By Rob Stein
Washington Post Staff Writer
Wednesday, March 15, 2006
When Daniel Hickey's doctor suggested he have a microchip implanted under his skin to provide instant access to his computerized medical record, the 77-year-old retired naval officer immediately agreed.
"If you're unconscious and end up in the emergency room, they won't know anything about you," Hickey said. "With this, they can find out everything they need to know right away and treat you better."
Roxanne Fischer felt the same way, and she had one of the devices injected into the arm of her 83-year-old mother, who has Alzheimer's disease. "I may not be available if she ends up in the emergency room. This gives me tremendous peace of mind," Fischer said.
The two D.C. residents are among just a handful of Americans who have had the tiny electronic VeriChip inserted since the government approved it two years ago. But the chip is being aggressively marketed by its manufacturer, which is targeting Washington to be the first metropolitan area with multiple hospitals equipped to read the device, a persuasive factor for Fischer and Hickey. Within weeks, the first hospital is expected to announce plans to start routinely scanning all emergency-room patients.
Some doctors are welcoming the technology as an exciting innovation that will speed care and prevent errors. But the concept alarms privacy advocates. They worry the devices could make it easier for unauthorized snoops to invade medical records. They also fear that the technology marks a dangerous step toward an Orwellian future in which people will be monitored using the chips or will be required to have them inserted for surveillance.
"It may seem innocuous, but the government and private corporations could use these devices to track people's movements," said Liz McIntyre, who co-wrote a book warning about the dangers of such radio-frequency identification (RFID) technology. "It may sound paranoid, but this is bound to be abused."
The devices, originally developed to track livestock, have been implanted in more than 6 million cats and dogs to trace lost or stolen pets. For medical identification, the device -- a microchip and a copper antenna encased in a glass capsule about the size of a grain of rice -- is inserted, usually under the skin on the back of a patient's arm, in a quick, relatively painless procedure. Each unit, which lasts indefinitely, transmits a unique 16-digit number that can be read by a handheld scanner. The number is used to locate a medical record previously stored on a secure Web site.
Using the system, emergency-room doctors could scan unconscious or incoherent patients to quickly check their blood type and find out if they are taking any medications or have allergies or other medical conditions. Nurses could identify family members and determine whether patients are organ donors or have living wills. Surgeons could scan patients on the operating table to make sure they are working on the right person.
VeriChip Corp. of Delray Beach, Fla., is selling kits containing scanners and the large-bore needles used to insert the chips, and recommending that doctors charge patients about $200 each. The company has sold about 2,500 chips worldwide for use in people, and several hundred have been implanted, including about 100 in the United States, spokesman John Procter said. So far in the United States, however, most of the chips have been implanted into the company's own employees. Suspecting that many people are hesitant to get the chips until more emergency rooms are able to scan them, the company has begun giving scanners to hospitals for free, Procter said.
Hackensack University Medical Center in New Jersey became the first hospital to begin routinely scanning emergency-room patients last summer, and about a dozen people in that area have now been "chipped," Procter said. About 80 other hospitals nationwide have agreed to follow, a number the company hopes will reach 200 by the end of the year.
Many of the hospitals, including three in the Washington area, have received scanners and started training their emergency-room staffs in their use, he said. Procter declined to name the hospitals until they formally announce their plans.
One area doctor has begun implanting the chips.
"I thought this would be important to offer to many of my patients," said Jonathan Musher, a Chevy Chase physician the company hired to help recruit hospitals and assemble a nationwide network of doctors offering the chips. "With this, a quick scan back and forth across their arm could make all the difference in critical life-and-death situations where seconds count."
Privacy advocates, however, worry that the devices are prone to invasion because they can be surreptitiously scanned from a distance.
"As far as I can tell, there are no security measures taken with the chip. It's not a secure chip," said Richard M. Smith, an Internet and privacy consultant in Boston. "There's nothing to stop someone from accessing the code and cloning the chip" to access records, he said.
Even though the medical information is stored in a protected computer, anyone with a password could obtain the information.
"Once the identification number is obtained, who gets to decide who gets access to the Web site?" asked Janlori Goldman of the Columbia College of Physicians and Surgeons, who heads the Health Privacy Project, a Washington-based research and advocacy group. "Can law enforcement have access? Can public health workers have access? Can employers have access? Given the recent efforts by law enforcement and data monitoring by the government, this is exactly the kind of technology that would be attractive."
And, like any computerized database, it could be vulnerable to hackers.
"We know from many other examples that there are lots of security breaches that occur across the country," said Marc Rotenberg of the Electronic Privacy Information Center, another Washington research and advocacy group. "There's no reason to think this will be any different."
Company officials and other proponents say the device and accompanying system are carefully designed to protect recipients.
"The privacy of VeriChip's customers is our highest priority," said Scott Silverman, the chief executive of Applied Digital Solutions Inc., the firm's parent company. "Both the amount of information and who has authorized access to that information is determined by the user."
Others worry about how the devices will be used in the future.
"This device is intended to uniquely number humans. It's embedded in the flesh, and it's permanent. It can be read without someone's knowledge and consent," McIntyre said. "Scanners can be installed in doorways or ceiling tiles to track people's comings and goings without people even being aware it's happening. That's not so far off."
Company officials scoff at those fears.
"Some people say, 'Oh, my God. It's "1984." It's George Orwell,' " Musher said. "But this is a passive device. It's not controlling or tracking anyone."
The company is, however, marketing the devices to limit entry to secure facilities. The Mexican government is using the implants like key cards for high-security offices. And CityWatcher.com of Cincinnati, which stores surveillance-camera footage from around the country, recently started using the chips to control access to tapes. Bars in Spain and Amsterdam, meanwhile, are offering the chips to patrons who want quick entry and to run electronic tabs.
"We're just waiting for the first case where a convicted sex offender on condition of release is required to have a VeriChip implanted," Rotenberg said.
For their part, Fischer and Hickey hope the devices catch on.
"This is the wave of the future," Fischer said. "I'm looking at this from the positive side. To obtain optimal care, I think we have to take advantage of the best technology available."