Chipping Away at Health Information Technology

We always talk about “big brother” conspiracies and wonder how far our society is willing to morph with technology. We question privacy rights as satellites pick-up our locations throughout the world, but I’m sure not many of us thought the day would come when we’d allow our bodies to house readable chips; radio frequency identification chips (RFID), inserted under our skin, that carry a 16-digit link to our personal electronic health record.

Well the day has come, and it’s not happening at intelligence agencies in Japan or space centers in Russia, it’s happening in U.S. hospitals…in New Jersey.

Ground-Breaking Motivation
Hackensack (NJ) University Medical Center has partnered with VeriChip Corp. and Horizon Blue Cross Blue Shield (BCBS) to offer 280 patients the chance to participate in a health information technology (HIT) trial. Patients suffering from chronic diseases who are part of Hackensack IPA (International Profits Associates) will be able to test VeriChip’s VeriMed Patient Identification System.

VeriChip created an RFID chip that can be subcutaneously implanted into patients to manage their long-term conditions.

The motivation behind this ground-breaking trial is the growing rate of medical errors in the U.S. “The Institute of Medicine reported about the number of deaths that occur each year due to medical errors, which raised enormous concerns across the entire health care industry,” explained Daryl Donlin, manager of member program development, Horizon BCBS. “We wanted to do something as a health plan to prevent this as much as possible.”

Knowing that correct information is crucial for accurate medical care, Horizon BCBS wanted to help provide that information at the most crucial times in the emergency room (ER). “The technology exists, the necessity exists and the resources exist, but a major piece was still missing, the funding. So by providing this pilot, we thought it would be a great way to understand the benefits and issues of this type of technology,” Donlin stated.

Is This for Real?
Apparently, Donlin’s train of thought was on track. According to John Proctor, director of communications, VeriChip, an impressive number of hospitals have agreed to register for the HIT system; 119 hospitals nationwide to be exact. “And six or seven ERs in New Jersey are already up and running,” Proctor added.

A hand-held scanner, slightly larger than a cell phone, is the only equipment needed to read the 16-digit number on the chip.

When a patient enters the ER, the medical staff quickly scans the upper right arm to check for the chip. This becomes part of the staff’s protocol once the hospital is registered with the reader.

VeriChip expects to have at least 200 hospitals registered by the end of 2006, Proctor noted.

Not Without Concerns
A major concern that always has to be addressed is privacy. “People’s first concern was with privacy, their second concern was about the chip itself,” Proctor related.

He explained that the privacy issues have been considered. VeriChip’s VeriMed System (the actual chip and electronic health record) is a secure encrypted system. “Patients are in complete control about whether or not they want to be ‘chipped,’” Proctor stated.

Patients must also authorize for Horizon BCBS to load their claim history into their VeriMed health record. To be able to access the information, the hospital staff must sign in as a user, use the facility’s identification number and then use the patient’s 16-digit number. “So the patient must be present for any of this to happen,” Proctor assured.

There’s also no actual information on the chip itself, the 16-digit number only acts as a link to the health record.

The concerns about the chip itself mainly touched on “big brother” and government conspiracies. Many asked, “If the chip can access health information, what else can it do?” Proctor explained.

It spiraled into conspiracy theories about government involvement. But, Proctor related, people actually have concerns with EZ-PassSM. They worry that authorities can monitor the speed it takes them to get to each toll on the Garden State Parkway. “So yes, there’s concern, but that’s a part of any type of change,” Proctor stated.

He also mentioned that along with all the concerns, he has received numerous phone calls considering the positive benefits of the system. “I’ve actually had people volunteer for the trial already and the letters haven’t even gone out yet,” Proctor explained.

Money’s Not an Issue
One of the reasons Hackensack patients are eager to volunteer could be because the trial is free. And once the trial is completed and if the results are positive, Horizon BCBS will then look at how they’ll be able to cover this option for their members. So price doesn’t become an overpowering variable.

“There will be two ways to do this,” Proctor stated. “One would be to offer typical benefit coverage; as part of medical necessity the patient has a chronic condition and it’s appropriate for them to use the chip. The other way would be to offer the chip at a discount.”

Basically, if the chip is a success, Horizon BCBS will want to spread its availability as much as possible.

Horizon BCBS will know the results of the trial after about 2½ years. The trial is scheduled to last 2 years, and 6 additional months will be needed for providers to submit the claims.

The results will be published based on a control group and a study group to see if medical information utilization differs, if there was a high level of acceptance and if it improved efficiency for the course of treatment.

The call for volunteers will begin after Labor Day this year. The letters will be sent out in early September, but not before Horizon BCBS makes sure everyone at Hackensack Hospital is on the same page.

“Communication with the entire hospital staff is critical,” Proctor emphasized.