Behind the Code: the making of a Health Pass

Governor Andrew M. Cuomo announced the launch of Excelsior Pass — a free, voluntary platform developed in partnership with IBM, which utilizes proven, secure technology to confirm an individual’s recent negative PCR or antigen test result or proof of vaccination to help fast-track the reopening of businesses and event venues in accordance with New York State Department of Health guidelines

It was in the early weeks of the COVID-19 pandemic in March 2020 when Elli Androulaki, the leader of blockchain research at the IBM Research Europe lab located near Zurich, started entertaining with her team the idea of a digital health passport as a technology to help in regaining some degree of normalcy. She knew that returning to the workplace, physically attending public events like a concert or a sports event, or using transportation would require individuals providing trustworthy information on their health status.

“It all started with a call I got from my manager asking to set up a brainstorming session with the entire team. I noticed a sense of urgency and excitement in his voice,” Androulaki recalls. Her manager, Marc Stoecklin, leads the Security Research department at IBM Research Europe. He asked the team to brainstorm and come up with proposals to help fight against the pandemic.

“We had launched the IBM COVID-19 Technology Task Force to respond to the crisis and I was confident that on the security team we had the right mix of skills and experience to produce a meaningful solution,” Stoecklin says.

On a swiftly convened virtual meeting, the scientists presented a handful of ideas. But all proposals were quickly dismissed in favor of an idea for a blockchain-powered solution to securely verify a user’s health status while protecting their privacy.

The idea was based on the concept that citizens would acquire certifications of their health status, including polymerase chain reaction (PCR), antibody test results, or vaccination status, from their selected healthcare providers, which could then be shared by them, to third parties, on demand.

The obvious device to store and share the data would be mobile phones, but not everyone has a smartphone. So to make the solution even more widely accessible, it could also be used without a mobile device in the form of a printed QR code, which could be scanned to verify an individual’s health status.

And that is how the IBM Digital Health Pass was born.

“I knew immediately that this was a technology with very high potential to have a lasting impact when dealing with the pandemic and even beyond,” Stoecklin says.

Getting a prototype in three days was just the beginning

After receiving approval from the Task Force, Stoecklin and Androulaki were given the responsibility for bringing the idea to commercialization.

On the other side of the globe, colleagues from IBM Watson Health brainstormed a similar solution. The teams got together: the Watson Health team designed the IBM Digital Health Pass user apps and services, and integrated the blockchain-based, identity-powered technology provided by IBM Research. All in all, a team of roughly 20 IBMers scattered across the globe came together to develop the solution.

Androulaki’s first action was to ask Ilie Circiumaru, a brilliant software engineer on her team, how long it would take him to build a prototype. His Slack message was short and confident, “three days.” And he did it with time to spare.

But having the backbone of the app was only the beginning. Soon enough, challenges started to pop up. Androulaki remembers having a hard time imagining all the different customer requirements the app would have to meet.

“For us, it was clear that privacy of user data had to be front center. We wanted the users, i.e., the data owners to be in the driver’s seat in terms of deciding which pieces of personal data they would share with others,” she says. The data owners would also be able to delete their data whenever they wished.

Mechanisms to address that concern with privacy were indeed built into the health pass from the get-go. But how would they implement this for different use cases?

“Our initial scenario was international travel, but we wanted the app to be as customizable as possible. We think that it could someday be used beyond the pandemic to manage everything from a student’s academic records to an employee’s CV,” says Androulaki.

But even sticking to the health status verification use case, questions arose around aspects like establishing trust in the issuers of a vaccination certificate, or accommodating data analytics without compromising privacy.

Figuring out client’s requirements

In extending the initial architecture to best-address the future costumer’s needs, the global team worked together in an ideal manner.

“Watson Health [engineers] were extremely good at translating client requirements into technical and security specifications that we could understand,” she says. “It was one of the best-functioning collaborations we ever had.”

Exactly six months later from the first brainstorm, IBM announced the IBM Digital Health Pass on August 25, with limited availability starting on November 15.

Part of the appeal of the IBM solution resides in the freedom it gives organizations to decide on which criteria it uses to assess health status based on medical information. Whether it’s vaccination or on-site temperature scans or other data, those managing admission can always choose which information they’d rather to rely on.

But for the Research team, it’s the focus on privacy protection, accountability and transparency that makes the most difference.

“Looking back, I think we made the right choice in being conservative about privacy,” Androulaki says. The team wanted the app to be used widely and that meant compliance with data protection regulations like the European GDPR were key. It also implied a change in mindset.

“We couldn’t just do things based on convenience and put everything on the blockchain,” says Androulaki. At the same time, she and her team had to be nimble and get the job done within a few months. “It was quite a challenge but rarely have I felt that my work has such an immediate impact on everyday life.”

This is the official Medium account of IBM Research. It’s managed by IBM Research Editorial Lead Katia Moskvitch & follows the IBM Social Computing Guidelines.

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