HealthPass is a health record that belongs to the patient and opens inside WhatsApp. Beckn is an open, free-to-use set of rules (a protocol) that lets clinics, labs, pharmacies and patient apps find each other, agree on a service and send each other results, with no single company or ministry in the middle. On a beckn network, HealthPass can work with any clinic, lab or pharmacy on the network, not only the ones it has connected to one at a time.
Take Thandi, a 34-year-old in Soweto being treated for high blood pressure. Over a year she sees a public clinic and a private doctor, has blood tests at a lab and collects medicine from a pharmacy. Her history ends up in four places that don’t talk to each other: the clinic’s paper file, the doctor’s computer system, a lab result sent to her by SMS, and a photo of a prescription on her phone. Each new provider starts from nothing. Tests get repeated, and no one has the full list of what she takes.
No shared record. Each provider keeps its own piece, and Thandi carries the rest on paper and on her phone.
One record that Thandi owns, opened in WhatsApp. It fills in only where HealthPass has built a connection to that provider’s system.
Each provider connects once, to the network. Results and prescriptions reach her record from any of them, in whichever wallet she chooses.
HealthPass gives each patient a personal health record that they control. It has three parts.
FHIR is the format of the record. Beckn is the set of rules for how independent organisations find each other, agree on a service and trust each other’s messages.
Over fifteen years India built a series of shared digital systems that the government provides and any company can build on. They are often called digital public infrastructure (DPI). Each reached national scale. Two of them, ONDC and Namma Yatri, use beckn.
Beckn is an open set of rules (a protocol) that lets independent apps and providers find each other, agree on a service, and follow it through to the end. Any app on a beckn network can place an order with any provider on it, without the two having to build a connection to each other and without a company in the middle.
Beckn handles the order or booking. Every message is digitally signed, so the receiver can check who sent it and that it wasn’t changed, and the receiver sends back a signed receipt. Both sides can later prove who asked for what, and when. FHIR, the international standard for health records, handles the records themselves, and only with the patient’s permission. Health records never travel inside a beckn message.
Every service goes through the same stages:
In the latest version of beckn (May 2026), each provider publishes its own signed catalogue and search services read those catalogues, so there is no central hub that every message has to pass through18.
These two jobs are easy to mix up. On a beckn network they are separate, and a patient can swap either one.
India’s payments work the same way. Your bank holds your money; that’s the wallet. PhonePe or Google Pay is the app you pay with, and it holds no money. Because the two are separate, you can change apps and still pay the same shops the next day.
A patient can switch in two ways:
Either way she keeps her ID, which is a national ID rather than an app account, and she keeps her providers, who join the network rather than any one app. HealthPass does both jobs but keeps them separate. That is what makes the promise of no lock-in believable to governments and funders, and it lets other apps work with records kept in HealthPass.
The same beckn rules handle all three.
Thandi, Kopano Clinic, Thuso Lab and Imbali Pharmacy are made up for these examples. Prices are rough estimates.
| Step | Lab test | Prescription | Appointment |
|---|---|---|---|
| Search, without saying who you are | Labs offering HbA1c within 5 km | Pharmacies that deliver within 5 km | Antenatal clinics within 5 km |
| Ask for today’s offer | Price, collection times | Stock, price, cheaper generic | Free appointment times |
| Give only the details needed | Time, address, which order | Address, which prescription | Name, phone, medical aid |
| Confirm, and give permission | The lab may see this one order | The pharmacy may see this one prescription | The clinic may see her summary for 7 days |
| Provider reads what it needs | The test order | The prescription, then checks the doctor’s licence | Her health summary |
| Updates | Collector arriving, sample at the lab | Rider on the way, delivered | Reminder the day before |
| Result added to her record | Lab result | What medicine was given; prescription marked as filled | Visit summary |
A provider that sets up these steps once can serve every patient app on the network, for every service it offers.
India’s Ayushman Bharat Digital Mission (ABDM), launched in September 2021, is the largest working example of a national system for sharing health records. There is no central database of records. Records stay with the hospital, clinic or lab that created them, and are shared only when the patient approves14.
priya@abdm. Patients use it to sign in to health-record apps and to approve requests for their records24.
Every hospital, clinic and lab keeps its own records in its own software. To take part, that software must be certified for ABDM, so it can link visits to an ABHA and answer requests for records. Nothing is copied to a national database. The system knows where records are, not what they say.
| Who | What it keeps | What it never sees |
|---|---|---|
| Hospital, clinic or lab | The health records, in its own system | |
| Consent manager | A list of which providers hold records for each ABHA address, and every approval the patient has given | Health records |
| ABDM gateway | Nothing lasting. It passes messages on and checks that senders are registered. | Health records |
| Provider asking for records | A copy of what the patient approved, until the permission ends | Anything she didn’t approve |
| Patient’s app | Her ABHA address, her approvals, and if she chooses, her own copy of her records |
India measures adoption in three stages. The first two have reached very large numbers. The third, which needs the patient to approve a request, is where it is stuck16.
| Stage | What it covers | Where it stands |
|---|---|---|
| 1 | Creating ABHA IDs | 978 million IDs (Sept 2026)7 |
| 2 | Providers linking records to ABHA IDs | 1.2 billion records linked (Sept 2026)7 |
| 3 | Providers requesting and receiving records with the patient’s approval | “Extremely low” use (July 2026)16 |
ABDM shares records, using FHIR. A separate network called UHI uses beckn to find and book services such as doctors, ambulances and blood banks14,20. India kept the two apart, which is the same split we propose for South Africa.
| India | South Africa | |
|---|---|---|
| Patient ID | ABHA number and address | Number from the Health Patient Registration System (HPRS), used in public facilities: 68.6 million registrations, 37.2 million verified12 |
| Registers of facilities and staff | National facility and professional registries | Master Health Facility List (over 55,000 facilities)12; registers of the Health Professions Council, Pharmacy Council and Nursing Council |
| Where records are kept | With each provider; nothing central | With each provider. An electronic record for public clinics is being rolled out from 202636, and a national exchange is being built19,35 |
| How patients give permission | A consent manager, for each request | No national system yet. POPIA allows health information to be shared only with consent or another legal basis11 |
| Patient’s app | Government ABHA app or private health-record apps | Any wallet, including HealthPass on WhatsApp |
| Finding and booking services | UHI, which uses beckn | The proposed network |
The prescription shows the difference most clearly.
| A central government record | One company’s platform | An open network | |
|---|---|---|---|
| Who builds it | The government, usually through one supplier | One company | The government runs the shared parts; many companies build apps |
| Who the patient depends on | The government’s system | The company: her account, history and providers are all inside its platform | No single app. She keeps her ID and record, and can change app or wallet without losing her providers |
| Adding a provider | A separate connection to the central system | On the company’s terms and fees | Join once |
| Booking, ordering and delivery | Usually not included | Yes, inside the platform | Yes, between everyone on the network |
| What usually goes wrong | Slow, one supplier, one point of failure | Patients get stuck and fees rise | Someone has to set and enforce the rules, and patients need an app they already use |
Being able to switch doesn’t mean people will. On UPI, two apps handle about 79% of payments10. But those apps win by being better, and they can’t hold people’s money or shops hostage, so leaving stays easy. The same will be true for health only if the network’s rules require every wallet to hand over the record in a standard format. Setting that rule is the government’s job.
HealthPass is one place a patient can keep her record. We call such a place a wallet. HealthPass shouldn’t be the only one. On a beckn network any company, hospital or NGO can run a wallet, and every wallet reaches every clinic, lab and pharmacy on the same terms. A patient can change wallet and take their record with them, the way people in India change payment app without changing bank.
A wallet joins the network once, the same way a lab does. It registers in the network registry, which lists every organisation on the network and its digital keys, and it is approved under the network’s rules, including the rule that it must hand records over when asked. From then on it can search, order and receive results for all of its patients. Patients don’t join one by one; their wallet acts for them. There are three ways to run a wallet:
Usually no lookup is needed, because the wallet starts nearly every order or booking. When HealthPass orders a lab test, the order carries HealthPass’s network address, so the lab sends the result straight back to it. Any other wallet works the same way.
A lookup only matters when the provider starts the contact and has nothing but the patient’s ID. For example, she walks into a clinic without booking through her wallet, or a doctor sends a prescription a week after the visit. There are two ways to handle that:
These are two registries with two jobs. The network registry lists organisations, and every beckn network needs one. The patient registry lists people, and it is optional. A central list of who uses which health wallet is sensitive, so if one exists it should be opt-in and held by the government. India’s ABHA works this way (see How India did it): the ID is voluntary and issued by a national registry, and a consent manager tracks which hospitals hold each person’s records without seeing what they say.
South Africa’s Department of Health already runs a national patient register, the Health Patient Registration System. It is used in 3,265 public facilities and holds 37.2 million verified registrations12. The network could add an optional note of each patient’s wallet to that register rather than building a new one. Where a country has no national register, one can be built as part of the network, as a public good.
The Department of Health already runs much of what a network needs. Its Health Patient Registration System has 68.6 million registrations, 37.2 million of them verified, across 3,265 public facilities, and its Master Health Facility List covers more than 55,000 public and private facilities12. Both are being made available through a national exchange that uses FHIR19. Doctors can already sign prescriptions electronically, as long as they use an advanced electronic signature13.
People already use health services on WhatsApp at national scale. MomConnect, the Department of Health’s service for pregnant women and new mothers, has 5.2 million users31, and the department describes WhatsApp as a “game-changer” for it12.
The government has also committed to shared digital systems. Its Digital Transformation Roadmap, launched in May 2025, covers digital ID, data sharing between systems and payments, and names health for its second phase, from mid-202730. PayShap, the instant payment system launched in 2023, passed one billion payments in June 202632.
What’s missing is a shared way for patient apps, clinics, labs and pharmacies to find each other, place orders and send results. A beckn network adds that, and HealthPass is one of the wallets on it. It would work alongside the national exchange rather than replace it. It also has to serve public clinics as well as private providers: 15.5% of South Africans belong to a medical aid33.