PharmaLedger Track Panel 4. Verifiable Credentials for COVID-19 Data Management | European Blockchain Convention 2021

PharmaLedger members joined to discuss verifiable credentials and their relation to COVID-19 data management.

PharmaLedger is entering its second of three-year partnership for dissemination with the European Blockchain Convention (EBC). This year’s 5th edition of the leading blockchain event occurred on the 12th-16h of April 2021. EBC invited PharmaLedger to present an introduction of the project, followed by four “PharmaLedger Track” panel discussions. You can read the recap of the first three PharmaTrack panel discussions linked below:

Following the third panel discussion, the fourth panel of the track was Verifiable Credentials for COVID-19 Data Management.

Verifiable Credentials for COVID-19 Data Management

The fourth and final PharmaLedger Track panel was moderated by Benedetto Biondi (Blockchain Italia) and the panellists included: PharmaLedger’s Architecture & Reference Implementation Co-Lead Marco Cuomo (Novartis), Heather Leigh Flannery (ConsenSys Health), Xavi Vila (Validated ID) and Daniel Uribe (Genobank.io).

The discussion began with Benedetto Biondi introducing the panellists. COVID-19 has forced us to stay at home for the past year, and now with the start of the vaccination campaign, it is mandatory to accelerate the international and socio-economic recovery. Blockchain technology and DLTs can help transfer data shared between governments and businesses to help protect the privacy of individuals and to help us get life back to normal.

Vila introduced Validated ID, a trust service provider for electronic signatures, electronic invoices, decentralized identity and CCIs (Copy Credentials Initiative). They are also partnered with the Good Health Pass Collaborative and closely following the work under WHO’s Smart Vaccination Certificate Working Group. The current status of the digital green pass and the WHO proposal is to rely on public infrastructure and provide a root of trust and he believes could evolve to a more user-centric approach which would use verifiable credentials. 

PharmaLedger’s Marco Cuomo then introduced himself and his work with blockchain in the healthcare environment. He said that blockchain is a team sport that requires an ecosystem, which is why the PharmaLedger consortium came together. Our goal is to build a blockchain platform for the healthcare industry, which is supported by eight use cases to showcase the technology’s potential. 

Next was Heather Flannery, who introduced herself and ConsenSys Health, which is building a global infrastructure focused on the transition to person-centeredness. They are building a platform that will be run by blockchain consortia and a portfolio of products, while also supporting an ecosystem of third-party product providers that wish to run on that platform. They are centred on the Ethereum ecosystem but are building solutions on other protocols and establishing cross-chain interoperability.

Daniel Uribe followed with an introduction and his work at Genobank.io. He showed a prototype of a saliva kit paired with a blockchain-based wallet. The main mission is to put the donors in control of their biosamples. They are pushing NFTs (non-fungible tokens) related to biodata. Their COVID-19 test is an RNA test that involves a biosample. 

Q: In relevance to NFT as a solution, what is your opinion about this topic? How do you think that this can help solve the COVID-19 issue?

Uribe answered first by saying that the most value they hold is authenticity or provenance. It’s a token that is generated with a signature of an author, like crypto art. Another example is their DNA or biosample (a biological artistic asset with only one author “owning” sample). Their NFT using a specific DNA variant that they tokenized allows users to establish ownership and control over that specific data set. “We think that your biosamples are your bio property, in this case in the digital metaverse,” he said. Another NFT they have was inspired in the GDPR law. It represents permission over the use of this specific data and in their use case. Researchers become collectors of these permissioned tokens from donors and can use their data within a GDPR framework.

Afterwards, Flannery continued the discussion by talking about the difference between a verifiable credential and an NFT and how these relate to each other. Decentralized identities or methods of implementing decentralised identities and verifiable credentials are both fixed and finite in what they are and what they can do. When you apply those kinds of technologies and add non-fundable tokens (NFTs) to them, they cease to be fixed and finite. You can link and hierarchically relate these things to create digital scarcity that enables the possibility of trading data as a new asset class. By combining all these different technologies, “we have the opportunity to create ethically intentional data markets that bring the data subject into economic transactions, empowering them further in their ability to engage in the healthcare system,” Flannery said. She stated that there is enormous potential in how NFTs can be used in healthcare.

Q: I wonder how changes to the Ethereum protocol or other public blockchains, gas fees fluctuations and bigger updates would impact the functioning of critical health services. 

To answer first, Flannery stated that in our world, we view the Ethereum mainnet as a critical, neutral backstop in a healthcare future that involves many blockchains and many protocols. As time will go on, the Ethereum mainnet will be one shard of the future Etherum. There are many scaling techniques that will allow private enterprise networks to be hierarchically bridged and tethered up to the ultimate mainnet as a backstop. This will also be without storing sensitive health information on a public or private chain. The question is: how can we use the Ethereum mainnet as an enterprise messaging bus? When there is talk about tightly cooped off-chain we can mean both the private and public chain and hybrid environments. She added that there is a lot of value being created in that area. 

Q: What is your opinion about the consideration of common interests of healthdata for research purposes. You have no access to know how they are being used and for what. Do you find it ethical to receive money from your data?

Cuomo answered this question by stating that coming from Novartis, this is a big topic: how do we get to the data and information? In the future, this could be a good way to access information from patients getting rewarded by sharing data for research or development purposes. The question is, how will the platform work and look? The industry talks a lot about health data markets where a patient shares health information. When looking at surveys, many patients are interested in sharing data if they know it has a positive effect. From an ethical standpoint, this is a win-win. You share your data and in the long-term, new medicine is created or a new solution for helping people.

Vila continued the discussion by agreeing that if it’s a common interest, it’s a win-win. We as individuals and society benefit from sharing this data for research purposes that improve treatments. He mentioned that care should be given to how these data pools are implemented.

To build on this, Flannery then agreed that we need to take caution when approaching this, but we need to recognise that we have evolving technology with many possibilities. Data sharing in our industry historically meant that you get copies of data, govern that data and incur all the liability to that data. New technologies converged with confidential computing and federated computing means that it is no longer necessary to share data in order to derive value from it. In the future, the need to exchange copies of information will in her opinion be an exceptional case. The new rule will be computation that’s blockchain facilitated and privacy-preserving. She stated that we must break out of the mental model that we have right now, where we believe everything is about data exchange front point-to-point, which is no longer necessary. 

Q: In terms of data sharing, what is the best protocol to adapt publicly or privately in healthcare for a more efficient way to implement the solution for COVID-19?

Cuomo stated it depends on the use case on whether public or private is the right one. PharmaLedger is going towards a hybrid model. Certain use cases have a situation where everyone would have access to the blockchain, but not everyone should be able to write on the blockchain. “You have to create a kind of onboarding for members. In some concrete use cases, it would say that only manufacturers can write new information on it, but everyone can read from it,” he said. At PharmaLedger, we try to be technology agnostic from a blockchain point of view. If after some time, we find out that a public or another protocol is better, it’s ideal to be able to switch to another technology easily. A lot of enterprise use cases will go towards a hybrid private model, but there are also many others that require a public one.

Technology is evolving and the distinction between public, private and hybrid is dissolving, added Flannery. The ability to fine-grained control over multiple layers of technology is evolving. Building software that can be modulated is critical. Our industry cannot risk being locked into technology that isn’t functioning when it comes to life and death. 

Benedetto Biondi then added that at Blockchain Italia, they have a new product called the health passport that aims to give verifiable credentials for COVID-19 vaccine and testing certificates. It’s a multi-cross-blockchain platform that uses a permissionless algorithm. They never register their data clearly but just the hash, which is the digital fingerprint of the document. This tamper-proof system allows one to check online that a certain document was registered.

Afterwards, Vila stated that the strategy of being resilient and being able to work with different technology is important, but it’ll take some time. They’ve been trying to showcase proof of concept with public administration, but the fact that there is a fear of using an infrastructure that isn’t under your control is something that is pushing back some players. He thinks that’s one of the good things about the European Blockchain Service Infrastructure that is being built to be developed and deployed. It’s the very first step that’s needed to show everyone that it’s possible. 

Q: What difficulties and barriers are seen in the countries you are working to implement this blockchain solution for healthcare and COVID-19 issues?

To answer this question, Uribe talked about problems in Mexico, where there was a rise of fake laboratories for COVID-19 testing and cloning fake certificates for travelling. He talked about how they established a relationship with the first laboratory in Mexico to issue tamper-proof blockchain certificates. They are substituting an autograph for a cryptographic signature based on Ethereum, so they can sign their own certificates using Genobank’s platform. It’s a QR code that stamps in the blockchain so it has the signature of the laboratory director, Genobank signature, timestamp of the test and the result. A QR code is presented at the airport that is verified and not even the laboratory keeps it as a record. This is a zero-copy mode kind of certification. They don’t want governments, airports, or enterprise clouds to hold this information. It’s only a relationship between the laboratory and the patient. 

Vila also added that one of the biggest challenges seen is interoperability. When dealing with these results or vaccine passports across country borders, it starts to be complicated. Some organisations such as WHO or the Digital Green Certificate are proposing to use the same system so it works across borders. Everyone needs to accept and implement the solution, which is a big challenge.

Continuing the conversation, Uribe added that they are implementing a new solution that aims to give verifiable credentials. In Italy, it is easier since they have the legal value of the timestamp due to the permissionless recording of the data on the permissionless blockchain. A big challenge is dealing with bureaucracy of public healthcare in Italy. This is often tedious when solutions are needed quickly. It would be easier if bureaucracy could be faster and accept blockchain as it is, especially given the vaccination process now. A barrier can be the lack of knowledge of blockchain technology overall, especially on the political level. If they knew the value of blockchain, protocol implementation could happen much faster.

Another problem Flannery also highlighted in the industry is financing these infrastructures. The team must abstract from within the enterprise’s and government’s IT organisations and processes that currently live separately. They must then be brought into a new shared infrastructure. How to govern it, how it’ll be paid for, who will absorb the risk and liability, how does that work within each jurisdiction around the world are just some things that must be determined. 

Reaching the end of the discussion, Cuomo stated how Novartis continues to experience the situation that a lot of promises are made with these new technologies. With blockchain, a lot of financial support is required, but showing the solutions is crucial. The new technology with little proof of solutions isn’t very convincing to implement. There needs to be solutions that show that the risk involved with the investment is paying off. 

As the panel came to end, it’s exciting to see how these various companies along with PharmaLedger are actively working towards showing actual proof of solutions. For this interesting and final PharmaLedger Tracks panel discussion, we learned a lot about the current and future direction of verifiable credentials and COVID-19 management. There are, however, many challenges to overcome for these new technologies to be implemented.

You can watch the full recording of the PharmaLedger Track panel: Verifiable Credentials for COVID-19 Data Management at EBC below. You can also watch the other three panel discussions linked at the beginning of this article.

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