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Verifiable clinical information is health data presented as a digitally verifiable credential and associated with the person it concerns. In the SMART Health Cards and Links standard, the data is represented using FHIR; the credential can help a recipient check who issued it and whether it was altered. That check does not, by itself, prove the original clinical record is correct.
What does verifiable clinical information mean?
The Verifiable Clinical Information (VCI) coalition uses the term for signed clinical data bound to an individual identity. In the HL7 SMART Health Cards and Links Implementation Guide, this information is represented in FHIR and packaged or shared using a verifiable-credential approach. The specific data depends on the purpose: there is no single fixed bundle that every credential must contain.
Identity binding is central. An implementation needs a way to associate the information with the person it concerns, but the particular method depends on the implementation and use case.
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VCI describes its scope as harmonizing standards and producing implementation guides for verifiable health credentials. It also says it led development of the open-source SMART Health Card Framework. VCI coalition
What can a SMART Health Card or Link contain?
The HL7 SMART Health Cards and Links FHIR Implementation Guide describes ways to present or share health information for different purposes. Its examples include proof of immunization, sharing insurance-member information at check-in, sharing a child’s immunization history, providing lab results, and giving a provider access to health data. These examples do not mean every organization accepts every credential.
| Format | How it shares information | Access and practical considerations |
|---|---|---|
| SMART Health Card | A compact credential presented as a QR code, digitally or on paper. | Can be carried and presented without relying on a smartphone if supplied as a printed copy. An organization may have its own acceptance rules. |
| SMART Health Link | Provides access to more information stored in the cloud. | Can support limited-time or ongoing access. Access may be protected with a PIN communicated separately. |
The guide is version 1.0.0, is based on FHIR R4, and is designated trial-use at maturity level 4. It covers both formally attested facts where verification matters and health information shared mainly for convenience or communication; it is not a universal mandate. HL7 SMART Health Cards and Links FHIR Implementation Guide
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What does verification establish—and what does it not?
Credential verification can help establish that a credential came from the stated issuer and has not been altered. It does not independently establish that the source record was entered correctly, that a test or vaccination was performed as recorded, or that the clinical information is complete.
The organization that performed the test or vaccination is responsible for the accuracy of that record and for correcting errors. If information on a SMART Health Card is wrong, contact the organization that performed the test or vaccination, or the relevant registry. A card does not update itself; request an updated record from the issuing entity. SMART Health Cards FAQ
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What should you check before sharing one?
- Issuer: Identify the organization that issued the credential and whether the recipient can verify it.
- Purpose and scope: Confirm that the information is relevant to the request; the credential’s contents depend on its use case.
- Access: For a link, understand whether access is time-limited or ongoing and how any separate PIN is delivered.
- Recipient: Share only with an organization you trust to handle the information. Whether a credential is accepted varies by organization and jurisdiction.
- Alternative format: If you do not have a smartphone, ask the issuing organization whether it can provide a paper card.
SMART Health Cards and Links are an approach for presenting or sharing verifiable health information, not a guarantee that every organization will accept a credential or that the underlying clinical facts are error-free.
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