Enough to Go Around

Generating efficiency in vaccine delivery with biometric authentication

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.


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