Implants will aid care of unconscious patients
Chips provide history plus meds
The next generation in patient identification and electronic medical information is now unfolding in a growing group of EDs across the country. The ED managers who are using it are convinced it will prove invaluable in the not-too-distant future.
The technology, called VeriMed, involves an implantable radiofrequency identification (RFID) chip the size of a grain of rice, which is injected into the patient’s triceps area. It contains an identification number that allows access to relevant medical information held in an external database.
VeriMed, manufactured by Delray Beach, FL-based VeriChip, received Food and Drug Administration approval as a Class II Medical Device just a year ago, but already more than 70 facilities have signed up for the technology. Only two facilities have complete systems running: Hackensack (NJ) University Hospital and CareGroup Health Systems/Beth Israel Deaconess Medical Center in Boston. According to those facilities, the potential benefits are numerous.
"Many patients come to EDs with an altered mental status: They are confused, shocked, demented, wandering from home, or too upset or have too complicated a history to give you one, and you can end this confusion right up front," says Joseph Feldman, MD, chairman of the emergency trauma department at Hackensack.
Emergency care providers often have to "fly blind," says John Halamka, MD, an emergency physician who is now the chief information officer (CIO) at Harvard Medical School in Boston and Beth Israel. When a patient comes in unconscious, he could have anything from a barbiturate overdose to a diabetic coma, he says.
"Beyond the initial set of resuscitation measures, wouldn’t it be great to know if this patient has a seizure history?" Halamka says. "Obviously, we’d be able to provide a much higher quality level of care if we did not have to go on such a big fishing expedition."
Halamka, who is an avid ice climber, had himself implanted in December 2004.
Getting patients on board
Since being implanted is totally voluntary, the chip passes all the rigor of the Health Insurance Portability & Accountability Act (HIPAA), Feldman asserts. "The only thing on the chip is your ID number — not your medical record."
Still, the two facilities are going about patient solicitation’ in different ways, with Hackensack being more proactive. "We’ve done physician focus groups, met with primary care providers in the county and with ED directors and chairmen in collaborative meetings on a monthly basis, and VeriChip made a pitch to spread the word in each of the hospitals," says Feldman.
It’s starting out slowly, he reports. "We’ve chipped only about 30 patients so far." Because Hackensack was a development test site, all patients were chipped free of charge.
In addition, Feldman says, Horizon Blue Cross/ Blue Shield of New Jersey is involved in the pilot program with Hackensack and VeriChip to evaluate this technology for the subscribers of their program. "They are giving us critical patient information that can be shared during an emergency," he explains. "They will look at this technology and evaluate its efficiency and familiarize themselves with it, to see how they can incorporate it into future programs."
Halamka is letting the patients come to him. "We’re not recruiting," he says. "If patients come in with it, we want to be able to support them." He estimates that about a dozen patients are implanted in the Boston area.
"This is a personal choice between patient and physician," he says. "As CIO, I believe there is value in investing in the technology, and as an ice climber, I thought it would be a good idea if I’m found at the bottom of a cliff that someone can scan me and know my medical history."
In fact, during the staff training sessions last March, Halamka served as the "patient."
A simple process
The scanners (readers) used by hospitals cost $300, while the chip and injector kits cost about $200 each.
The process itself is quite simple: A scanner is placed 6 inches from the patient’s arm. If it shows the presence of a chip, the provider goes to a web site, types in the identifier, and reads whatever information the patient has elected to put on the site, such as current medications, allergies, blood type, and emergency contact information. "It’s a truly personal health record," Halamka explains.
Both facilities developed special protocols for dealing with implanted patients. "Once a patient comes in with an altered mental status or is delirious, they are automatically scanned at the direction of the nurse or physician," Feldman summarizes.
His ED has computers on wheels available so that the provider can access either the VeriChip internet site (which requires a double password) or the Hackensack intranet to get to patient information.
"Our ultimate vision is to have a hyperlink to people’s discharge summaries, lab results, and so forth, but it will take a lot of work to get past the potential legal issues," Feldman shares. He adds that future versions of chips might be able to detect body temperature, blood glucose levels, and the like.
Sources/Resource
For more information on implantable radiofrequency identification (RFID) chips, contact:
- John Halamka, MD, Chief Information Officer, Harvard Medical School and CareGroup Health Systems/Beth Israel Deaconess Medical Center, Boston. Phone: (617) 754-8002. Fax: (617) 754-8006. E-mail: [email protected].
- Joseph Feldman, MD, Chairman, Emergency Trauma Department, Hackensack University Medical Center, 30 Prospect Ave., Hackensack, NJ 07601. Phone: (201) 996-3192.
For additional information on the VeriMed chip, contact:
- VeriChip, 1690 S. Congress Ave., Suite 200, Delray Beach, FL 33445. Phone: (800) 970-2447.
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