. ↑ "SMART Health Cards: Vaccination & Testing Implementation Guide". HL7 FHIR. 2023-08-04. Archived from the original on 2023-09-27. Retrieved 2023-12-26.
  4. ↑ "SMART Health Card Verifier". The Commons Project. Archived from the original on 2023-12-26. Retrieved 2023-12-26.
  5. 1 2 3 4 5 "Albertans can't yet use Canada's vaccine passport system for international travel". CTV News Edmonton . 2021-10-21. Archived from the original on 2022-07-02. Retrieved 2024-06-20.
  6. 1 2 "SMART Health Card Uses Technology Developed At Boston Children's Hospital". WBZ NewsRadio 1030. 2021-08-06. Archived from the original on 2023-06-01. Retrieved 2023-12-26.
  7. ↑ "About". Vaccination Credential Initiative . Archived from the original on 2023-05-20. Retrieved 2023-12-26.
  8. ↑ Mandl, Kenneth D.; Kohane, Isaac S. (2009-03-26). "No Small Change for the Health Information Economy". New England Journal of Medicine . 360 (13): 1278–1281. doi:10.1056/NEJMp0900411. ISSN   0028-4793. PMID   19321867.
  9. 1 2 "About SMART". SMART Health IT. 2019-10-29. Archived from the original on 2023-12-25. Retrieved 2023-12-26.
  10. ↑ "SMART, FHIR, and a Plan for Achieving Healthcare IT Interoperability". SMART Health IT. 2013-11-15. Archived from the original on 2023-04-01. Retrieved 2023-12-26.
  11. 1 2 Mandel, Joshua C; Kreda, David A; Mandl, Kenneth D; Kohane, Isaac S; Ramoni, Rachel B (2016-09-01). "SMART on FHIR: a standards-based, interoperable apps platform for electronic health records". Journal of the American Medical Informatics Association . 23 (5): 899–908. doi:10.1093/jamia/ocv189. ISSN   1527-974X. PMC   4997036 . PMID   26911829 – via PubMed.
  12. ↑ Mandl, Kenneth D.; Kohane, Isaac S. (2019-10-03). "Data standards may be wonky, but they will transform health care". STAT News. Archived from the original on 2023-05-29. Retrieved 2023-12-27.
  13. ↑ Mandl, Kenneth D.; Gottlieb, Dan; Mandel, Josh C. (2018-10-16). "Ensuring that the 21st Century Cures Act Health IT Provisions Promotes Interoperability and Data Exchange". The Health Care Blog. Archived from the original on 2023-09-22. Retrieved 2023-12-27.
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  15. 1 2 "Excelsior Pass Plus to be recognized out of state, internationally". WGRZ. 2021-08-05. Archived from the original on 2023-05-31. Retrieved 2023-12-26.
  16. 1 2 3 Ingram, David (2022-01-13). "Quietly and over some objections, a national digital vaccine card has emerged". NBC News . Archived from the original on 2023-03-28. Retrieved 2023-12-29.
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  18. ↑ "Broad Coalition of Health and Technology Industry Leaders Announce Vaccination Credential Initiative to Accelerate Digital Access to COVID-19 Vaccination Records". Mitre Corporation . 2021-01-14. Archived from the original on 2022-09-26.
  19. ↑ Landi, Heather (2021-01-14). "Microsoft, Epic, Mayo Clinic join effort to accelerate digital COVID-19 vaccine records". Fierce Healthcare. Archived from the original on 2023-09-22.
  20. ↑ Collier, Kevin (2021-06-18). "California rolls out digital vaccine verification — but don't call it a passport". NBC News . Archived from the original on 2023-02-25. Retrieved 2023-12-30.
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  23. ↑ "COVID-19 Information". LA Wallet. 2021-08-27. Archived from the original on 2023-06-03.
  24. ↑ "Office of the Governor News Release: State Launches Hawai'i SMART Health Card for Digital Vaccination Certificate". Governor of Hawaii . 2021-09-08. Archived from the original on 2021-09-09.
  25. 1 2 Kelleher, Suzanne Rowan (2021-11-15). "How To Get Digital Proof Of Vaccination—And Why You're Going To Need It More Often". Forbes . Archived from the original on 2022-01-06. Retrieved 2023-12-31.
  26. ↑ "Partners". VaccineCheck. Archived from the original on 2021-09-11. Retrieved 2023-12-31.{{cite web}}: CS1 maint: unfit URL (link)
  27. ↑ Mahmud, Aqil Haziq (2021-11-12). "Singaporeans hoping to return from US on VTL face challenges getting proof of COVID-19 jabs". Channel News Asia . Archived from the original on 2023-12-31. Retrieved 2023-12-31.
  28. ↑ "ArriveCAN costs". Canada Border Services Agency . 2022-10-24. Archived from the original on 2023-06-15. Retrieved 2023-12-29.
  29. ↑ "Using Canada's COVID-19 proof of vaccination for travel". Government of Canada . Immigration, Refugees and Citizenship Canada. 2021-10-21. Archived from the original on 2021-10-21. Retrieved 2024-04-27.
  30. ↑ Osman, Laura (2021-10-21). "Feds, provinces agree on vaccine passport for domestic, international travel: PM". CP24 . The Canadian Press. Archived from the original on 2023-12-29. Retrieved 2022-01-27.
  31. ↑ "Proof of vaccination". BC Ministry of Health . 2021-12-24. Archived from the original on 2022-01-25. Retrieved 2023-12-28.{{cite web}}: CS1 maint: unfit URL (link)
  32. ↑ "Apple Wallet Update Now Compatible with Ontario Vaccine Certificate". Ontario Newsroom . 2021-10-29. Archived from the original on 2023-12-28. Retrieved 2023-12-28.
  33. ↑ "Accessing your COVID-19 Vaccination Record with QR Code from your mobile device". eHealth Saskatchewan. Archived from the original on 2023-12-28. Retrieved 2023-12-28.
  34. ↑ "Sample proof of vaccination credential" (PDF). Government of Yukon . 2021-11-17. Archived (PDF) from the original on 2023-06-15.
  35. ↑ "AIRA, IIS and VCI/Smart Health Cards Support" (PDF). American Immunization Registry Association. 2021-10-13. Archived (PDF) from the original on 2023-12-31.
  36. ↑ "Our Members". American Immunization Registry Association. Archived from the original on 2023-03-31. Retrieved 2024-04-29.
  37. ↑ "Events". Vaccination Credential Initiative . Archived from the original on 2023-12-29.
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  39. ↑ Takahara, Kanako (2021-12-20). "Japan has released its digital vaccine passport. Here's what you need to know". The Japan Times . Archived from the original on 2022-12-26. Retrieved 2023-12-29.
  40. ↑ "COVID-19 vaccination certificate". Ministry of Health, Labour and Welfare (in Japanese and English). Archived from the original on 2023-12-29. Retrieved 2023-12-29.
  41. ↑ "About CHIP". Computational Health Informatics Program. Archived from the original on 2023-06-02.
  42. ↑ Denning, Paul (2021-11-24). "SMART Health Cards - Vaccination and Testing IG Project Page". Health Level Seven International . Archived from the original on 2023-12-26. Retrieved 2023-12-26.
  43. ↑ Johnson, David (2023-04-13). "Public Health Work Group". Health Level Seven International . Archived from the original on 2023-06-02.{{cite web}}: CS1 maint: unfit URL (link)
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  45. ↑ "SMART Health Issuers". SMART Health Cards. Archived from the original on 2023-06-01. Retrieved 2023-12-27.
  46. ↑ "SMART Health Card Registry". CommonTrust Network. Archived from the original on 2023-06-19. Retrieved 2023-12-28.
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