Enough to Go Around
Generating efficiency in vaccine delivery with biometric authentication
- By Bill Spence
- Sep 01, 2014
Some of the most satisfying applications of sophisticated security technologies
have little to do with security. Today, biometric identity management
plays a critical role in delivering necessary vaccines to children
in the developing world.
Let’s take a look at how modern biometrics moved from “nice to have” to “essential”
at a mobile vaccination clinic in Africa, Mexico’s Seguro Popular project
and in hospital settings.
Extending resources
While there has been tremendous success over the past few decades in vaccinating
the world’s children against endemic diseases, funding and resource constraints
continue to limit progress. Even today, millions of young children are not being
vaccinated and an estimated 2.5 million born this year will die before the age of 5.
The people at the non-profit organization VacTrac realized that in some regions
as much as 50 percent of vaccines are wasted and never make it to a child. With
their mission of providing developing countries with the technologies and services
needed to maximize the effectiveness of vaccination programs, VacTrac set about
understanding the root causes of vaccine wastage. What they found was unexpected.
Ineffective vaccine tracking and reporting was a big part of the problem.
The vaccine delivery model in many parts of the developing world depends on
a multitude of healthcare workers who serve very large, remote areas. When there
are no vaccination records to consult, many patients are re-immunized unnecessarily
and a finite supply of vaccine is wasted. Others are simply missed. This is the
opportunity that VaxTrac took advantage of.
Biometric Vaccine Registry
VaxTrac is solving the vaccine delivery
model with a biometric vaccination
registry that is operated and managed
in the field with low-cost, Android,
mobile devices and multispectral fingerprint
sensors from Lumidigm. Using
biometrics to authenticate a child,
in place of paper-based vaccine cards,
allows health workers to have all the information
necessary to provide appropriate
health services, without putting
the burden on the mother to retain and
return with a paper card. In some settings,
paper vaccine cards return to the
clinics with the child less than 5 percent
of the time, rendering them ineffective.
Now, returning patients can pull
up their vaccination records with the
touch of a finger.
The proper biometric authentication
of a child and matching them to
their health record ensures that they
receive only the vaccines they need,
avoiding situations where health workers
administer unnecessary vaccines. In
the limited supply environment, every
dose administered unnecessarily means
another child goes without that lifesaving
vaccine.
Furthermore, the ability to do smarter
demand forecasting, supply chain management
and resource allocation means
that health officials can better manage
which vaccines go where and when. This
helps reduce the number of lost vaccines;
and because they expire, this ensures that
health workers are bringing only what
they need into the field. This also reduces
the number of vaccines that are lost,
opened unnecessarily or exceeds their
temperature limits.
The Multispectral
Imaging Advantage
Once the idea of a biometric vaccine
registry was established and tested in
the field, it quickly became apparent
that imaging children’s fingerprints in
demanding environments would be a
challenge.
“We started evaluating multispectral
imaging sensors from Lumidigm
in 2012,” said Mark Thomas, executive
director of VaxTrac. “Since the skin
of children, especially young children,
can be very malleable, we knew from
experience that conventional biometric
technologies that need a finger
pressed against the device do not work.
The multispectral imaging capability
of capturing fingerprint images from
deeper layers produces images less susceptible
to distortion and allows us to
track vaccinations accurately.”
Multispectral imaging is a sophisticated
technology specifically developed
to overcome the fingerprint capture
problems that conventional imaging systems
have in less-than-ideal conditions.
This more effective technology is based
on the use of multiple spectrums of light
and advanced optical techniques to extract
unique fingerprint characteristics
from both the surface and subsurface
of the skin. The subsurface capability is
important because the fingerprint ridges
seen on the surface of the finger have
their foundation beneath the surface of
the skin, in the capillary beds and other
sub-dermal structures.
The first in-country VaxTrac deployment
of Lumidigm fingerprint
sensors was in 2013. The units are now
in Kenya, Uganda and Benin, with
the largest deployment in 40 clinics
throughout Zambia.
The Right Solution
This system was designed with significant
input from health workers, resulting
in the workers becoming proficient
quite rapidly. Additionally, the multispectral
imaging sensors’ superior biometric
performance means they work
on the first try and are easy to use. This
minimizes the amount of ongoing support
required after initial training and
deployment, keeping indirect project
costs low.
This biometric system captures a
wealth of data and provides it to health
managers and officials in a manner that
empowers them to make decisions to
increase the effectiveness and efficiency
of the vaccine delivery system. With
the VaxTrac system, health officials
can use data-driven decision making in
many of their required workflows including
resource allocation, outbreak
and emergency response, strategic
planning and evaluation of intervention
effectiveness. The most important
element of this feature is that the information
is delivered in an actionable
format rather than as another large
and confusing spreadsheet.
To keep collected data safe and secure,
VaxTrac uses industry-standard
data protection methods and protocols
for both storage and transmission of
sensitive data. They also only collect patient
information specifically relevant to
vaccine delivery, minimizing the amount
of sensitive data. The only biometric
information stored is a unique hexadecimal
identifier—as opposed to actual
images of the fingerprint—that is the
output of the fingerprint evaluation algorithm.
This preserves a one-way flow
of information. A record can never be
matched to a specific individual; it requires
that the individual actually be
present to be matched to their record.
Patients’ Biometrics
VaxTrac’s mandate is to streamline the
delivery of vaccines and provide efficiency
to a decentralized vaccine delivery
model. A more common patientfacing
application uses biometrics to
ensure access to government healthcare
programs by all eligible citizens. Administrators
must be able to know who
is receiving the goods and services, and
only biometrics can authenticate recipients
with certainty.
Mexico’s Seguro Popular project is
a government healthcare initiative with
broad political support that aims to
provide social security benefits to underprivileged
members of the population
who receive no healthcare benefits
by providing them with subsidies for
medicine and medical care. Unfortunately,
authorized people were sharing
their healthcare ID cards with friends
and family members not authorized to
use the program. Today, the program
relies on multispectral fingerprint biometrics
to prevent fraudulent use of the
policy. Importantly, officials report that
the biometric actually facilitates faster
access to medical service for authorized
patients while saving costs.
Biometric patient authentication
can take on a variety of formats including
mobile, handheld terminals; selfservice
terminals; and temporary and
permanent staffed facilities. These are
not “security” applications, but they
use the very best biometric systems to
save costs, ensure goods and services
reach the intended users, and make
public programs extremely accessible.
Healthcare Mandates
Healthcare provider authentication is
becoming more common, even mandated,
in many parts of the world as access
to electronic medical records and controlled
substances becomes automated.
One of the world’s largest deployments
of biometrics in healthcare secures
and tracks access to controlled
substances. Medical dispensing systems
with multispectral fingerprint authentication
are currently deployed in most
major U.S. hospitals, with more than 1
million user touches per day. Reliability
was clearly a priority in this deployment
as some nurses require access to
such cabinets several dozen times a day.
The biometric solution is quick and
convenient, shaving seconds off of each
transaction and allowing providers to
focus on their patients.
E-prescribing and access to medical
records are heavily-regulated activities
that are also being supported by biometric
authentication. Most hospitals’
current technology investments, such
as enterprise single sign-on (ESSO) and
clinical information systems (CIS), allow
easy integration with fingerprint
sensors. Identity and access management
is being secured and simplified
with the touch of a finger.
Reliable, Secure
and Convenient
Fingerprint is the most widely used biometric
technology in healthcare. More
convenient than using a card-based system,
a fingerprint biometric authentication
solution does not require healthcare
workers or patients to carry some
other device, card or token.
It is critical to select a fingerprint
sensor that works in real world environments
and can deliver consistent results
irrespective of race, gender, age or
physical conditions. To truly support the
healthcare application, the sensor needs
to work every time, and for every user.
These attributes were make-orbreak
for the VaxTrac deployment.
Solutions providers could not control
the environment, nor could they familiarize
children with the proper use
of fingerprint sensors. But, the overall
success speaks for itself. Biometric authentication
has streamlined vaccine
delivery and reduced waste in several
countries, supporting the humanitarian
goal of providing life-saving vaccines to
all children.
This article originally appeared in the September 2014 issue of Security Today.