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nagham.kheir25 edited this page Oct 11, 2026 · 3 revisions

Project 85 — Global Patient Record Project

Organization: Public Invention
Status: Research-stage Proof of Concept (PoC)
Date: October 11, 2026

1. What Is Project 85?

Project 85 is an open-source initiative aimed at enabling patients to securely access, carry, and share essential medical records across different healthcare facilities, including in low-resource and disaster-affected environments.

Core objective: Make patient health information portable, trustworthy, and accessible to authorized healthcare professionals, independently of the original healthcare facility.

2. What Problem Are We Solving?

Medical records are often:

  • Scattered across hospitals and clinics.
  • Inaccessible to patients.
  • Lost or unavailable during disasters.
  • Difficult to transfer between healthcare providers.
  • Stored in incompatible systems.

Example: A patient arrives at Clinic B after receiving treatment at Clinic A. Clinic B needs access to their allergies, medications, vaccination history, and previous treatments without relying on Clinic A's internal database.

3. What Is Already Developed?

The current research prototype includes or documents:

  • Dual-unlock authorization: Patient factor + authorized clinician credentials.
  • Tamper detection: Cryptographic signatures, hashes, and message authentication mechanisms.
  • Append-only history: Preserves a traceable history of clinical entries.
  • FHIR-based structures: Supports allergies, conditions, medications, vaccinations, and observations.
  • Local demonstration: Uses synthetic patient data and simulated authorization.
  • Storage abstraction: Supports different storage backend implementations.

Important: The patient fingerprint mechanism is currently simulated using a token. Real biometric authentication and clinical deployment have not been validated.

4. Key findings:

  • Many existing systems focus on identity verification, vaccination certificates, or facility-owned medical records.
  • Patient-controlled, multi-condition health-record portability remains a potential unmet need.
  • Open-source standards and existing infrastructure should be reused where possible.
  • Long-term sustainability requires real healthcare partners and operational ownership.

Main recommendation: Develop the patient authorization, provenance, and portability capabilities while integrating established technologies.

5. What Solutions Already Exist?

Technology Purpose Project 85 Relevance
OpenMRS Electronic medical records Potential integration
HL7 FHIR Healthcare interoperability Adopt
MOSIP / Inji Digital identity and verifiable credentials Evaluate
SMART Health Cards Portable signed health information Evaluate
WHO GDHCN International health-credential trust framework Potential future integration
VaxTrac Offline immunization tracking Learn from
DHIS2 Health information and disease surveillance Conditional integration

Strategic lesson: Fingerprint identification, offline access, QR-based credentials, and cross-facility data sharing are not entirely new technologies.

Project 85's potential differentiator is combining these capabilities into a patient-authorized, portable, multi-condition clinical record with verifiable provenance.

6. What Should Project 85 Build?

BUILD — Core Project Capabilities

  1. Patient authorization and clinician authentication.
  2. Secure and traceable medical-record history.
  3. Tamper detection and record provenance.
  4. Offline access and synchronization.
  5. Credential management, revocation, and recovery.
  6. Patient and clinician user interfaces.
  7. Clinical record sharing across independent facilities.

INTEGRATE — Existing Technologies

  1. HL7 FHIR for clinical data structures.
  2. International Patient Summary (IPS) profiles where appropriate.
  3. OpenMRS or other compatible EHR systems.
  4. Verifiable credentials using established standards.
  5. Existing clinical terminology and coding systems.
  6. Applicable health-certificate verification infrastructure.

7. What Is Still Missing?

Component Current Gap
Multi-clinic interoperability No demonstrated end-to-end exchange
Offline synchronization Requires implementation and validation
Clinician credential governance Issuance and revocation policies needed
Patient credential recovery Not established
Real biometric authentication Currently simulated
Clinical user interface Requires workflow validation
Clinical safety Not validated
Regulatory compliance Deployment-specific review needed
Healthcare partnerships Operational partner not confirmed

8. Recommended First Use Case

Cross-clinic continuity of care.

Proposed Workflow

  1. A patient visits Clinic A.
  2. Clinic A records allergies, medications, and vaccinations.
  3. Project 85 securely preserves clinical information and its provenance.
  4. The patient visits Clinic B.
  5. An authorized clinician requests access.
  6. The patient authorizes the request.
  7. Clinic B accesses and verifies relevant clinical information.

Initially, this workflow should use synthetic data and simulated clinics.

Goal: Demonstrate that clinical information can move between independent healthcare environments without requiring a shared hospital database.

9. Main Risks

  • Patient loses access to their credentials.
  • Clinician authorization cannot be reliably verified.
  • Clinical information is authentic but inaccurate or outdated.
  • Different healthcare systems cannot exchange data correctly.
  • Offline updates create conflicting records.
  • Biometric authentication excludes or misidentifies patients.
  • No organization agrees to maintain or operate the system.
  • Patient privacy is compromised in emergency or hostile environments.

10. Strategic Decisions Needed

The team needs to determine:

  1. Primary use case: Routine continuity of care or emergency patient tracking?
  2. Record architecture: Patient-held wallet, encrypted remote storage, or hybrid?
  3. Authentication: How should patient authorization and clinician access work?
  4. Emergency access: What happens when patients are unconscious or unidentified?
  5. Interoperability: Which clinical data standards and systems should be supported first?
  6. Deployment: Who will operate, maintain, govern, and fund the system?

Bottom Line

Project 85 is a promising research prototype, not yet a deployable healthcare platform.

We have: 11 October 2026

  • A technical foundation.
  • A clearer understanding of the healthcare interoperability landscape.
  • Potential clinical and humanitarian applications.
  • A preliminary build-versus-integrate strategy.

We still need:

  • Demonstrated interoperability.
  • Validated authorization and recovery mechanisms.
  • Realistic clinical workflows.
  • Operational and clinical partners.
  • Evidence of safety, usability, and sustainability.

References

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