 Fantastic. Alrighty, welcome everybody to today's edition, June 6th of the Cardio Working Group under Hyperledger Labs. We're excited today to have a presenter and we'll get into that in just a minute before we have a couple of housekeeping items that includes our antitrust policy. So we are not talking about specific business opportunities here, you know, financial gain and things like that. We're talking about that at a more general level. If anybody has concerns, please let us know. You can email me or there are some ways to report that through Hyperledger directly. Similarly, our Code of Conduct, which is linked in our meeting notes, I'll chat this to you guys. These are community notes, so feel free to participate or correct. Also, you can tell me to correct as we go if that's helpful. But our Code of Conduct is really that we're an inclusive community. We encourage everybody to have a voice. If anybody feels like they're not getting the voice that they would like to have here, please again, you can reach out to me as a co-chair or again through Hyperledger to escalate an issue. Ken, who is our other co-chair, unfortunately, had a death in the family, so he's not able to join us today. We hope that he'll be able to take care of those things with his family and return soon. And so that takes care of our housekeeping items. Does anybody want to introduce themselves today? Maybe been a while. I can go first, because I know we're talking about some very specific health things. As co-chair, my name is Keela Schatzkin. I'm based in New York. I work in health data and operations, sort of the intersection of healthcare data and operations, primarily in the health information exchange space. And I've been doing so for a very long time at this point. I do that both in New York and in other states across the US. And so this obviously is very close to my heart as a data exchange method for healthcare data. Right, did I miss something and you wanted to chime in? No, I was just raising my hand. To introduce yourself. For introduction. Fantastic. So that's what I usually ask people to do is if you have a comment to make, please raise your hand. So I'm Ray Jones. I'm a community architect here at the Linux Foundation. I've been working on Hyperledger since before it was Hyperledger. And I was working with Cardia when they were over in LFPH, which went through some turbulence. So I'm really glad to see that Cardia has moved to a Hyperledger lab and is working on becoming what it promised to be. So I'm really glad if you need any support, I'm on Discord. Please reach out. And we're forever grateful for your support. Rai, we really feel it here. So thank you. Would anybody else like to introduce themselves? I will just because it's been a while. Hi everybody. My name is Helen Garno. I do the marketing work here at Cardia in conjunction with some of my colleagues, Tim Spring and Trevor Butterworth, and the community. I also do marketing for NDCO and was there when Cardia was born, I guess, last year. No, two years ago now. Three years ago. 2019, 2020, 2020, 20, 20. Anyways, so again, happy to see it grow. Happy to see us move forward and be part of the Hyperledger Foundation community. I'm also the Hyperledger membership marketing chair. So that's a role that I was elected in by the kind of doothpane members of Hyperledger, all the all the groups that are part of the community. And so if there's anything I can do to help support, yeah, just the visibility of Cardia, I have many, many hats that I wear that would support that effort. So if anybody has any ideas, please don't hesitate to reach out. I think Trevor might have an update on white paper potentially. So we might want to add just grab some time at the end for that at some point. Sure. Okay, so then just for an update, we've migrated all of our housekeeping, we've migrated all of our things to the Hyperledger platforms so that we're more integrated. It's been super helpful. Like as I mentioned, we're eternally grateful for the support that we're getting here. And so I've left the minutes about some of those transition things. If you're, you know, if you come to late to the party, there's some cheat sheets about sort of what's changed and how we're operating and where to find things. You can see those here. So I'll leave those we'll probably take them out moving forward. But just as a reminder, that's there for you. And we're taking notes in the Hyperledger labs space now, which I've linked in our chat. So today we are very excited to have a speaker participate and join and talk about some of the healthcare vital stats space. I'm not going to do it justice in terms of the breadth and scope of what we're going to learn about today and how it intersects with the work we're doing here at Cardia. So I'm very pleased to introduce Sarah and to encourage participation from our community. If you have questions as we go through today's discussion, feel free to throw your hand up and we'll get that asked or you can put it in the chat box and I'll be monitoring that through the course of today. So without further ado, Sarah, do you want to introduce yourself and Ivan? Sure. Hi, I'm Sarah Samus. I work at GCOM. We're a primarily state and local government product, software product and IT services company. And we work with many states across the country. And one of our product areas that we focus on is vital records, issuance and management. And then we also have been working on digital identity solutions using verifiable credentials. So we after talking with Ken and Helen and Kayla previously and Heather, we were invited to come speak to you guys and go through a little bit more of our design process on the vital records use cases for verifiable credentials. The vital records national association has sort of made a goal for its membership that all of the vital records, your restrictions across the country will figure out how to do at least some kind of pilot level digital certificate issuance by 2026. And we feel really strongly along with the community that decentralized identity should be a component of that solution and process because it is more secure and better user experience for constituents. So let me share my screen. Yeah. And is it loading? It's thinking about it. Let me try. Did it work? Let me try again. It's not a presentation without some technical glitches. I'm sorry guys. Can people see it now? We are with you. We're in the power point view. Great. Okay. How do I use the keyboard to do the screen slide view? Does anyone remember? If you... Yeah, there's a little icon that looks like a screen being pulled down at the bottom right. Here we go. Oh, or there. Okay. Okay. Cool. We're with you. So first I was going to talk a little bit about what vital records are and how they are somewhat unique in the United States compared to a lot of other nations and international countries. So vital records are a form of identity credentials. That is true both in the U.S. and abroad. They're used for a range of identity verification when you go to get other types of identity documents including your social security card and your passport and your driver's license. So they are one of the foundational identity credentials in the United States. However, they are not issued at the federal level. In the U.S. they're issued at the local jurisdiction level and there are 57 state and territorial vital records offices across the country. There are 57 because some states have delegated some of this authority to counties and cities and then we have our U.S. territories including Guam, American Samoa, Virgin Islands, that kind of thing. The states share all of their vital records data with the federal government through the CDC and the National Center for Health Statistics Cooperative Program. So the federal government's help supports and makes investments in state vital records IT systems so that they can do this data sharing and that kind of stuff. Any questions about that? This is very unique to the United States. Most other countries have vital records issued at the national level. And this sort of federated nature makes it a little harder to do sort of standardization and interoperability quickly across the jurisdiction. So I think, Kayla, you're super familiar with these types of challenges from working with healthcare providers on HIEs and some of those similar challenges occur at the vital records jurisdiction level. NAPSIS does have a bunch of tools that help with that in a way that your HIEs also do that sort of matching and consolidation. So there are investments in the vital records technology space that have helped to massage and address these challenges. And I happen to live in one of the wonderful states that has two because there is a city, New York City Department of Health and there is a New York State Department of Health and they have disparate systems that do not talk to each other. In fact, occasionally there's some bad blood there and so they don't collaborate as much as you would hope that they do. So there's all sorts of nuances and I think there's also, and correct me if I'm wrong, there is specific state law that also unlevels the playing field across these agencies. Each state has its own state law that dictates how vital records should be collected and can specify even down to the data field level what should be collected and included in a birth and death certificate. State laws also often govern how much it costs to get a birth or death certificate, but again this is all somewhat varied by states and the National Association does have a model law that it propagates for states to use in sort of drafting and updating their state legislation. But they can choose to go go rogue. Yes it is really up to their own individual jurisdictional authority though. So in addition to this federated system which as we just discussed has some data sharing and integration challenges, you also have a lot of different end users across all levels of government that use vital records. If we think back to the first slide where we talked about how this is an identity credential uses identity verification to get other identity credentials you can understand how all of the lines in this high level user flow and data flow chart have been drawn because there's just so much interaction across different both federal and state and local jurisdictions as well as the private sector. So we've bucketed and this is pretty industry standard. There's three primary end users of vital records IT systems and the systems that store your information that's put into your birth and death certificate. So you have your state and local jurisdiction staff, you have your external data providers, sorry the state and local jurisdictions after in the dark bill, your external data providers that enter data about birth and death including people's names, their cause of death, their time of birth, time of death, all that stuff and relationship to relatives. Those are all in the yellow on this diagram and then you have the general public when you want to request a birth or death certificate they're in the light blue here. So each of these 57 jurisdictions has to serve all of these stakeholder groups. And this means there's a lot of friction and interaction because you have multiple end users of one system and you're trying to make that system seamless and a good user experience and also be able to produce the certificates in a timely fashion. The CDC has set a goal that they want all births ideally registered within 72 hours of birth and I am blanking on the death cutoff but during COVID it was really important to have timely death reporting because that was really helping with the disease surveillance and understanding the flow of the epidemic. So I think COVID really highlighted the need for timely death reporting and again you can see that all of these people involved doing all of these different data entry pieces into the different portions of the vital record system really complicates all of those processes happening quickly. We have a question from Simon. Simon do you want to ask your question or do you want me to relay it? You're on mute so I'm going to relay it unless you come off. So there's a question about why are these things not free to citizens of the US? Is that because it's state by state? I don't know if you have any insight to that Sarah. That is a really good question. It is definitely the fee scale is set state by state. I would say that and I can go back and check more with the association on this but the fees do help cover the operating costs of producing the birth and death certificate so that money generally goes into the operating budget for the vital records division. Normally those are within state health departments and so there's all the staff here right the IT systems. When you're talking about paper certificates there's very specific security paper with a lot of broad protection built in and the same way your driver's licenses are continually being updated with new broad protection methodologies. They have the similar type of broad protection approaches built into vital records paper certificates as well so there's all of this investment and operating costs around keeping the system safe and secure and able to handle the again as you can see from this diagram the volume of users entering data into the system. Including that there's an office there's like people that are having to be interacted with because it's not a seamless system and again it varies widely but because it's not seamless there's like an office that you have to go talk to. There are almost always walk-in offices where you can order a birth and death certificate because you can't do it all online. A lot of times you can't do it online for some of those exceptional relationship cases like adoption or custodial relationships where you're not a blood relative you have to do a lot more identity verification to even be able to request the birth certificate so they check that you're a valid requester so there's a lot of IV upfront when requesting a birth certificate if you have a more complicated relationship or death certificate to the child or the deceased so there's again a lot of resource-intensive processes around that identity verification and fraud protection because it is in one of the foundational identity documents you don't just want to give it out to anyone. Was there a follow-up? Sorry I apologize I was in the mute and I don't know if you know the vital check this is the company that issues vital credentials here in Idaho State. Do you know if it's the government owned organization or is it a private organization? Vital check is a software product provided by Lexis and Access and most jurisdictions use it for at a minimum their order processing so when you want to order an online birth or death certificate or over the phone or have a kiosk that is generally the software system that's used to help with that process. So it's a private technical solution but contracted by the public? Yes and that is common most states either have purchased a private technical solution or they've built their own homegrown solution so I would say the more jurisdictions have moved to the private hosted solutions or private maintained even if it's not hosted by the vendor and there are fewer homegrown systems anymore because again all of the maintenance required and the complexity and the business rules configuration it becomes very laborious and expensive so more places have moved to a private vendor provided solution. And I have another following question if you don't mind so if all of the vital checks on the territory of the United States should have the same architecture and basically meaning that the birth certificate issued in Hawaii should not be any difference from the one issued in Arkansas or Alaska doesn't it doesn't make sense to unify the whole process and make one software solution that would issue the mandate that those processes and the content be exactly the same but again that's all set by individual state law and if it's not already conforming to the sort of model all minimum requirements it does require the state to pass legislation amending and moving it closer their own law closer to that direction. Okay thanks. Yeah so it's really not a unified system there's a minimum sort of floor base that the association has set and most states try to reach that but there's still nuance and variation on top of it. These are great questions. I think one other thought I have is there and maybe it's more of just highlighting this that blue which is the public there are also it's not just like me personally it may be right if I'm getting social security benefits if I'm getting if I have life insurance right there's there's private companies that also need to know right and they become end users as well. I think if we go back to this this one is the birth one but there's one of these this is the generic sort of use case mapping that I think the CDC did and I can put the link in the chat or send it as a follow-up email if people are interested this is a great overview and this use case document goes through who all of those stakeholders are and talks a little bit more about some of the clearinghouse integration systems that are similar to HIE so this like Steve and Sam's thing in the middle here that helps to do some of that intermediary data sharing work but yes there are like on the it's more obvious on the on the death one in terms of the private users but here all all of the the pink is private entities not government I mean I guess it could be a hospital or a birthing center that's a public benefit corporation like when I worked at health and hospitals but all of these people in the pink are the private slash public users of vital records for birth certificates and then just to underscore these are typical modules in a vital records IT system each of these blue boxes in the middle with the white lettering so when you asked about vital check the order processing one is the one that they're most prevalent in but they also have full stack system so that provide all of these modules as well and just in full disclosure GCOM has a COTS vital records management system so we have a software product that does all of these functionalities so now the focus I think for you guys was really like what does this industry mean for decentralized identity technology and distributed letter technology so we've mapped out a couple use cases to discuss with you guys and and we have some trust triangles to illustrate the different use cases so the first one is the medical certifier so if we go back to this diagram we're talking primarily about the yellow external data providers here are the ones who certify records and say like this person was born at this time and it was you know a regular vaginal delivery versus cesarean delivery or this person died at this time and it was a natural cause of death versus something else so there's a way to use decentralized identity to make the certification process quicker and easier for the medical certifiers and this one is pretty interesting because it can be done it's not so clear from the the first glance who the the admin is who's issuing the credentials here so if you're if you're a doctor or funeral home director generally you're licensed at the state level but that agency that's licensing you may or may not be um the health department so you might you might need a different agency than the health department to be your admin here um and then your vital records are generally going to be in your health department so your your verifier is still going to be within the health department most likely but the admin could potentially be a different agency if that makes sense I don't know if I'm being clear here so this this type are you suggesting that it could be like the hospital for example that becomes the initiating admin because no it's usually like for example in New York state the medical licensure right the the agency that oversees your medical license is the state department of education so in in New York state's example the admin would most likely be the state department of education here and then your verifier in this case is the vital records system owned by the state health department which says okay I realize that you have a verifiable credentials saying that you're this licensed medical doctor okay so this is this is highlighting the trust triangle of saying who's qualified correct to formally submit a birth or death by that record that is a perfect way to phrase it um thank you for being so succinct and I think again the interesting thing is that this use case may or may not be totally controlled by one agency and might require some more interagency coordination to implement but we like this use case because it is more secure right now there's a lot of biometric data stored often for mobile apps that certifiers use and we don't think that ideally long term that's a great way to go because you're then centralizing storage of biometric data and it's such a high security risk I'm sure Ivan can go into way more um elaboration on this point so we think we're we think that trying to get the industry more interested in moving to a verifiable credential for medical certifiers would really accelerate security and lower costs if you want to hear a funny story the New York City Department of Health rolled out an app to people who were allowed to submit data to their vital stats and it had facial recognition and they had to roll it all back out because it didn't work and they were not able to meet those timeline requirements they couldn't mark anybody as deceased it was a major flop very painful Ivan you came off uh you came on camera do you want to add no yeah I was just going to add that you know you have a system with medical certifiers where you have a lot of different like systems that the state can't necessarily manage you have a lot of different doctors providers and whatnot so kind of a decentralized identity solution for that makes a lot of sense because the state doesn't necessarily have to manage that where if you have a centralized system it becomes a fairly significant cost and an overhead burden on the state itself I think one of the other interesting nuances to this use case in addition to like the multiple agency coordination and the um the comments Ivan was talking about is that the you might need some changes to state law because of what we're talking about earlier where state law governs like everything about vital records collection essentially if state law says you need certain types of um identity verification for the medical certifier you might have to amend state law or get some kind of creative legal opinion talking about how this technology which shouldn't exist um when those laws were written satisfies that existing state requirement so when we think about implementation challenges like that one also comes to my mind any more questions on this but we we again see real value in this because um and Kayla you worked with hospital systems so you know that anything that saves a doctor's time or clerk's time is like bottom line and freeze up time for patient care right so if we can arm providers with the ability to use their verifiable credentials in a quick and easy fashion on their mobile device then they've freed up so much more time to do the things that really matter to their profession absolutely so how does this fit into the next step so you've verified the certifier of the so this is the person who's now been rubber stamped basically to submit the death record to the vital status system what are those submission protocols do they also does this then piggyback into another trust triangle for the submission process um or is this do you see this as them using a credential to sort of like log in both it could be logging into the the data entry portal okay for the vital record system and it can also be about the submission so you could have two potential ways to apply um decentralized identity for certifiers excellent yeah so i think this one you get not only is it more secure potentially better workflows for the um external data providers which helps timeliness of reporting um but you can also potentially get two sort of use cases out of one application okay and anything else these are all great comments they're really helping us like flesh out the the use case um value prop as well okay so then we're going to switch to what the trust triangle looks like for the public customers the people who are ordering the birth and death certificates so um here's one where it's a parent and they're getting a birth certificate copy for their child because often a birth certificate is required to do um school enrollment for your child at the local um school district level so in this instance the issuer is the health department um office of vital records and then the verifier is the local school district um and there there are already some jurisdictions some local school districts that do online enrollment but think about the sort of security and um vulnerability associated with like uploading a picture of your birth certificate to a local school district website that's no bueno so this switching to verifiable credentials would probably be easier from a resident parent perspective and it's definitely a whole lot more secure um so in this workflow you've got your digital verifiable birth certificate credential on the parent's phone and then the local school district can have some kind of like qr scanner that scans it and then the child's birth certificate information can get automatically ingested into their online registration system this is also a really great use case to highlight the selective disclosure elements of or zero knowledge proof whichever your school district wants to move towards um aspect of verifiable credentials because if the school district just wants to know okay this child is of age for this grade then that could be zero knowledge proof and if the school district just wants to know their birth date to automatically determine the grade or and their parents address to automatically determine their um um residency um that could also be zero knowledge proof or selective disclosure so there the there's generally two forms of the birth certificate there's the long form which has a whole lot of information like it has both parents names it has information about the mom's health status and the type of delivery they had um whether there were some newborn screening health um characteristics collected at the time of birth and the school doesn't need all of that nor would you want to share all of it with the school um so the short form is generally what people use for the school and the again the selective disclosure functionality with a verifiable credential allows the resident to really easily make sure they're only giving the short form level information or even less than the short form level information to the school district so we really like this use case because we feel it really highlights all of the capabilities around verifiable credentials Ivan did you have stuff to add uh not exactly I think on the verifier side it it definitely presents a lot of value for these schools I mean a lot of times when you're applying for different school you know programs or even just the initial application into the whatever primary school it is um there is a lot of friction there in terms of ordering physical birth certificates um and the presentation process of those physical birth certificates um so you know we've seen a lot of positive feedback in terms of in that application process you know if there is a process where you can get your birth certificate you know instantaneously at the same time you're applying for something um it just amox a lot of possibilities for the the local school districts and the parents I see Mike has his hand up yeah so uh this may be one of the most important credentials to be issued as verifiable credential bar none anywhere in the entire world for any use case period um so for example I've been doing work with passport credentials that's a use case that actually spawned the you know originally started with uh vaccine records but morphed into the trials in aruba for DTC passport stuff and to get a passport I've recently gone through the the process with my with my daughter we had to mail her birth certificate into a federal agency and then pray that it came back you know and so besides having the friction of receiving the birth certificate there's the fact that you know do I really want to put this and trust this to the mail system and um and like you were mentioning with all of the data that they may not need to know um so you know where birth certificates are not only required to go to school you need them for driver's license and a passport which are you know the the later on universal identities that people use um I'd be really excited about this becoming reality um this on the horizon or is this just a really awesome presentation about um the possibilities and the use case we we think it's on the horizon again there was a lot of um interest and um we did some really great um implementation um brainstorming at the napsis conference in april where this was heavily investigated so I do think that there are a lot of there is a lot of momentum on the vital records side right now in addition some states um and Ivan can go into more detail are really moving towards um their own policies and regulations around digital identity to begin with so Ivan I don't know if you want to talk about Utah's law that was just passed but there there's this sort of this confluence like vital records themselves is really interested in this and then some states are um approaching digital identity you know from a a whole statewide policy perspective I think there's there's a couple different things to to talk about there um you know you mentioned that birth certificates are kind of a foundation for both passports and driver's license and in reality is in the United States that um birth certificates have lagged behind driver's licenses and passports um due to simply their portability um in terms of how you can use the actual credential itself and what we recognize is that you know if we can take birth certificates and digitize them in any way even if you didn't use the centralize identity in any way um it makes the the birth certificate um and a lot of those other processes after the birth certificate like driver's license and passports much more efficient and much simpler and it reduces a lot of overhead and burden on both the state the resident as well as anybody that wants to use it so there is a very significant use case for this and like Sarah was saying you know at NAFSA this was the biggest topic of discussion here was how do we bring birth certificates and all vital records into a modern age and yes there are a lot of different states we've seen in Utah and Michigan and Rhode Island a lot of different states are really trying to push decentralize identity and recognizing that birth certificates are a kind of a genesis credential for just about everything so if you can solve birth certificates you can then use this to apply for you know your SNAP benefits or unemployment or you can use this actually as um the credentials intended to be that kind of driver's license and passports have taken the place up I would also add that um the input impetus in the field right now is even though we're behind on the vital record side compared to the DMV sometimes it's easier to do that leapfrogging to the more advanced technology when you haven't tried to go the intermediate route first so I feel like personally as somebody who's worked in innovation for a while now this might be the more ready use case because there haven't been intermediate digital identity solutions already piloted or rolled out and so it might be more ripe for decentralized identity adoption from the beginning for a confluence of reasons right like the cost to ledger stuff is coming down now I kind of feel like this is we're at this moment where um decentralized identity is very similar to the credit card chip technology where it was clearly the superior and more secure technology from the get-go but the cost to production was so high that you haven't seen mainstream adoption until like 20 years after it was technically physically manufacturable right so I feel like again if if there's this sense of urgency and momentum on the state registrar side and the state registrars have so many operational pressures on them especially post-covid they're short on staff they want to like offer their staff more flexibility and remote work options to keep the staff that they have they want to simplify their workflow and processes to be able to provide better customer experience and do more order processing because again that gets them more revenue the faster they can issue more certificates and then you have the cost to use decentralized identity technology coming down and they're not tied down by an intermediate solution that they've already invested in right there's no sunk costs in some of the dmv type approaches that have already happened so we might be able to do that leapfrog in this market and for this use case in particular I think it's it's very appealing and the timing might really work out fantastic I have one question on this flow and then we'll get to Mike's technical question one second so it this is very interesting that you brought this one up because we've been sitting at this space where we're talking about the intersection of healthcare verifiable credentials which isn't dissimilar from the vital stats data but also for example the school based health requirements and those could be credentials so if you start to pair these things together you really start to see the ecosystem coming to fruition with you know the birth certificate sharing but also the immunization record sharing and etc that we've been working on in terms of conceptualizing that for cardiac as our extension use case I totally agree with you and I think this school enrollment example is the perfect confluence of that where you can use the immunization credential with the birth certificate credential together to almost fully automate and digitize the process so the parent literally doesn't have to produce any paper for the school to get their kid enrolled like that really excites me and I feel like there's high potential here for this use case for it to be almost fully digitized going forward right Mike you have a question about the technical structure and I I heard you say selective disclosure which would lend itself to an on creds but where do you see this from a technical perspective going in terms of credential formats do you have any read on that yes well I guess no would be the answer so I guess in our discussions that we've had both at NAFSA and kind of around the country the focus right now is less on the the technical aspect of it like there really is a desire just period from a business use case to just digitize credential digitize vital records and we've kind of pushed this decentralized method of doing that but I don't think there is the conversation is ready yet for which standard should prevail kind of across the United States and the reality is you will see stratification in different states and what they choose it's not a it's not you know it's not one central location of course there will be the recommendations from the association so I would say we're probably not probably at least two years away from you know one standard emerging as what's going to be the standard going forward but until then you know I think for the next few years you're probably just going to continue to see pilots happen around the space to where that question will get answered eventually but I don't think is answered now and Ivan do you anticipate or maybe have nightmares about a state where that doesn't get a consolidated single answer and the states go in deviating directions around their specific technical standard in reality I think it will happen you will have deviation I mean you take even just driver's license today around the MDL standards you see what Louisiana is doing with their kind of homegrown solution which is super effective and works really well from what I've heard in Louisiana but isn't interoperable with other standards and I think the reality is the United States you will see that that's unfortunate we can just hope to come together I guess as a community and try to push one of them over time which everyone kind of gains the most popular interaction is you know the most secure and best for the use case but I think reality is you will see stratification that's unfortunate but with 57 different jurisdictions it's very difficult to come to one I will say that there's a potential role for the federal funding aspect of vital records jurisdictions to help steer people towards the preferred standards so the national cooperative data sharing program does provide funding for the states and so they can attach some guidelines or requirements around the systems that share the data with the federal government for that program and then the CDC also provides data modernization funding for vital records jurisdictions usually on a more discretionary basis but should they you know really want to dictate more in this space I think a grant opportunity would help move the industry in one direction if if there was consensus I'm sure Napsis and the CDC folks are talking about this but which is the carrot that provides an opportunity I don't know whether there's a corollary and the DMV side and whether that was even a lever on the DMV side but that is certainly a carrot lever that the federal government could help with right and it's interesting I heard you mentioned CDC right so that means that there because CDC is heavily involved in federal standards in in health care and other you know tangential health care spaces and so there is an opportunity for some mandates potentially in that flow down Ivan I'm so sorry did I cut you off you were going to try no no you're absolutely correct and it's not just to see I think the Department of Homeland Security is doing some work around this space as well in terms of trying to I guess find federal standards I mean we hope that that kind of work works between you know the CDC and them as well but I guess to Mike what Mike just put in the chat is going to be key I mean you're going to need to have software that's just going to work I mean the states care about the use case and the state cares about the outcomes and you know there if they want to interoperate with another state that has a different credential we kind of have to make it work and I think that's I guess early on now that we can kind of predict that that's going to happen based on what's happening with driver's licenses I think we just have to be prepared to support whatever whatever direction the state in the legislature goes down great I just want to do a quick time check we have about 10 minutes left I don't know how much more are you more how many more use cases you have here that you should delve into before we move on to the death use case which is the one we have the least fleshed out so far one more aspect of the birth use case is that the revocable credential functionality could be really applicable for birth certificates for example like you would you might want to revoke the parent being able to have access to the child's birth certificate once they come of legal age so that is another functionality that we feel like really highlights the birth use case are there also complicating factors around parental accessibility like if somebody's removed would that be a similar application of that use case I think so we have less investigation into that aspect but I do think that yes some of these complicated guardianship cases could be made easier for all involved with a verifiable credential solution yeah and I brought up guardianship in the comments I think that's a that's one of those it's been kind of interesting and discussing like how that should or shouldn't work from what my understanding of my feeling now is that it may not be like a technical level of guardianship I think what you said with the revocation and reissuance is significant the reality is today in a birth certificate is the parent gets the birth certificate and they hold on to it regardless of what happens so anything we do around guardianship is an improvement over the existing process so this may not be an area where you need to you know engineer you know a more robust guardianship I think just the ability to revoke and reissue is already a massive improvement over today's systems and just to add on to what Ivan was saying that would apply not just to guardianship but to amendments and corrections so often especially with different languages being spoken and some legacy credential or legacy vital records there could be a lot of manual errors that require manual correction to people's names and spellings and all that stuff and so again the verifiable credential where you can easily revoke and reissue could make that back and forth like a lot of back and forth happens between the supervising clerks and the issuing day to day data entry clerks because of these types of things and the public customer has to bring in you know proof of changes all the time and that's like a huge burden on them one of the really interesting edge cases that was presented at the NAFSA's conferences in April is there are people who are born in the U.S. to non-citizen parents and then go back to their home their parents home country without a birth certificate because the parents have never fulfilled the process or been able to get the birth certificate because they're not a citizen in the same way so then you have an undocumented U.S. citizen in a foreign country and the steps they have to go through to actually get the U.S. birth certificate is incredible very state by state often involves tons of lawyers and representation and so again figuring out a verifiable credential solution would make it a lot easier for them they're stateless people they're they're actually like not often eligible to even enroll in school in the foreign country that they went home to with their parents because they don't have an identity document so there's a lot of benefits to the birth certificate use case excellent okay so really quickly on the death use case um the issuer here is again the vital records office generally at the health department um your you know so your relative or or legal representative would be the the holder after the disease is gone and then some of the um verifier use cases um are include not just government but as we were talking about before a bunch of private sector functions so title search companies life insurance that kind of stuff and then government often hires um third party services to do program integrity for benefit programs so think about Kayla Medicaid or um social security pension benefits for any local pensions for for government ex-government workers and their beneficiaries so there there's a whole industry out there that uses the death certificates to figure out when to terminate benefits so there that those would be some of the um verifiers for the death digital verifiable credential for death certificates i think um from my own experience the the selective disclosure is super valuable here too because so many people don't need any detail they just need a fact of death which i know naftis has worked on for many years i've been engaged with that but it's been really tricky just to say is this person alive or not uh so that they can take their appropriate follow-up action they don't need the details of related to their death or even the date they just need to know like yes or no what happened here um so that plays another role into that selective disclosure on the death scenario as well and that people find death data to be very sensitive that makes a lot of sense um especially like causes we think about the opioid crisis for example right highlighting that they had a substance use issue is super sensitive data on the why they died yep or like thinking back to the AIDS um crisis in the 80s and 90s right that was that was a sensitive cause of death back then um as well um i think some of the exciting implementation nuances for this one is when you think about the verifiers in in the death certificate use case there's a lot of heavy IT investment already in like IV for these um entities and so figuring out like what makes sense to do as like standard integrations across industry fields would be i think some of the interesting um sort of scoping and implementation next steps excellent and so and there's that play in the middle again in terms of generating the death certificate where a medically verified person had to submit the reason for death yeah the certifier use case that we talked about applies to either birth or death certificates excellent does anyone have any questions as we come to the end of our session here Ivan do you have anything else to add on the death use case no i think it's i think it's pretty straightforward i i think the one thing about death certificates is that we're what we've seen is longer like times to delivery in terms of the death certificates as well like you know in certain states taking weeks or months to process those um so i think just from an operational standpoint um there is a pretty intense emphasis on making those processes more efficient um which is significant and the certifier use case would play heavily into that um timeliness for the death certificate as well right right absolutely okay excellent i think this has been really wonderful very very critical to the conversations we've been having here in this community and so we hope that we'll be able to connect with you guys again in the near term future um because i think there's a huge overlap in in sort of what cardio is focused on and from the health-based credential and how it intersects with these vital stats credentials so i found this very interesting that this is this is quite possibly one of the best meetings we've had most informative yes that we recorded it it was spot on so very very very relevant for what we've been working on and i really appreciate what you've done um i took a couple of screenshots from the of the interesting deck pictures i don't know if that's okay to put in the meeting notes and maybe there we can just put the whole deck in our review of the whole deck a pdf of the whole deck too um and then um we'll put a link to that use case document that i was talking about as well um and i don't know i've been anything else you can think of we should add based on this conversation you there's something uh was it the cdc uh use is every time with use case yeah the use case document yeah just just bear in mind that is supposed to be a generalizable one across all 57 jurisdictions and they all have nuances to that all of them levels in the details with these kind of things yeah yes it always is i think this has been really excellent and gives us a lot to think about and how we see the future and interacting in some of these spaces so again huge thank you to both of you really appreciate your time i hope we'll have you back soon definitely and hopefully everybody has a wonderful day i took a lot of notes people are welcome to go read them if you have any corrections feel free and um we will talk to you all soon in two weeks is our next meeting june 22nd we'll be sending out some notes on what to expect in that meeting excellent great thanks sir thanks everybody