Safe and Sound: Blockchain-Backed Digital Identity in the Post-Coronavirus Era

After spending months in lockdown, countries across the world have begun lifting stay-at-home orders enforced due to the coronavirus pandemic. Yet as countries look to reopen, and students and employees return to schools and offices, there is a fear that coronavirus cases will spike. In an attempt to ease these concerns, a number of blockchain companies are developing blockchain-based digital identity solutions designed to help regions reopen safely. 

Digital identity startup Civic Technologies recently entered a partnership with Circle Medical, an affiliate of San Francisco’s UCSF Health hospital, which will allow companies with more than 500 employees to verify whether or not their workforce has been tested for COVID-19. Known as “Health Key by Civic,” this solution will enable employers to see the results of each COVID-19 test taken by their employees. Moreover, once a vaccine is developed, employers will be able to determine if their employees have received the treatment. 

Similarly, the Mediterannian Hospital of Cyprus just announced the deployment of a blockchain-based medical data management platform called “E-NewHealthLife.” The tracking platform was developed by VeChain and digital healthcare solution firm I-Dante to store COVID-19 test results. 

According to CyprusMail, the platform produces a digital health passport, which is an encrypted non-fungible card that patients can use to identify themselves automatically when registering at the hospital’s emergency room. The passport is stored within a mobile app called E-HCert, which keeps track of each patient’s medical data and can be shared as needed.

Ecosystem manager at VeChain, Dimitris Neocleous, further told Cointelegraph that everyone arriving at Cyprus’ Larnaca International Airport will now have the option to receive their COVID-19 test results via E-HCert, as proof-of-health is a current requirement to enter the country.

Co-founder of the Blockchain Research Institute and author of Financial Services Revolution, Alex Tapscott, told Cointelegraph that proof-of-health solutions such as these are starting to play a major role, as COVID-19 has highlighted the potential for health data and identity management:

“This pandemic has demonstrated the need for easy access to people’s private information, to help mitigate spread, while also showing us the risks of going too far, with China being an example of a country that has no limits when it comes to violating personal privacy. Blockchain in many ways has emerged as a bridge between these wants, allowing us to easily access sensitive data, while also protecting personal privacy.”

Putting personal data on a blockchain network

Tapscott further explained that it’s becoming easier to imagine a digital identity stored on a digital wallet. He noted that this use case is how blockchain can be leveraged in healthcare to securely store identities across distributed networks:

“A digital identity on a blockchain sweeps up the exhaust of all our daily health and transactional data — from our biological data to purchases or our location at any point in time — protecting it and enabling each of us to use it anyway we want.”

Founder and CEO of Civic, Vinny Lingham, told Cointelegraph that while Health Key is a forward-thinking concept (since a COVID19 vaccination is yet to be developed), this particular use case works well, as the Civic Wallet was designed to store personal data that makes up a user’s digital identity.

“Health Key by Civic resides in the Civic Wallet, which natively houses both a user’s identity and crypto assets in a single mobile app, if applicable. The user is in complete control of their own personal information, which includes elements of identity such as those found on a government document like a driver’s license, and will soon include proof-of-health data via their Health Key.”

Civic’s wallet is built on the Ethereum blockchain. Lingham explained that Ethereum smart contracts work to ensure that a user is the owner of their digital identity, noting that these help facilitate the exchange of identities with identity requesters and the validation of identities with identity validators.

Once identity requests are received, an agreed-upon fee in Civic’s token (CVC) is placed into an escrow account, allowing third parties to access personally identifiable information from the user. When the request is met and access is granted, the fee in escrow is released. 

Unlike Civic’s Health Key that leverages the Ethereum blockchain, the E-HCert app is built upon encryption, meaning patient data doesn’t directly reside on the VeChain blockchain. Neocleous noted that the hash, or footprint, of the COVD-19 test results is the only information placed on the VeChain blockchain. “Blockchain is the last layer before it reaches the other layers that the data needs to go through in order to be in compliance with Europe’s GDPR and HealthCare Standards,” Neocleous said.

Interestingly, while both Health Key and the E-HCert app require some personally identifiable information from users, such as a driver’s license or passport, a blockchain-based prototype from EOS Costa Rica only requires a blood donation to prove their digital identity. Known as “Lifebank,” this is an application that was designed to incentivize individuals to donate blood, as there has been a sharp decline in blood donations following the COVID-19 outbreak. 

Co-founder of EOS Costa Rica, Edgar Fernandez, told Cointelegrah that Lifebank is built on the EOS.IO blockchain and is meant to create a circle of value exchange between different parties. In this case, the Lifebank app connects three specific users — an eligible blood donor, a donation center and a participating local business called a sponsor. 

According to Fernandez, individuals who choose to donate blood through Lifebank only need to register with a nine-character account name and password for an EOS.IO blockchain account to be created. “The only information required is a username, no other KYC information is needed, as a user’s blood will always prove they are human,” Fernandez said.

Privacy and security appeals to the mainstream

It’s also important to point out that these solutions are in compliance with the EU’s General Data Protection Regulation to ensure patient privacy. Lingham explained that Health Key users can deny credential access in compliance with regulations. He further explained that not even Civic has access to user data, as it leverages zero-knowledge proofs, which allow users to choose who can access certain information.

Neocleous mentioned that although COVID-19 test results are automatically uploaded onto VeChain’s public blockchain, the patient must provide the permission to have their results displayed within the E-HCert app. “When a doctor wants to view a patient’s medical records, a notification is shown from the app and the users can decide whether to share that or not,” Neocleous said.

According to Neocleous, the most common cases for sharing test results would be for citizens returning to Cyprus from abroad or those wanting to return to workplaces and require proof-of-testing. 

Due to the private and secure nature of blockchain networks, such solutions could very well prove to be appealing for individuals who are not familiar with cryptocurrency but want to securely store their personal health information within a crypto wallet. 

According to Lingham, more than 100,000 people are already signed up on the waiting list to access Health Key by Civic. He noted that COVID-19 antibody tests are currently being administered. Neocleous further mentioned that more than 2,700 people have downloaded the E-HCert app at the Larnaca airport and have asked to receive their COVID-19 test results on it. 

As for Civic’s partner, Circle Medical, the company will supply testing for interested San Francisco Bay Area companies and expand to other areas as needed. Circle Medical CEO and co-founder, George Favvas, told Cointelegraph:

“I think that traditionally, there has been a clear separation between employees’ health data and their employers. This is a unique case though, where employers do need some information in order to let individuals return to workplaces and I think we will see a growing need for proof-of-health solutions.”

Overcoming data sharing challenges

Although these solutions are revolutionary, data sharing guidelines and procedures must be exhibited in order for blockchain solutions in healthcare to go mainstream. According to Tapscott, many of the solutions mentioned above require data sharing guidelines in order to be successful. “This is why consortia and organizations with convening power are important, because they allow us to come together to develop common frameworks, and industry standards,” he said. 

Unfortunately, the healthcare industry could be reluctant to innovate. Findings from Deloitte’s 2020 Global Blockchain Survey indicate that out of 1,488 senior executives, 63% view digital identity as “very important.” However, only 9% saw the use of digital identity progressing in the healthcare industry.

While this may be, data sharing solutions designed for the healthcare industry are underway. For example, blockchain startup Duality Health recently entered a collaboration with The University of Texas at Austin’s Dell Medical School to determine how digital identity can be leveraged to ensure efficient sharing of health data between patients and different hospitals.

CEO of Duality Health, Clayton Saliba, told Cointelegraph that the company has created a prototype for a patient identity solution that leverages blockchain and facial recognition. The solution is intended to accurately identify, manage, track and then link a patient’s healthcare information across different facilities. Saliba said:

“Due to COVID-19, there is a greater need for an accurate, immediate and touchless form of identification. Our solution allows a patient to walk into a hospital or clinic and register or check-in using facial recognition. By leveraging blockchain, patients will have their electronic health records identified and linked, regardless of the hospital they visit.”

Saliba explained that the company uses its own public blockchain, called Dynamic, to allow patient data to be shared securely between healthcare organizations. Dynamic is a fork of the Bitcoin blockchain and is used to store hashes of a patient’s identity, allowing for public ID verification, while keeping sensitive data private. Hyperledger Fabric is also used as a private sidechain, allowing sensitive data to be accessible at different hospitals that are requesting patient information.

According to Saliba, a specific use case Duality is exploring with Dell Medical School is a disease surveillance system that can be linked to state and federal health networks. The system will ensure that information on patients who test positive for COVID-19 will immediately be accessible at both the state and federal levels. Currently, that information is trapped at the state level in the U.S., which has resulted in major discrepancies between statistics that states are reporting to the federal government.

While this use case is great in theory, state and federal guidelines regarding how data is shared between the two are still required to ensure that a solution such as Duality’s would work. 

In regards to Civic’s Health Key, Favvas of Circle Medical commented that a challenge moving forward will be meeting the varying policies between employers. For instance, a nursing facility will have different guidelines for employees returning to work versus those of a cafe. 

While clear guidelines are yet to be achieved, Favvas predicts that employers will most likely set policies based on government guidelines and specific requirements of their business. Once guidelines are in place, the underlying health records from employees will run through their policies to determine which individuals can safely return to public settings. 

Another concern is whether or not patients will want to store their personal health data inside cryptocurrency wallets or applications powered by blockchain. This being the case, Favvas mentioned that technology often works best when it’s “a bit invisible.” He commented:

“I think it’s important for patients to understand and ask questions about what’s happening to their personal information. But, do all users need to know the nuts-and-bolts of how blockchain works? I don't think so. Most people will only care if they are able to go to work, while protecting the privacy of their health records.”