SMART Health Cards and Links FHIR IG, published by HL7 International / FHIR Infrastructure. This guide is not an authorized publication; it is the continuous build for version 1.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/smart-health-cards-and-links/ and changes regularly. See the Directory of published versions

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Official URL: http://hl7.org/fhir/uv/smart-health-cards-and-links/ImplementationGuide/hl7.fhir.uv.smart-health-cards-and-links				Version: 1.0.0
Draft as of 2024-04-29				Computable Name: SMARTHealthCardsandLinks

Overview

Paper medical records–such as vaccination histories and insurance cards–are easily lost or damaged, are difficult to authenticate, and are often not on-hand when they’re needed.

SMART Health Cards and Links are FHIR-based standards that address these challenges, enabling individuals to receive their health information and share it with others in a tamper-proof and verifiable digital form.They provide a digital version of an individual’s clinical information that can be kept at the ready and easily shared with others when the need arises–using a QR code, mobile app or web browser.

Together SMART Health Cards and Links provide options that support multiple goals–from keeping a small amount of verifiable medical information close by to authorizing a trusted party to access their entire medical record. They empower individuals with secure, equitable, and privacy-preserving access to their clinical information.

Examples of what an individual can do using these standards include:

• receive proof of critical immunizations on a physical card or in a mobile app and allow others to verify them by scanning the attached QR code
• scan their insurance card’s QR code when checking in at their doctor’s office–transmitting their member ID and other coverage information directly to the clinic’s system
• send an elementary school a link to their child’s immunization history, allowing the school to verify the information with the immunization registry and copy in the details if it wishes
• receive a “ticket” to access the results of a lab test when they’re ready
• give a provider time-limited or ongoing access to some or all of their medical data, including the ability to search.

IG Organization

The implementation guide is organized into two sections:

• SMART Health Cards describes the protocol that allows an individual to keep a copy of their important health records with them in the form of a secure QR code that may be saved digitally or printed on paper. SMART Health Cards build on international open standards and decentralized infrastructure to provide end-user privacy and the ability to work across organizational and jurisdictional boundaries. This section includes:
  • Cards User Stories
  • the formal protocol Cards specification
  • the Issue Verifiable Credential operation
  • Cards examples
  • a description of Cards credential modeling
  • a Cards FAQ and changelog

• SMART Health Links describes the protocol that enables storage and sharing of more information than can be kept on a single SMART Health Card (using cloud storage) and provides additional sharing options including limited-time access, long-term sharing of data that can evolve over time, and protecting access with a PIN that can be communicated to the recipient out-of-band. This section contains:
  • Links User Stories
  • and the formal protocol Specification

Dependencies

This implementation guide relies on the following other specifications:

[to be added]

Contributing

[to be updated (this is from the existing specs)]

The SMART Health Cards specification is copyright by Computational Health Informatics Program, Boston Children’s Hospital, Boston, MA and licensed under CC-BY 4.0.

We welcome discussion on the SMART Health Cards channel of the FHIR community chat.

[remove or reference HL7 jira?] You can also propose changes via GitHub Issues or create a Pull Request.

[remove or ?] Security issues can be disclosed privately by emailing security@smarthealth.cards to allow for a responsible disclosure to affected parties.

Sponsoring HL7 Workgroup

FHIR Infrastructure

Authors

[to be updated]

HL7 FHIR Infrastructure Work Group
Frank McKinney	fm@frankmckinney.com
[?] SMART, Boston Children's
[?] Argonaut and Vaccination Credential Initiative (VCI) projects

Dependencies

Package hl7.fhir.uv.extensions.r4#1.0.0 This IG defines the global extensions - the ones defined for everyone. These extensions are always in scope wherever FHIR is being used (built Sun, Mar 26, 2023 08:46+1100+11:00)

Cross Version Analysis

This is an R4 IG. None of the features it uses are changed in R4B, so it can be used as is with R4B systems. Packages for both R4 (hl7.fhir.uv.smart-health-cards-and-links.r4) and R4B (hl7.fhir.uv.smart-health-cards-and-links.r4b) are available.

Global Profiles

There are no Global profiles defined

IP Statements

This publication includes IP covered under the following statements.

• Most of the information on the CDC and ATSDR websites is not subject to copyright, is in the public domain, and may be freely used or reproduced without obtaining copyright permission. For information and exceptions regarding use of CDC material please see https://www.cdc.gov/other/agencymaterials.html
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  • Vaccine Administered Code Set (CVX): Bundle/00-a, Bundle/01-a and Bundle/03-a
• The UCUM codes, UCUM table (regardless of format), and UCUM Specification are copyright 1999-2009, Regenstrief Institute, Inc. and the Unified Codes for Units of Measures (UCUM) Organization. All rights reserved. https://ucum.org/trac/wiki/TermsOfUse
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• This material contains content from LOINC. LOINC is copyright © 1995-2020, Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee and is available at no cost under the license. LOINC® is a registered United States trademark of Regenstrief Institute, Inc.
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  • SNOMED Clinical Terms® (SNOMED CT®): Bundle/02-a
• This material derives from the HL7 Terminology THO. THO is copyright ©1989+ Health Level Seven International and is made available under the CC0 designation. For more licensing information see: https://terminology.hl7.org/license
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  • ObservationInterpretation: Bundle/02-a