I’m a doctor. The vaccine passport debate feels like deja vu

These days I’ve discovered myself experiencing flashbacks to precisely 12 years in the past. For these of you in healthcare, perhaps you’ve had comparable déjà vu. The extra I hear in regards to the polarized discourse round vaccine passports, the extra I understand: We’ve been right here earlier than.

The HITECH Act of 2009 catalyzed the digitization of America’s well being data and widespread adoption of digital well being data (EHRs). With that got here the promise of improved high quality, security, and effectivity in the best way we ship and expertise care. However the promise fell quick: We digitized in silos and with out the end-user in thoughts, leaving complexity for sufferers and frustration for clinicians in its wake. Quick ahead to at present, and the vaccine passport affords a digital various to a paper report, designed to enhance high quality, security, and effectivity as we search to return to a regular life and navigate new variants. As these applied sciences roll out and extra folks use them for social engagements, we now have a bigger crucial to keep away from making the identical errors once more.

In our preliminary digitization push, we overfocused on creating expertise constructed to authorities specs, leading to a system that was by no means designed with the top consumer in thoughts. We additionally didn’t align as an trade on find out how to share affected person data, making entry tough for each the physician and the affected person. Our EHR-era errors—tech-centric design and trade fragmentation—entrenched healthcare as an inefficient system, targeted foremost on illness as an alternative of affected person wellness or clinician expertise.


I skilled the implications of our system’s fragmentation firsthand years in the past when navigating my mom’s most cancers analysis and remedy. At the same time as a doctor, the method was a maze of complexity, from hospitals to specialists to the insurance coverage firm, and extra. From each the doctor and affected person perspective, it grew to become manifestly apparent: Our present digital framework places tech on the middle, not the affected person.

Then, lockdown hit and fragmentation wasn’t an choice. Everybody—suppliers, sufferers, payers, directors, and extra—needed to discover a approach to digitally talk, and focus shifted to the affected person. The widespread adoption of recent expertise and care fashions was thrilling. We realized the perks of digital care, from decreased journey instances to a lowered threat of ready room illness transmissions. However we might additionally higher pinpoint when an in-person go to was wanted. We see now that sufferers need a hybrid-care expertise that balances the human with the digital. Intuitively, everyone knows this: We as customers need care that’s straightforward to entry, retains us wholesome, and is there for us after we get sick or injured.

Enter the vaccine passport. Within the U.S., digital vaccine credentials are usually not mandated federally, and customers and states will in the end determine which—if any—functions stick. No matter how that performs out, the digital passports current a gateway to a broader dialog round what function the affected person performs within the entry, sharing, and management of their knowledge.

On this second, we now have a probability to transition from delivering reactive healthcare to a proactive system of enabling well being assurance—a system that empowers the whole healthcare workforce to help high quality affected person care whereas empowering customers to share their well being knowledge, together with their vaccination standing, with whomever they select by way of holistic design.

To drag this off, we now have to return to basic rules of open expertise requirements, empathetic design, and accountable expertise. These three components lay the muse for an ecosystem that’s secure and safe, whether or not for digital vaccine verification, well being passes, telehealth, or different wellness-forward functions that personalize and have interaction sufferers of their well being:

1. Open tech requirements. To scale a verification system for folks’s well being or vaccination standing, we have to guarantee interoperability and shopper alternative with an ecosystem of apps that lets customers securely and simply share their standing with whomever, each time, and nonetheless they need. On this means, we might help a multitude of verification choices. Every might be profitable if they supply worth to the patron and finish customers.

2. Empathetic UX design. The final objective of digital vaccine verification is to assist make returning to regular life simpler and really feel extra secure for everybody. Empathetic design means assembly the wants and behaviors of the individuals who will use these functions. We missed that boat with EHRs and have seen the hurt it precipitated to provider-patient relationship.


3. Accountable expertise. Healthcare’s digital transformation will hinge on shopper belief. Safety, privateness, and shopper possession of information are basic. Equally vital to the dialog—together with within the case of digital vaccine passports—is the function of expertise in inequities. If digital vaccine verification goes to work, it has to work for everybody, it doesn’t matter what machine they’re carrying.

All of us have a function to play on this nice do-over of our EHR-era errors. We have to be proactive in how we rebuild our system to encourage open collaboration throughout the trade. Reaching a future the place sufferers give attention to their well being and wellness, not their illness, requires the trade to focus foremost on the affected person, not on expertise. If profitable, the digital passport will function the turning level our trade must recommit to affected person properly being above all else.

Ashwini Zenooz, MD, is the president of Commure.