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I wanted to draw your attention to Emily Culbertson's thoughtful recap, on the Pioneering Ideas Blog, of the recent Health 2.0 User Generated Healthcare conference in San Francisco. How will interactive Web 2.0 tools change the "hairball" that is the healthcare system? Emily's post (in addition to some other blogs she links to) explores the answer.
This AP article ties into the thread on embedded RFID -- as well as the post about the Charmr. Widespread use of these sensors may not be so far in the future after all....
- Lygeia
RFID implants in humans have been relatively rare, but they could become more mainstream. According to VeriChip, manufacturer of the only FDA approved version, more than 2,000 people worldwide now carry the chips under their skins. Some view them as a medical safeguard—a chip could convey the identity and condition of an unconscious patient to a doctor in an emergency room. For others, an implanted RFID chip is primarily a convenience or status symbol—one that lets them pay, with the wave of a hand, for drinks in certain trendy bars.
The basic concept behind RFID was first articulated in 1948, but in recent years the chips themselves have become smaller, cheaper, and more widely used. RFID is effectively the next generation of the bar codes you find on groceries. Except that RFID, because it uses radio waves, can communicate information without the line of sight required by bar code readers, and makes it possible to read multiple tags at a time. It is also more durable than a bar code—better able to withstand heat, moisture, and pressure. In humans, a tag about the size of a long grain of rice is generally implanted above the right tricep. After the surgery there is no outward sign that it exists.
While some RFID tags regularly emit data through radio waves, subcutaneous ones are “passive,” responding only to a request from an outside reading device. Because of both size constraints and privacy concerns, the tags embedded in humans contain only a reference number (as opposed to say, a list of the individual’s allergies). That number is linked to a database containing medical, financial, or other data, and it may require a password or other means of authentication for access.
One hundred and sixteen US hospitals have already signed up to adopt the technology in their emergency rooms, while others, such as Beth Israel Deaconess Medical Center in Boston, already use RFID on humans (embedded or merely affixed to a bracelet) to match newborns in the intensive care unit with their mothers’ milk or to verify that patients are taking the correct medications.
What are the potential implications of embedded RFID from a Project HealthDesign perspective? It could help solve a big challenge several of the grantee teams are wrestling with: patient identification and authentication. Several of the teams are developing devices that wirelessly transmit data, such as blood sugar levels from a glucometer, to a software program that can track and analyze it. But how do you really know who used the glucometer? What if you have two people in the same household that are using the same measuring device? Embedded RFID chips could automatically identify individual patients and keep their records separate and accurate.
But assuming the potential health dangers associated with the chips can be overcome, is society ready for embedded RFID chips? Many people are alarmed by their potential privacy implications. If information on the chips is linked to the user, theoretically anyone from law enforcement officials to criminals or terrorists could abuse it, for example by tracking an individual’s movements. Some extremists even suggest that RFID portends the end of the earth.
Dr John Halamka is the CIO of Harvard Medical School and the CareGroup Healthcare System. He’s also an emergency physician at the Beth Israel Deaconess Medical Center. His research has shown that it would be fairly easy to intercept and mimic the data on an implanted RFID chip. In part because of this vulnerability, he argues that subcutaneous RFID chips should be used only to identify people, but that they should not be used for authentication purposes. Identification confirms that a person is, for example, Jane Smith, but authentication takes identity a step further, using it as a condition to enable an individual to do something—like access a building, bank account, or anything else of value. If chips are used for authentication, they could put their “hosts” at greater risk of kidnapping or physical harm.
I asked Halamka, who is an avid mountain climber, about his own decision to have an RFID chip implanted in his arm a few years ago. “Implanted RFID is a personal choice. For some people, such as those with cognitive or communication impairments, it offers an easy electronic pointer to a PHR which authorized clinicians can access in case of emergency. For others, such as myself, who travel to the corners of the earth, including its most extreme places, I have the security of knowing that my record is always with me. Of course, not every healthcare institution has the ability to scan RFID, so at present the technology is in the early adopter phase.”
On the topic of privacy he underscores the importance addressing the privacy and security features of implantable RFID as early as possible. As he put it, “You can’t just let the technology develop and try to correct the resulting social problems later.”
