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A SMART Health Card is a verifiable digital or printed credential containing signed health information, such as a vaccination record or test result. Its QR code lets a verifier check whether the credential is authentic and unaltered. It does not, by itself, prove the identity of the person presenting it or guarantee acceptance by a particular organization.
What a SMART Health Card means
HL7’s SMART Health Cards and Links Implementation Guide defines a SMART Health Card as “a verifiable credential containing signed healthcare data that can be stored and presented by users for various purposes like proving vaccination status or sharing health information.” The name refers to a FHIR-based standard and protocol for sharing selected health data in a tamper-evident form, not to a central medical-record database or an identity document. HL7 SMART Health Cards and Links Implementation Guide
“SMART” is part of the standard’s name. A card may contain information such as vaccination history or a test result, depending on what its issuer includes. It can be kept digitally or printed for presentation. CommonHealth: SMART Health Cards
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- An issuer creates and signs the credential. The issuer may be a lab, pharmacy, healthcare provider, electronic health record system, public health department, or immunization information system.
- The holder stores and presents it. The holder can show the card digitally or use a printed copy. A QR code is a common way to carry and present the credential’s data.
- A verifier checks the signature. A compatible verifier assesses whether the credential was issued by a trusted source and has not been altered. The QR code is only the presentation method; its appearance alone does not establish authenticity. HL7 SMART Health Cards and Links Implementation Guide
What information can a verifier see?
The contents depend on the credential the issuer creates. In CommonHealth’s card flow, a verifier may see the holder’s first and last name, date of birth, and vaccination or testing status. The holder chooses whether to present the card; the standard does not mean every card contains the same information. CommonHealth: SMART Health Cards
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SMART Health Card vs. SMART Health Link
A card is a portable credential for presenting a specific set of signed data. A SMART Health Link is suited to larger or evolving information that may not fit in a single card; it uses cloud storage and can provide options such as limited-time access or PIN protection. The right format depends on whether someone needs to present a self-contained credential or grant controlled access to more extensive or changing information. HL7 SMART Health Cards and Links Implementation Guide
What a SMART Health Card does not prove
Signature verification supports the authenticity and integrity of the credential. It does not independently confirm that the person holding up the QR code is the person named in it. HL7’s FAQ says these cards are intended to be used alongside existing identification, such as an in-person driver’s license or an online identity-verification service. HL7 SMART Health Cards and Links FAQ, September 2024 ballot guide
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Nor does having a valid card ensure a clinic, employer, venue, or other organization will accept it. Acceptance depends on the verifier, issuer, and relevant policy or trust arrangements. A card is a way to carry and verify selected health data, not a universal access pass.
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