The medical record you can't lose

The MOHT blog continues its series describing MOHT’s collaborations in the fight against COVID-19. This post looks at multi-organisation efforts towards the development of a digitally verifiable COVID-19 medical record.

After the peak of Singapore’s COVID-19 outbreak in May 2020, migrant workers were issued physical discharge memos as proof of their COVID-negative health status in preparation for their return to their dormitories. A key challenge posed by hardcopy discharge memos was their inability to be efficiently verified or digitally processed.

The sheer number of migrant workers who had to be tested called for a digital and efficient verification method to facilitate their safe re-entry into workplaces and dormitories. Enter distributed ledger technology (DLT) – a solution which enables authorities to issue digital and instantly verifiable COVID-19 medical records.

DLT allows for a secure online database in which authorities can upload and store documents which are traceable back to the source. This unique feature reduces the time and manpower required to verify the authenticity of a medical record. Previously, manual verification such as calls or emails to a clinic was the only mode of verification. With this technology, authorities can instantly check the authenticity of a record by scanning the document’s unique QR code, enabling an efficient on-site COVID-19 health screening framework.

The Ministry of Health (MOH) trialled the use of DLT in the issuance of verifiable discharge memos to migrant workers in July 2020; these discharge memos have since been verified more than 4.5 million times.

There was a sense that verifiable test results which display an individual’s COVID-19 status can contribute to managing and easing the reopening of travel borders at scale. However, there was no standardised COVID-19 test result template for Singapore laboratories and clinics to adhere to.

In response to this issue, MOH partnered GovTech, Temasek, and Accredify to develop HealthCerts, a standard for verifiable COVID-19 swab results, which was both nationally recognised and in line with international standards. In October 2020, Parkway Pantai, was the first private provider in Singapore to issue HealthCerts to outbound travellers in partnership with Accredify. To trial the use of HealthCerts as a viable method of verification at immigration, Singapore’s national carrier, Singapore Airlines, became the first airline to recognise and accept HealthCerts as part of its digital health verification process for travellers.

Following the trial’s success, MOH mandated that from March 2021, all pre-departure COVID-19 swab results follow the HealthCerts schema to facilitate a seamless verification process and travel experience for authorities and passengers respectively.

DLT is a promising technology to digitalise targeted health transactions and place secured access of records into the hands of patients.

We are now working with providers and patients to extend these successes to potential non-COVID use cases that enable population health.

Quah Zheng Wei is the Chief Executive Officer and Co-founder of Accredify. Zheng Wei leads the team in establishing the company’s strategic vision and direction, focusing on business development, partnerships, and sales.

Ong Pang Hao is the former lead for industry engagement for MOHT’s iConnect Project. He was a pioneering team member for Singapore’s HealthCerts initiative.

Jayan Arunasalam is the Deputy Director, Corporate IT at MOHT. He specialises in strategic IT consulting, collaborating towards best practice use of IT in support of population health initiatives with partners and enterprise IT service excellence.