Inspiration
Forcibly displaced people often move between NGO clinics, camps, public hospitals, and even countries. When these health systems do not connect—or when internet access is unavailable—their essential medical history can become inaccessible at the point of care. Continuum is designed around a simple principle: the patient should be able to carry continuity of care with them.
What it does
Continuum is an offline-first, patient-controlled clinical summary for refugees, asylum seekers, internally displaced people, and other highly mobile patients.
It carries essential information such as:
- Allergies
- Current medicines
- Critical or chronic conditions
- Vaccinations
- Recent care
The patient can selectively share only the information needed for a particular encounter. Records are digitally signed so receiving clinicians can verify their source and detect tampering. Standardized clinical concepts can also be rendered in multiple languages without relying on free-form AI translation for critical medical meaning.
How it works
- Clinic A creates or imports a clinical summary.
- A clinician reviews and digitally signs the record.
- The encrypted record is stored with the patient.
- The patient chooses what information to share through an offline QR exchange.
- Clinic B scans and verifies the record even without internet access.
For legacy paper records, OCR can propose structured fields, but a clinician must review and verify them before they become part of the trusted record. AI assists extraction only; it does not diagnose or autonomously modify the clinical record.
How we would build it
The proposed technical approach combines:
- FHIR-compatible structured health data
- Public-key digital signatures for authenticity and tamper detection
- Encrypted local storage
- Offline QR exchange
- Web/PWA clinician interface
- Multilingual labels mapped to standardized clinical concepts
- Human-in-the-loop OCR for importing paper records
Why it is different
Continuum is not another centralized electronic health record. It is a continuity layer between disconnected health systems.
Its core differences are:
- Works when systems do not interoperate
- Designed to function without continuous connectivity
- Gives the patient control over what is shared
- Uses cryptographic verification rather than trusting an unverified screenshot or document
- Supports multilingual presentation from structured clinical concepts
- Can operate as a compact emergency summary rather than exposing a full medical history
Feasibility
A Round 1 prototype does not require access to a hospital database or real patient dataset. The full workflow can be demonstrated safely using fictional patient records. FHIR and standard cryptography are established technologies, while a smartphone plus printable QR backup makes the concept practical for low-resource settings.
Key deployment challenges include privacy, lost/shared devices, trust across organizations, QR capacity, different workflows, and clinical governance. These would be addressed through encryption, patient-selected views, digitally signed issuer verification, compact emergency summaries, standardized terminology, and pilots with humanitarian and clinical partners.
Impact
Continuum is designed around four outcomes:
Continuity: Essential medical information remains available as a person moves between facilities or borders.
Safety: Clinicians can see verified allergies, current medicines, and critical conditions instead of relying only on patient recall.
Patient agency: The patient chooses which clinical view to share instead of exposing an entire history.
Equity: Offline operation and multilingual rendering reduce dependence on connectivity and a single language.
The same architecture could later support migrant workers, people displaced by disasters, and other highly mobile populations.
Research basis
WHO has highlighted barriers to healthcare for refugees and migrants, including language, cultural, and institutional barriers, as well as the difficulty of continuity of care when people are on the move. WHO also emphasizes good record keeping and cross-border continuity of care.
References:
- WHO — Refugee and migrant health: https://www.who.int/news-room/fact-sheets/detail/refugee-and-migrant-health
- WHO — Refugee and migrant health Q&A: https://www.who.int/news-room/questions-and-answers/item/refugee-and-migrant-health
- WHO — World report on promoting refugee and migrant health: https://www.who.int/publications/i/item/B09672
Built With
- encrypted-local-storage
- fhir
- ocr
- progressive-web-app
- public-key-cryptography
- qr-codes