Wednesday, August 30, 2006

microchip the size of a long grain of rice encased in a tiny glass capsule and injected into the upper right arm could, in an emergency, save a person’s life.

The device, called VeriMed by its manufacturer, contains a series of 16 numbers — a code — that when read by a hand-held scanner can reveal key computerized medical information to properly registered people. The device is meant to help with treatment and prevent giving needless or possibly harmful medication to patients unable to talk to health care workers about their medical history and condition.

Admirers see it as a technological convenience no different from bar codes in supermarkets or the electronic EZ-Pass in one’s car. Detractors say it has dangerous implications for civil liberties.

The problem is getting enough scanners and trained personnel in hospitals while simultaneously persuading enough people to be implanted with the chip, which is known as a passive radio frequency identification device, or RFID. The cost of an implant is between $150 and $400, and insurance does not yet cover the procedure.

“It’s a three-prong approach, and all three [doctors, hospitals and patients] have to come together,” explains Dr. Jonathan Musher, a Bethesda physician. He works for the manufacturer, VeriChip Corp. of Delray Beach, Fla., a subsidiary of Applied Digital, building what he calls “the network” required to make the chips effective. He says he was convinced of the device’s merit before he joined the company and always has mixed his clinical practice — geriatrics and adult medicine — with what he calls “an administrative component.”



Dr. Musher has about 260 doctors in his network and has implanted about 30 chips to date, mostly in elderly people who he says are those most likely to need the device — especially the senior population in assisted-living facilities and anyone suffering from mild dementia. About 2,200 patients have been implanted worldwide since the chip was introduced in 2004, he says.

“If someone presents to an emergency room who is comatose, he gets scanned, and important information comes up,” Dr. Musher says, giving one example of how the chip would function to save time and avert mistakes. An authorized person would put in his own identifying number and, with a password, be able in five to 10 seconds to learn a patient’s name and pertinent medical history.

“Let’s say, worst case, someone can do that who is not authorized and they come up with a name, certain allergies, diagnoses and the fact [the patient is] on three or four medicines and has an advanced directive not to [take extreme measures] to resuscitate. I say, ‘So what?’ Everything in life is a risk-benefit. That is low risk versus the benefit.”

Dr. Musher equates the procedure to getting an injection halfway between the right arm’s shoulder and elbow, with a local anesthetic used to numb the site. “The body physiologically forms a cocoon around it,” he says, adding that “the chip is not visible as it might be in the shin.

New medical data is added and old data changed by using a special password in the computer program that stores the information.

“It appealed to me immediately,” says Roxanne Fischer, a biologist with a local government health agency whose 83-year-old mother has Alzheimer’s disease. “I would love to see more people take advantage of this. Certainly anyone with pets thinks it is an incredible idea. I’d definitely get one myself. There is a lot to be said [for having] a means of identification on your body so you don’t have to be carrying something.”

Worry about identity theft doesn’t bother her.

“Just the opposite,” she says. “It is a passive chip and doesn’t emit energy and can’t be tracked.”

Nevertheless, she says she might have been more skeptical if she had not known Dr. Musher as a physician caring for her mother. She cites troubles with her mother, who, when living alone in Florida, once was lost for two days after eluding a caregiver.

Daniel Hickey, 77, a naval commander living in a military retirement home, agrees. He has had the chip implanted although he is of sound mind and in relatively good health in spite of having had high blood pressure for most of his life.

“As soon as [Dr. Musher] mentioned it, I said, ‘Why not?’” he says. “If you are unconscious and they wheel you into the emergency room, what do they know about you? Nothing. Even if you are conscious and in pain, you don’t want to answer a bunch of questions.”

High-profile supporters include former Wisconsin governor and U.S. Health and Human Services Secretary Tommy Thompson, now partner in the law firm of Akin Gump Strauss Hauer & Feld LLP and a member of the board of the VeriChip Corp. His primary interest, he says, is promoting new technologies he believes are badly needed in the health care field — “It’s my shtick.” He once pledged publicly to have the chip put in himself, but says now that he is waiting until “more hospitals have signed up.”

It’s that chicken-and-egg question again.

Washington Hospital Center, the area’s largest medical facility, has a scanner but has not trained anyone to use it because the chances an emergency patient will have a chip are slim, says spokeswoman Paula Faria.

“We don’t feel we are at that point yet,” she says.

Suburban Hospital in Bethesda and Shady Grove Adventist in Gaithersburg have scanners, supplied free by VeriChip, and have trained personnel to use them.

“I think it is better than any method to date,” says Dr. Robert Rothstein, Suburban’s director of emergency medicine, who is an advocate without any association with the corporation. “Plenty of people are around who could benefit. You can imagine when police find somebody wandering and they sit around and wait for somebody to call.”

The chip’s main opposition is a group called CASPIAN Consumer Advocacy, for Consumers Against Supermarket Privacy Invasion and Numbering. One group leader is Katherine Albrecht, who holds a doctorate in education and is co-author of the book “Spychips: How Major Corporations and Government Plan to Track Your Every Move With RFID.”

In a telephone interview, she raises questions about the technical proficiency of the chip — “The information may not always be there when you need it, especially in the case of natural disaster and where the community is not functioning at top-notch rate” — and asks rhetorically why a medical ID bracelet won’t do as well.

New to the market is a product called the Portable Health Profile (www.portablehealthprofile.com) that, for $49.95, provides a consumer with a mini-CD as well as a USB Flash Drive, both of which can store an individual’s medical information and can be accessed by computer as needed.

Dr. Musher counters by pointing up the danger that bracelets and other portable devices can be lost and that patients, especially those with a form of dementia, are liable to pull off a bracelet.

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