HealthCerts – Singapore’s blockchain-based standards for digital COVID test certificates

Hospitals and clinics in Singapore conducting COVID-19 tests are using this set of interoperable standards which ensures reports are tamper-proof.

To allow digital COVID-19 test result certificates to be verified across borders, Singapore’s Ministry of Health (MOH) collaborated with the country’s Government Technology Agency (GovTech) in developing the HealthCerts standards. HealthCerts is a set of open-source, interoperable digital standards that leverages on blockchain technology. First announced in February 2021, the standards have since been used for the issuance of digital Pre-Departure Tests (PDT) certificates for travellers at authorised clinics and hospitals.

Digital documents issued in line with HealthCerts standards are tamper-proof, trustworthy documents that can be authenticated and verified. Built in accordance with international standards, HealthCerts is designed for global interoperability. Its use is set to “smoothen and expedite check-in processing and customs clearance at foreign and local immigration checkpoints,” according to Singapore’s Smart Nation and Digital Government Office.

Singapore’s MOH regularly updates the list of clinics and hospitals authorised to provide HealthCerts, for ease of reference of travellers.

Ease of use by staff and travellers

Farrer Park Hospital is one of the few hospitals which are providing HealthCerts. Farrer Park Hospital shared that when PDTs for travellers were first introduced, the hospital had decided to join as a provider, to contribute to testing capacity and ensure this service is accessible to all.

Before the HealthCerts standards were introduced, staff had to perform data entry manually, for example in editing the PDT reports with each patient’s particulars. However, “with the adoption of HealthCerts, patients’ PDT results can be updated and accessed on our end seamlessly,” said the hospital. “Once PDT results are ready, they will be uploaded to the portal where our staff will be alerted. Staff will then retrieve the link and send it to the patient, who will be able to access their PDT results digitally. This minimises the administrative work required (e.g. printing out the report, mailing it to patients or requiring them to make a second trip to the hospital to retrieve their report).”

Travellers will then need to submit the results to the government’s Notarise portal, for digital authentication and endorsement by MOH. This step provides assurance that the digital certificates have not been tampered with and were issued from an authorised clinic or hospitals, facilitating inspection and verification by border authorities. Patients can expect an email response from MOH on the authentication within 15 minutes of submission.

Sample of notarised PDT certificate
healthcerts screenshot
Sample display after verification by immigration officers

With the use of such digitally authenticated documents, border officials can simply scan the QR code from the traveller’s soft-copy or print-out HealthCerts, to verify that the certificate is valid and endorsed by MOH.

“Our hospital definitely saw the potential in how HealthCerts can make accessing of results easier; especially when traveling during a time when border restrictions are tight,” noted Farrer Park Hospital. In addition, digitalisation and integration of information also helps to minimise and avoid errors. “As a hospital, accuracy is paramount and there is no room for errors. It is definitely heartening to see such services being introduced by the Singapore Government to enhance workflow.”

Currently, it is mandatory for all clinics and hospitals providing PDT services in Singapore to issue the certificates following HealthCerts standards. They can partner with a private vendor, a list of which is published on the official HealthCerts website, to work on the set-up, staff training and integration of the standards into the clinic’s existing systems; or partner with a licensed laboratory that has already procured the service.

Facilitating seamless travel

As of May 2021, there are 10 private vendors which are helping medical institutions issue HealthCerts. The Singapore government has open-sourced the codebase of all components of HealthCerts, in the hope that widespread use and recognition of common standards can help to open up safe travel in more countries. According to GovTech, there are now some 420 medical facilities across nine countries which are using HealthCerts.

With HealthCerts being an open, ongoing project, GovTech has also called on all interested private entities or parties to work with them on “further work on the standards, including further enhancing interoperability, privacy, and verifiability of digital certificates.”

HealthCerts is another example of blockchain applications in healthcare, which is catching on in recent years. In Malaysia, the cHEART application leverages on blockchain to provide a secure platform for patients and doctors to access patient data, and has been implemented at the AmalMedik clinics. Blockchain has also been used for medical supply chain management, where hospital users using the solution can access trusted and quality medical equipment suppliers.

While large-scale travel still seems off the cards in the near future, innovative initiatives such as HealthCerts facilitate a smoother and safer COVID-era travel experience for essential travellers, and will be key for slow ramping up of travel when country borders open up.