There’s a small booklet I carry around when I travel (remember those days?). It is falling apart with scribbles and stamps and even pages added. But it looks official or at least it did as it has words and symbols from the government of Canada.
It’s my vaccine record book. One of the added pages is my yellow fever record which I need to show when entering some countries. I’ve always found that process odd. Show a piece of paper, which happens to be yellow, with some dates scribbled on it and I’m allowed in. My vaccine book is different than my passport as there are no codes, photos, and clever bits of wizardry to reduce the ability to forge it or confirm the booklet to be about to me.
Therefore when I think about going digital, I often think about health records, especially vaccine records. At a simplistic level it seems ‘easy’ and smart. However, I know for it to work globally it requires a huge effort and many challenges to overcome. Converting my vaccine records to a digital format is extremely easy. Making the digital format useful is a different matter all together.
In the end I always end up with the same two challenges. First, it is about standards, not technology. For digital vaccine records to work, we need to agree, globally, on open technology standards so that whichever software provider people use, their records can be read by others. In theory, this should not be too difficult to solve, but often power dynamics come into play here causing delays.
Secondly, and I dare most importantly, is the challenge of who do we leave behind? Inequality. Digital vaccine records would work brilliantly for me. I am literate, relatively digital literate, have a smartphone, access to the internet, and so on. In many of the countries I work, I am in the extreme minority. Many people live on less than a dollar a day or only a few dollars. And while many have mobile phones, they are not smartphones and there is often one phone per household. Now, one argument is that these folk don’t travel abroad so don’t need to show a yellow fever record. And while this is true, having a vaccine record is still relevant for them.
Therefore, my question or challenge is how do we digitalise vaccine records in a way that doesn’t perpetuate or increase inequality? How do we make it relevant to all?
But perhaps this is the wrong question?