Notice F1: Implementation of the WHO digital documentation of COVID-19 certificates: vaccination status (DDCC:VS) technical specifications

AVERT (Application for Vaccine Equity, Rollout and Tracking) - Everwell Health Solutions

Two Sentence Overview: 
Everwell Health Solutions Pvt. Ltd. (“Everwell”) is excited to submit this technical application to Digital Square in support of Notice F1: Implementation of the WHO digital documentation of COVID-19 certificates. We propose to create AVERT (Application for Vaccine Equity, Rollout and Tracking) to enable Patient Enrollment, ID Verification, Certificate Issuing and Storage, Vaccination status tracking, Analytics to enable digital documentation of COVID-19 certificates compliant with WHO specifications and implementation guidelines; while leveraging components of the Everwell Hub (which digitizes a patient’s journey from awareness to recovery, to enable more autonomy by users for setting up, managing, and customizing deployments). While our platform is fully featured and in use in 15 countries supporting nearly 2.6 million registrations per year, the Everwell team manages deployments and customizations centrally as per partners’ requests.
Executive Summary: 
Everwell was founded in 2015 as a spin-out from Microsoft Research originally to champion innovations to support patient-centered adherence support and healthcare programs to monitor, visualize, and improve treatment for patients. Based on our initial work, we developed the Everwell Hub, an open-source module-based platform to digitize the cascade of care. The Everwell Hub is an open-source platform that supports treatment recovery and programs management of healthcare domains such as Tuberculosis, HIV, COVID, mental health, and beyond. As a platform, the Hub aligns with data standards and is interoperable with external applications. The Hub has been deployed in 15 countries in partnerships with governments, NGOs, and hospitals and supports over 1 in 5 newly diagnosed active TB patients annually and has registered over 18 million Person episodes. In this proposal, we suggest to build AVERT which can be used by Beneficiaries, Field Level and Administrative Users and has the following features 1. Is compliant with OpenHIE framework and is built as an extension of the same utilizing the components and services that already exist and augment its features. 2. Can adopt and adhere to digital health interoperability standards 3. Open source and generic enough to be customized for different deployment scenarios 4. Can enable enrollment and ID Verification of beneficiaries including OTP and ID Verification 5. Tracking Vaccination Status of Beneficiaries 6. Master data management and Inventories for available Vaccines 7. Implement Digital Documentation of Certificates and enable Digital signatures as per WHO guidelines 8. Utilize AI Components like Optical Character Recognition and Natural Language Processing, where it’s apt 9. Self-Serve Reporting engine for the admin users for instant insights on Program
Consortium Team: 
Everwell is leading the development of this concept note as a technical proposal for new platform development. We have active partnerships in several countries globally through which we would take partner feedback, suggestions, and ultimately demonstrate new features. Some of our country deployments include India, Bangladesh, Myanmar, Vietnam, Philippines, Ukraine, Ethiopia, Uganda, Tanzania, Mozambique, Nigeria, DRC, South Africa where we do have local associations and partnerships. At Everwell, our philosophy is that engineering, research and evaluation, and organizational capacity building in our users is the key to developing user-centric, reliable, scalable software systems to support healthcare practices globally. All of our work is open-sourced; we release our code under the MIT license which is one of the most permissive licenses available. Both our approach to sustainability and our technical commitments to open source allow partners to customize and manage projects after Everwell’s initial involvement.
Project Description: 
Background and problem statement: The only way for the Pandemic to end is to enable every person in this world immune, which is now possible through vaccines. The current challenge is to make these vaccines available to everyone and constantly track them through digital means. There is a need for a digital platform that can support the mass vaccination efforts of governments, donors and partners; a solution that is scalable, accessible and interoperable in various different geo-political contexts. Objectives of the Proposed Solution: The broad functional objectives of AVERT are highlighted in the executive summary. We would like to focus on key technicalities which would be significant for implementation. Solution Approach: 1. Discovery and Design: Finalize scope of the project including digital signature flow and reach and agreement on the use of the WHO guidelines. Create persona specific designs UI for the application to achieve the best User Experience. 2. DB Setup: Finalize Data points and Create Data models 3. Backend Development: Use open source technologies (NodeJs, Go, Java or Ruby) to Implement the API, HL7 FHIR compliant 4. Frontend Development: Use open source technologies (vuejs, react, angular or svelte) to Implement the UI(s) 5. Implement DSC signing process: With class 1 private keys (optional - a desktop plugin or a desktop application is needed to support signatures using a class-2 & class-3 certificates) 6. Security: Add security measures as needed and applicable (Data Backup, Firewalls, 2FA, data Encryption, SSL etc) 7. Productionize: Containerize the application for ease of deployment management 8. Monitoring and Evaluation: Open source and on-premise tools will be used like ELK + Kibana with Application performance management, Superset and Matomo for analytics, and Sentry for bug tracking. 9. Documentation and Training Materials
Application Status: 
Not Approved


Thank you for the application. We would like to make sure there is a little more detail on the alignment to Instant OpenHIE and engagement in the DevOps community in the full application.

Thank you for a great application. Please elaborate on:

  1. How will the application be expected to incorporate key data standards and align to workflows?
  2. How will you ensure alignment with OpenHIE approach and interact with other solutions?

AVERT - Response to queries for F1

How will the application be expected to incorporate key data standards and align to workflows?

For key data standards, we are planning to make use of the HAPI FHIR server, to store data in HL7 format.

and We are also following the data sets mentioned in the "WHO Digital Documentation of COVID-19 Certificates"


While making a plan for the implementation document we have referenced the workflow mentioned in "WHO Digital Documentation of COVID-19 Certificates"


How will you ensure alignment with the OpenHIE approach and interact with other solutions?

We did check "OpenHIE Instant" to initially model the architecture proposal, however, with a lack of documentation and working "use case packages" in the OpenHIE Instant ecosystem we are now considering using Individual OpenHIE components, like

 * HAPI FHIR server for storage

 * (optional services) Open MRS, Elastic Search and Kibana, DISH2

 * A new micro-service to generate/store certificate, following the data guideline provided in the who documentation.

 * Open HIM as the gateway and orchestrator between these services

Though we have briefly explained our approach in our response and tried to answer the queries, due to the complexity of the system it would be best if we can connect over a virtual meeting for a detailed discussion.


Everwell Team