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The call takes place over Zoom: https://zoom.us/j/9959292508697575630290?pwd=UlpLU2pJeGMvVmljM3JHUmNkZ0FqUT09di9hNThXSXNhRVhkak1heXVGblM5Zz09
Date
9am PT/ 10am MT/ 12pm ET
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All activities should be conducted in accordance with the Antitrust Policy found here.
Attendees
Keela Shatzkin, Ken Ebert, Ry Jones, Helen Garneau, Serhat Pala, Elisabeth Green, Heather Dahl, James Schulte, Sarah Samis, Ivan, Mike Ebert, Simon Nazarenko, Steve Davis, Tim Spring, Trevor Butterworth, Will Groah, Bhaskar Ram
Announcements:
- Next meeting: 6/22
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- Transitioning to Hyperledger
- Calendar transition
- 2nd&4th Thursdays for now will continue
- Groups io: https://lists.hyperledger.org/g/labs
- Helen is admin
- Notes/Materials
- Old notes and materials have been transitioned to the wiki page
- Can track notes real time
- Zoom/Meeting Invites
- Will transition to hyperledger zoom
- Recordings are posted to youtube as “playlist” people can subscribe to
- Chat
- Move from slack to discord: https://discord.gg/hyperledger
- #cardea channel under Labs
- Blog announcing transtition to Hyperledger:
- Calendar transition
- Transitioning to Hyperledger
- Introductions
- Keela Shatzkin
- Ry Jones
- Helen Garneau
- Discussion with Serhat Pala
- Covering the Basics:
- Chain of Custody matters with specimen
- Point of Service
- Instant testing
- These are usually screening tests not confirmatory tests
- i.e. non-negative test should/could result in follow up confirmation test (due to false positives, etc)
- These are usually screening tests not confirmatory tests
- Lab based/off-site
- have higher sensitivity
- Instant testing
- Primary Specimens
- Urine
- Saliva
- newer, slightly less acceptance for variety of reasons
- Lifecycle
- Pre-employment
- during application process, generally after acceptance of position
- drug testing & background screening often happen together, many service providers offer both
- Order:
- Send order form to candidate for them to bring to lab
- release of info to employer is likely included in onboarding paperwork OR
- collection site explicitly collects the consent to release the result to the employer (ordering "provider")
- On-site/self hosted testing (if applicable to the company type/size/setting)
- Send order form to candidate for them to bring to lab
- Testing procedure
- Identity proof at the site/during collection
- Low-tech solutions today, during check-in process
- opportunities for issues with authenticity of sample (person swap, sample tampering, etc)
- Result
- Usually never shared with the employee themselves, only the employer
- there is usually a Medical Review Officer that determines if the result is pass/fail for the employer; "the interpreter"
- critical for cases where patient might be on medication the indicates positive result, for legal/medical reasons
- the MRO is usually independent, contracted by either lab or 3rd party administrator (i.e. employment verification company)
- Employer generally gets yes/no answer to control workflow, not details of the test, but may also include them
- Transmission of data:
- often incorporated into MRO system
- HIPAA... but occasionally email might happen (hopefully encrypted!)
- Ongoing/Event based testing
- Some industries are regulated
- Dept of Transportation has minimum requirements
- State/Federal might have additional oversight of specific industries
- Companies can layer on additional requirements as needed
- 3rd party administrators usually manage these programs
- Consent
- Is this consent each time or once that covers the recurring/program agreement
- Schedule is usually at random (once per year - unscheduled, or random sample of company)
- timeliness to respond to request for order is important to ensure there is no tampering
- Some industries are regulated
- Pre-employment
- Business Trending
- Growth industry
- Other factors
- when it's hard to find employees, standards might lower to attract more people
- similarly, tightens during economic downturns because you're more choosy for candidates (and current staff)
- Changing landscape on legalization/decriminalization of certain individual drug use
- Does not appear to decrease test rates, impact of business relationship/industry requirements, might have legal exposure for company (to test and not to test)
- Economies of scale
- companies would like to reduce burden on employee to streamline process, issues with ownership of result (currently with the employer)
- the 3rd party administrators could potentially share if the service the same companies (and contracts allow)
Questions: - Organ Donation overlap?
- donation is provided but only yes/no is passed down on whether sample is viable and a match
- Needs more follow up
Is there a need for the employer to allow the employee/candidate to request the data to be shared with them (via verifiable cred)? - Yes, the result should belong to the specimen owner, especially since the use cases go way beyond just work-place testing
- but it opens up a lot of questions and could result in additional issues for the employer, i.e. the result could be challenged after the result is released based on the room for interpretation. For example, this opens up the black box for the employer to be scrutinized on their decisions/process IF there is trust in the system, this may change the flow and employers would be happy to give up the cost of testing if they can trust other results& Presentation with Sarah Samis & Ivan
- GCOM, state and local government IT services company, work with most/many states across US
- Vital Records issuance and management
- digital identity solutions using verifiable credentials
- Vital Records community goal:
- pilot level digital certificate issuance by 2026
- Vital Records overview
- a form of identity credentials, used for a range of verifications of other critical documents, i.e. driver's license
- Issued at local/state level, NOT federal level
- 57 agencies (some states have more than 1, plus US territories
- each STATE has laws the specify how these things should be collected and managed
- Most other countries have vital records at national/federal level
- User/community
- State and Local jurisdiction staff
- Providers who enter data
- birth data
- death data
- End User/public requesting data
- includes clearing house integrations
- There are timeline requirements for providers to submit the data, especially timely death reporting
- Use Cases:
- Who's qualified to submit vital stats records, Medical Certification
- Issuer: ED department (who oversees medical licensing)
- Holder: Licensed medical certifier
- Verifier: Health Department
- Discussion
- May require adjustments to state law if there are mandates on identity verification, to ensure verifiable creds meet/satisfy these requirements
- Could be used to manage login to the reporting system
- Supports the submission cycle
- Birth Use Case: Public/Person requesting their record
- Issuer: Dept of Health
- Holder: person/parent
- Verifier: Local school district
- Discussion
- Verifiable creds would help make enrollment easier and would be more secure by use of the ED systems
- School could provider registration QR code
- Supports selective disclosure
- i.e. school district only needs to verify age for grade eligibility
- Paper forms:
- Long form includes ALL data including a lot of medical and family based data
- Short form is more limited, but still may include more than what's needed for school
- Children born to non-citizen parents have a really hard time getting birth certificates
- There is a major value in being able to revocate access when needed
- 18th birthday
- Emancipated Minors
- Amendments and Corrections, ease of revoke and reissue
- Verifiable creds would help make enrollment easier and would be more secure by use of the ED systems
- Death Use Case:
- Issuer: Dept of Health
- Holder: Relative
- Verifiers: Government, Private sector (titles, life insurance), 3rd party to Government
- Discussion
- WHY people died is considered super sensitive data point
- can be managed by selective disclosure
- Longer times for delivery can cause delays
- WHY people died is considered super sensitive data point
- Who's qualified to submit vital stats records, Medical Certification
- WILL need tools to help interoperate because there WILL be deviation in the standards
- Introductions
- Questions:
- Why are these not free?
- Fees help cover the operating costs
- There are special fraud protection paper requirements that also add costs
- special cases may require a lot more investigation/vetting which requires staffing & resources
- VitalCheck
- software product provided by LexisNexis, this is contracted with local governments
- MOST states are live with public/private partnership
- How close is birth certificate to becoming verifiable credentials?
- Since this is foundational document.... and sometimes we need to MAIL this to agencies, etc, how close is this to becoming real?
- We think this is on the horizon, there is a lot of interest, NAPHSIS conference is investigating. Some states are laying foundation laws for digital identity (Utah, Michigan, etc)
- some drivers licenses and passports ARE already digitized, partially because they NEED to be more mobile, so they came first
- This could help leapfrog the use case for birth certificates because the path is being paved and barriers are being reduced
- There is a significant use case, could help with other state/government program enrollments
- some drivers licenses and passports ARE already digitized, partially because they NEED to be more mobile, so they came first
- Technical formats?
- Focus isn't on the tech detail yet, but rather the general goal of digitizing the data
- There hasn't been a rallying around a single tech answer yet.
- There is a risk for state based deviations here... but there is federal role to help fund and encourage states to move in certain directions... the carrot to drive toward consistency
- Why are these not free?
- White paper Update
- Future Agendas:
- Next meeting: 6/22