Evan Schuman's StorefrontBacktalk

January 28, 2005
By , eWEEK

As an emergency medicine physician, Dr. John D. Halamka immediately saw the life-saving potential of embedding tiny wireless RFID (radio-frequency identification) devices in people. As the CIO of the Harvard Medical School, he was naturally skeptical of such devices and wanted to test them thoroughly before recommending their adoption.

As a physician CIO, he knew that there would be risks inserting any foreign object into a human being and that the body might interfere with the device’s functioning and that the device could interfere with the body’s functioning.

Therefore, Halamka said he did the only reasonable move: He offered himself as a radio-signal guinea pig and got a first-hand experience of having an embedded transmitter.

“I’m not necessarily an advocate, but as a CIO and a physician, I think it’s important for me to evaluate it fully,” Halamka said in an eWEEK.com interview. “I’m just experimenting with the technology. I think RFID now is at the peak of the hype curve. It has great promise, but it will require a bit of time.”

RFID technology is a subject of extreme interest to retailers, consumer goods manufacturers, law enforcement and the medical communities, but it has been beset by reports of inaccurate read rates and interference from other devices. The technology also has been the subject of privacy concerns.

Halamka’s experiment is intended to see how the variables of the human body affect the device’s functioning and its read rate and whether RFID can be a practical, safe and privacy-respecting technology in today’s hospitals.

One medical benefit that Halamka sees is in dealing with nonresponsive patients?perhaps an unconscious car accident victim?who have particular medical issues that the physician needs to know.

The chip itself is a passive RFID device that merely transmits a 16-digit numeric identifier. Properly credentialed emergency room staff could access a secure Web site that would allow them to identify him and access relevant medical records, he said.

Another possibility is medical error reductions. Halamka painted a scenario where a hospitalized patient has an embedded RFID tag. All medication bottles would also have RFID tags, as would the identification tags worn by nurses and doctors.

“What if a nurse walks into your room with the wrong medication?” he asked. With the triple RFID scenario he painted, the chart information could immediately flag that the medication about to be administered was incorrect.

Although it’s more intrusive, the RFID approach would work a lot better than having a tag attached to today’s typical hospital patient plastic wristband, he said, as those tags can be lost or damaged.

Halamka said the implant procedure itself was “painless” and “took five minutes in a doctor’s office.” The RFID device is about the size of two grains of rice, and it’s inserted using what Halamka described as “a big syringe.”

It is typically inserted into the triceps area of the right arm, an attractive area because it’s relatively clean, more pain-free than other body parts, and it’s easily accessed in an emergency.

To be precise, the skin is treated with a sterile iodine solution and the RFID chip is inserted less than one-quarter-of-an-inch into the triceps’ fascia, which is a connective tissue that envelops the triceps. Because it rests within the fascia, it is not technically considered subdermal, and it also does not cause the discoloration typical with subdermal procedures.

The benefit of the consistent placement, Halamka said, is that emergency room personnel can routinely give a quick scan to that part of the arm to see if an RFID chip exists. Otherwise, there would be no way for staff to know that it existed.

Halamka said his body seems to have accepted the RFID chip without incident. His chip is made by VeriChip Corp., a wholly owned subsidiary of Applied Digital.

“The RFID is enclosed in medical-grade glass. It is just seen as a foreign body” but a non-threatening one, he said. “There’s no immune system on the planet that attacks glass.” This is similar to the way the body sees a properly administered intravenous (IV) insert, Halamka said, adding that the glass itself is so thin that it has no risk of breaking.

The implanted RFID chip “will last for hundreds of years, longer than I will,” Halamka said.

But if there is some kind of a problem, the method for removing the chip is far more invasive and troublesome than inserting it. The removal process involves actual surgery, albeit a minor one.

Because it is a passive device, the RFID chip requires no independent power source and accesses all needed power from the radio signal. The small handheld reader needs to be within five inches of the chip to get a signal.

Halamka has found that the read-rates under real-world conditions are excellent and consistent. “I have experimented with reading it from a variety of angles and distances,” including during a mountain climb where the temperature fell to minus-20 at a 6,000-foot altitude.

The only reader-related concern the CIO expressed was that the readers are proprietary. Once standards take better hold and competing quality readers are on the market, he’d feel better about recommending the technology, he said.

As for the privacy concerns, the doctor said he was confident it could be worked out. He envisions a trusted host-like approach, where a major hospital would have access and could then extend access to trusted individuals.

Halamka estimated that there are about 200 people today with the RFID chip implants, many of them in Mexico where the government is using them as secure identifiers.