For an introduction to our Global COVID Certificate Series and links to the other options covered in this series, please see this post.
SMART Health Cards (SHC) originates from the SMART Health IT project at the Boston Children’s Hospital Computational Health Informatics Program. This initiative develops open standards and technologies to connect people with their health data. SHCs provide individuals with verifiable health and clinical data, such as vaccination history or test results.They allow individuals to keep a copy of their selected clinical events on hand in a digital or paper format, providing a means to easily share this information with others if they choose.
Organizations that lead the development and implementation of SHCs include Microsoft, Vaccination Credential Initiative (VCI), The Commons Project, and The MITRE Corporation. The Chief Architect of Microsoft Healthcare, Josh Mandel, is also the Chief Architect at SMART Health IT and the leading developer of SHC. VCI has hundreds of participating organizations, mostly in North America including governments and many large corporations (e.g. Walmart, CVS, EPIC, Cerner), committed to implementing, testing, and refining the SMART Health Cards Framework within their sphere of influence. CommonPass, a proprietary system created by The Commons Project, is implementing SHC and operates the CommonTrust Network that manages a list of SHC issuers.
SHCs are formatted and encoded using standards within the JOSE (Javascript Object and Encryption) framework. The minimized schema is smaller than the set of data attributes required for EU DCC. It contains one’s legal name, date of birth and clinical information (tests: date, manufacturer, and result; vaccinations: type, data, and location). SHC’s data model is based on the HL7/FHIR standard. The clinical data included in a SHC is formatted as a W3C:VC JSON-JWT credential Each health card represents specific use case data which the holder has to choose based on context. The implementation goal is to include just the minimum data required to display one’s vaccination history and/or test status, and let the holder decide whether to share their Cards or not. SHC’s signing certificates are published to a URL defined in their signing certificate protocol. This is similar in design to the DCC, where the signing certificates (DSC) are published to a public endpoint.
Currently, SHCs are mainly implemented in North America, but more countries/jurisdictions outside the region are evaluating and considering it for domestic use. The California government has recently open sourced its SHC codebase and is actively helping other jurisdictions with adoption and implementation.
| Countries/Jurisdictions | US States: Hawaii, New York, Louisiana, Virginia, California (more States soon) Canadian Provinces: Quebec, British Columbia, Ontario, Alberta, Saskatchewan (more Provinces soon) Others: North Macedonia, Aruba, Cayman Islands EACPass is implementing CommonPass for Uganda, Rwanda, Kenya, South Sudan, Burundi, Tanzania |
| Website | https://smarthealth.cards/ |
| Technical Specifications | https://spec.smarthealth.cards/ |
| Open Source Repo | https://github.com/smart-on-fhir/health-cards/ |
| Implementation Guide | https://build.fhir.org/ig/HL7/fhir-shc-vaccination-ig/ |
| Governance Framework | No. Jurisdictions and private organizations implementing SHC can define their own governance framework. |
| Trust Registry | https://github.com/the-commons-project/vci-directory/blob/main/vci-issuers.json. This repository provides a public directory of institutions issuing COVID-19 Vaccination SMART Health Cards operated by VCI. You can see the requirements for issuers here. CommonPass also manages a private list of issuers for its CommonTrust Network. |
| Example QR Code | |
| Others | Verifier App: https://thecommonsproject.org/smart-health-card-verifier |