Al Shiferaw, a technical director at JSI, a global public health organization, shared his experience of many years of work in the domain of digital identity and digital health in Africa. He agrees that many countries don’t have unique health identifiers which health programs can use to identify patients. Such unique IDs, he says, may or may not be dependent on foundational ID systems, depending on how they are designed.
Pam Dixon from the World Privacy Forum said in the Global North, health ID systems “are quite fractured,” although that was less the case about 15 years ago when unique IDs were widely used to identify patients. She cited the case of the United States where the health ID system was eventually fragmented by design, explaining that the government removed a unique identifier for the provision of healthcare, and introduced functional IDs for specific health services.
The speakers also agree that healthcare is a special use case for digital ID although its deployment has to be contextual, given the circumstances of different countries. To them, there is also no universal need to have a specific health ID as countries have different ground realities. The panelists approve of a link between digital ID used for health purposes and foundational or legal ID systems, however.
In any case, the officials emphasize that whichever health ID system is adopted must prioritize the security of patients’ digital data files. “Having all the health data in one location is not actually going to be easy to secure,” says Dixon while making the case for a decentralized health ID system.
For countries seeking to use specific identifiers for healthcare systems, the panelists advise them to first put in place the requisite regulatory and governance frameworks, set up patient registries, sort out logistical issues and put in place mechanisms to protect sensitive data while addressing human rights aspects. Governments should consult with all stakeholders including vulnerable populations, and select a couple of systems that might work and get them tested in pilot projects.