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MED INF 407: Karin J. Lindgren, Esq. Legal, Ethical & Social Issues in Medical Informatics Northwestern University
Research Paper Student: Biljana Spasic
1
Research Paper
Legal, Ethical and Other Issues Arising From Use of Human-Implantable RFID Chips
Introduction
Throughout human history technology advances transitioned from scientist’s
laboratories to the broader and often times mass use by regular people, and most of the
time improved human lives. One of the technologies that we started to see more of in
the last decade or so is the Radio Frequency Identification (RFID) which found its way
into many areas of our lives. As it is the case with other technological advances, first
came the hardware, software development followed and it has ways to go, but we still
struggle with definition and implementation of the legislation to regulate the use of this
technology and its various applications.
One of the most controversial uses of the RFID technology is the human
implantable RFID microchip. Due to its ability to uniquely identify a person and provide
tracking capabilities, the wide adoption of this technology sometimes faces strong
opposition from federal and state governments , advocacy groups, and individuals
concerned with privacy, security, safety, and constitutional and other rights of
individuals. Sometimes ethical and social issues of putting somewhat permanent
identification marks on people and tracking them bring back memories and examples
from not so distant history. Some religious groups raise concerns about, for them
MED INF 407: Karin J. Lindgren, Esq. Legal, Ethical & Social Issues in Medical Informatics Northwestern University
Research Paper Student: Biljana Spasic
2
obvious, connections to undesirable implications and outcomes of apocalyptic
proportions highlighted in the religious texts.
The lack of standards, different levels of adoption and implementation across the
globe, and considerable ethical, social and legal issues that have not been sufficiently
addressed as yet add to the complexity that the adoption of this new technology faces.
The technology advancements however continue, providing new legal and other
challenges.
RFID Technology Overview
RFID is based on a well known radio transmission technology, but with different
application. This is another example of a spiral development when the technology
makes a full circle, improves and introduces new functionality and new uses.
What is Radio Frequency Identification (RFID)? It is an electronic identification
system based on radio frequency communication, comprised of the following basic
components:
1. RFID tag. It is a miniature electronic circuit, microchip, with an antenna. It is
enclosed in a special casing made of material that does not stop the radio waves,
such as special plastic or glass. An RFID tag is placed on an object or a living
body and it contains the information that identifies the object or the living body,
person or animal. It can contain a single identification data point, such as unique
MED INF 407: Karin J. Lindgren, Esq. Legal, Ethical & Social Issues in Medical Informatics Northwestern University
Research Paper Student: Biljana Spasic
3
identification number, or up to a few pages of information. The RFID tag is
activated and data stored on the tag is read by a RFID reader.
2. RFID reader. The reader has an antenna and it can read tags from a certain
distance without direct physical contact required by similar devices such as
scanners or optical readers. The tags can be read while moving and not
necessarily in line of sight. RFID reader can be portable, handheld, or fixed,
mounted on walls, doors, etc. RFID reader requires a communication protocol
that allows it to read all tags within its range without duplicate reads (1).
3. Backend database. The database supports processing and storage of collected
RFID data, as well as data exchange with other systems as needed. The
environment includes communication protocols and communication networks for
these databases to get the data from readers and to send them to other systems
as required by the intended use.
Components of an RFID System (14)
MED INF 407: Karin J. Lindgren, Esq. Legal, Ethical & Social Issues in Medical Informatics Northwestern University
Research Paper Student: Biljana Spasic
4
RFID tags can be read only or read/write. The read only tags are configured once,
mostly during the production cycle, and can be read many times for as long as they are
in use. Read/write tags allow for updates of their content, such as adding or changing
the data stored in a tag. They too can be read multiple times. RFID technology is fast in
replacing bar coding and optical readers because the tags are read faster and more
efficiently. An additional advantage is that tags can be read many times which supports
uses of identification tags for tracking marked objects or living beings throughout their
lifecycle.
The use of the RFID technology is wide spread. Some examples of its current uses
across industries include the following: (3)
- Human Resources - personnel identification, id cards, access control to certain
areas
- Travel – passports for entry control, tagging rental cars for tracking
- Agriculture - livestock, animal, pet identification and tracking
- Healthcare - patient identification, tracking and safety, and medication control
- Transportation - electronic toll collection, tracking high value items for increased
security
- Supply Chain - visibility of supply chain objects through product tracking, cargo
and container identification and security
- Mercantile - point of sale, replacing bar code technology, tracking targeted
products (an example is Prada merchandise)
- Education – library books, self check-out and tracking, books inventory control
MED INF 407: Karin J. Lindgren, Esq. Legal, Ethical & Social Issues in Medical Informatics Northwestern University
Research Paper Student: Biljana Spasic
5
Example of the RFID technology application in libraries (2):
Example of RFID systems in Supply Chain (3)
MED INF 407: Karin J. Lindgren, Esq. Legal, Ethical & Social Issues in Medical Informatics Northwestern University
Research Paper Student: Biljana Spasic
6
RFID in Healthcare, Examples of Applications
One use of the RFID technology in Healthcare is to track patients, mobile assets,
and medical staff within the healthcare organization’s premises by providing to patients
and staff RFID tags that can be conveniently attached to clothing or wrist bands while in
the hospital, and placing tags on hospital-owned assets.
Cisco and GE Health are creating an integrated system for tracking patients, mobile
equipment, other assets, and personnel by using the RFID technology (4). The
improved visibility and workflow are expected to help with streamlining processes,
improve patents’ safety and care, and ultimately increase patient satisfaction. Below are
three example diagrams of how the RFID technology is implemented and used in this
integrated solution.
Cisco example of monitoring patients’ location:
“Improve Patient
Safety with Monitoring
of Patient Location,
patient tags can be
used to monitor the
location of patients as
they move from
procedures to their
beds.” (4)
MED INF 407: Karin J. Lindgren, Esq. Legal, Ethical & Social Issues in Medical Informatics Northwestern University
Research Paper Student: Biljana Spasic
7
Cisco example of checkpoint notification: “Reduce Asset Loss and Misplacement - To
track essential mobile
equipment such as
wheelchairs, the Cisco
Unified Wireless
Network must be
deployed pervasively
throughout the facility.
A Wi-Fi asset tag is
applied to the wheelchair so that it can be tracked either in real time as it moves
throughout your facility or, using chokepoint technology, only when it moves through a
doorway as it exits the building.” (4)
The picture below shows Cisco example of using location technology to manage staff:
“Optimize Workflow
and Staff
Management the
Location-Aware
Healthcare solution
can also be used for
staff management.”
(4)
MED INF 407: Karin J. Lindgren, Esq. Legal, Ethical & Social Issues in Medical Informatics Northwestern University
Research Paper Student: Biljana Spasic
8
Another successful use of RFID technology in Healthcare is an introduction of
surgical RFID tags placed on the patient’s skin. These tags contain information about
patient and the procedure, and are placed on the skin near the surgical site. They are
updated with details about the surgery, kept with the medical record, and made
available for review and analysis of the collected data. The equipment uses RFID
components and local area network to transmit data to the appropriate database.
One example of a surgical RFID tag is SurgiChip, the product by InfoLogic.
“Designed to prevent surgical errors, the system now includes a larger wireless
handheld device allowing health-care workers to exchange information in real time at
the point of care.” (6) The best adoption rate of surgical RFID tags is by orthopedic
surgeons where the preventable errors, such as wrong site, are most likely to occur.
The picture below shows an example of a SurgiChip RFID tag and reader. (6)
SurgiChip aims to eliminate errors caused by using markers for the documentation of surgery.
SurgiChip is not the only surgical RFID solution on the market. There are others who
have similarly good adoption rates and overall results.
MED INF 407: Karin J. Lindgren, Esq. Legal, Ethical & Social Issues in Medical Informatics Northwestern University
Research Paper Student: Biljana Spasic
9
Other good example of the RFID use in healthcare is in tracking medication from the
production line at the pharmaceutical company to dispensing it at the pharmacy or
hospital, even administering it to the right patient with automated control of the right,
prescribed, dosage. RFID enables faster and more precise control of medication’s path
through the pharmaceuticals supply chain and potential recalls. It also improves tracking
of particular types of drugs that are often subject to abuse, such as narcotics or some
pain medications which contain controlled substances. (11)
“RFID technology makes it easier to ensure that drugs are authentic, and it also
creates an electronic pedigree, or record of the chain of custody, from the point of
manufacture to the point of dispensing. Electronic pedigrees will improve patient safety
and protect the public health by allowing wholesalers and retailers to rapidly identify,
quarantine, and report suspected counterfeit drugs and conduct efficient, targeted
recalls.” (11)
The success of medication tracking, or any other RFID implementation in healthcare
is dependent upon process integration within workflows and efficient data flow between
the systems that create, update, use, or otherwise process the information provided by
the RFID technology components.
The patients are integral and vital part of this system and availability of their medical
information embedded in their personal RFID tags play significant role in the
improvements in care that the new technologies and processes initiated by them
enable. The more integrated the processes, the more control of steps and overall
improvement can be expected.
MED INF 407: Karin J. Lindgren, Esq. Legal, Ethical & Social Issues in Medical Informatics Northwestern University
Research Paper Student: Biljana Spasic
10
Implanted RFID Chips
Probably the most controversial of all RFID applications is the one which includes
RFID microchips implants in humans. In the last decade the technology advanced
enough for the human implantable microchip to be designed and manufactured. In 2004
FDA approved marketing of VeriChip, the human implantable RFID microchip that
contains person’s identification information. The FDA approval was accompanied with
the letter that outlined health risks and concerns. “Based on the information submitted in
the petition for the VeriChip(TM)Health Information Microtransponder System, FDA has
determined that the VeriChip(TM) Health Information Microtransponder System can be
classified in class II with the establishment of special controls. FDA believes that class II
special controls provide reasonable assurance of the safety and effectiveness of the
device.
The potential risks to health associated with the device are: adverse tissue reaction;
migration of implanted transponder; compromised information security; failure of
implanted transponder; failure of inserter; failure of electronic scanner; electromagnetic
interference; electrical hazards; magnetic resonance imaging incompatibility; and
needle stick. The special controls document aids in mitigating the risks by identifying
performance and safety testing, and appropriate labeling.” (15)
Human implanted RFID microchips have not had any significant following since the
FDA approval. A small number of enthusiasts had the RFID chips implanted for various
reasons. In 2004 Dr. Halamka, the Chief Information Officer at the Harvard Medical
Center, had the FRID microchip implanted in his arm to test its easy identification
MED INF 407: Karin J. Lindgren, Esq. Legal, Ethical & Social Issues in Medical Informatics Northwestern University
Research Paper Student: Biljana Spasic
11
capabilities for the use in healthcare but also to “evaluate the medical, privacy, social
and technological implications” (13). Others tested the software capabilities for different
every day conveniences, such as opening doors, turning on lights and so on. An
interesting commercial application of an implant is for bar hopping in Barcelona, Spain,
where a number of regular customers had the RFID chops implanted for the
convenience of faster orders and automated billing.
The picture to the left shows an example of a human
implantable RFID microchip, VeriChip, the size of two grains of
rice. (16)
VeriChip is currently the only human implantable microchip.
Human Implantable RFID Chips, Issues and Concerns
There are a number of issues and concerns concerning human RFID implants. They
range from health risks, to maturity of this technology, to ethical consequences, and
many more.
1. Health
Before the human implants, RFID chips were implanted in animals primarily for
tracking purposes. Health issues related to animal implants include adverse effects on
surrounding tissue and prominent cancer development in the areas surrounding the
MED INF 407: Karin J. Lindgren, Esq. Legal, Ethical & Social Issues in Medical Informatics Northwestern University
Research Paper Student: Biljana Spasic
12
implant. There are opinions that this would not be the case with humans due to the size
of the chip compared to the size of human body.
RFID emits a form of radiation. There were no formal studies to evaluate impact of
this radiation on the human body over a long period of time. Similarly, the chip and
reader create a magnetic field the effect of which has not been studied.
There are other health concerns that have not been researched to the extent
required for a comprehensive evaluation of health risks.
2. Safety
There are significant concerns about interference of RFID implant with other medical
devices, such as pace makers, and medical diagnostic equipment such as MRI. There
is a theory that an implant may cause severe burns end even react as a bullet when the
patient is taking an MRI. No significant research was made to confirm or deny these
concerns with high certainty.
White implanting the chip is relatively easy, removing it may not be. One of the
reasons is that the chip may migrate and move through the body, and locating it may be
a challenge.
3. Technology / Data
Currently the RFID chip contains a 16 digit code that identifies the carrier. There is
no universal standard for any RFID coding that can be used everywhere. While the chip
has the code, there is no standardized way of using the data and exchanging it with
appropriate systems. There is no clear standard how this data can be used and by who,
how it is stored, retention rules, and backup procedures in case of chip malfunction.
MED INF 407: Karin J. Lindgren, Esq. Legal, Ethical & Social Issues in Medical Informatics Northwestern University
Research Paper Student: Biljana Spasic
13
Readers are not all the same, neither are frequencies, or any other hardware or
communication details. Industry standards for all components of RFID technology are
not in place to support wide use. Also, there is no blocking mechanism to prevent
unauthorized reading.
There are no industry standards and processes for deactivation of the implanted
chip. One of the issues may be theft by unwilling extraction and there is no technical
process for making the chip unusable by an unintended host.
Because RFID microchips can contain more than a single identification data point,
soon there may be a question of how much data can and should be stored. Also,
implantable chips can become read/write which opens up a new set of issues related to
compatibility of all components, data quality, control of access to data stored in a
microchip and ability to make updates, consistency and completeness of data stored in
associated databases, and general data management such as responsibility for regular
backups and ability to recreate content in case of the need to replace an implant, etc.
Responsibility for correct data capture and consequences of incorrect changes have
not been discussed to the degree that leads to having an industry standard in place
along with regulations for any unintentional wrong changes in data. The data can be
incorrect or corrupt in the chip, or in the databases that store it in the backend. These
data quality issues can be unintentional, due to technology malfunctions, interference
during read or write functions, simple human errors, or any other reason. It is not clear
today who would be the responsible party for the system of record and appropriate
updates to the data in the implant and any associated data repositories.
MED INF 407: Karin J. Lindgren, Esq. Legal, Ethical & Social Issues in Medical Informatics Northwestern University
Research Paper Student: Biljana Spasic
14
There is not industry standard or a defined approach for handling technology
upgrades and managing backward compatibility with outdated units. Current estimates
are that the existing human implantable microchip has a life of approximately twenty
years. Knowing the speed of changes in high tech industry, once adopted and widely
used this technology and its various components are bound to change at the rapid
pace, and so will other medical devices and medical record systems which may create
an increased need for data exchange with the RFID systems. Since replacement of
implants is not resolved any significant changes in the ability of the implants to store a
particular data set, or new standards, or any other significant advancement in the
associated technologies and systems may require additional RFID implants to stay up
to date.
Even if an implanted RFID becomes the main identification method for patients,
there must be an established alternative method to identify people. Not all medical
institutions will have their electronic health record on the same level of sophistication
and interoperability with systems in other medical facilities. Processes and technology
must be in place to use these alternative identification methods interchangeably. This is
an area where a comprehensive set of international standards for data exchange and
system interoperability would be of great help.
4. Privacy and Security
Privacy and security are big questions and issue that have not been successfully
resolved. Because the RFID readers read tags from a distance and from any angle, not
necessarily in the line of sight, it is possible to intercept the signals. Currently the data is
MED INF 407: Karin J. Lindgren, Esq. Legal, Ethical & Social Issues in Medical Informatics Northwestern University
Research Paper Student: Biljana Spasic
15
not encrypted, and there is no access control that would put additional control on data
availability. In addition, readers are small and can be placed on various objects. Tags
can be read without awareness of their hosts. RFID tags used in passports can be
blocked from reading by special covers, but there is no solution for an implanted RFID
chip to block unauthorized access; it is open to any reader all the time.
Since the data is not properly protected, those who have RFID implants have no
control or knowledge of the people and systems reading their information. If and when
in the future the implantable RFID chips become read/write and are able to store a mini
health record this issue will become even bigger HIPAA violation. However, the
responsibilities for data, systems, and privacy breaches are not clearly defined in this
area. Until there is an authorization and authentication method embedded into this
technology it will cause privacy and security issues and HIPAA non-compliance.
5. Religious, Social and Political Concerns
Religious groups are finding unfavorable close similarities between implanted
identification and their religious texts, and are openly calling for a boycott of such
devices by their followers and beyond.
Tagging and branding people can easily lead to labeling them in favorable or
unfavorable ways. After that there is an easy way to becoming a victim of discrimination
or different forms of hate crime. For some, mostly hi-tech devotees, RFID is just
another must-have gadget and those that do not have it are pushed out of their inner
circle. On the other end of the spectrum are those that may have a medical condition or
MED INF 407: Karin J. Lindgren, Esq. Legal, Ethical & Social Issues in Medical Informatics Northwestern University
Research Paper Student: Biljana Spasic
16
any other personal characteristic accessible via the RFID tag that can have devastating
impact on acceptance by their social and professional circles.
Lately there is an increased use of religious and social concerns related to the RFID
implants for political marketing. Some sources indicate and predict that everyone
affected by the new Healthcare Reform will have to have a RFID implant for easier
tracking of provided health services. (18)
6. Ethics
Ethical issues, questions and concerns cover broad spectrum of topics related to the
RFID implants and the implications of their adoption. In my opinion, one of the biggest
ethical issues are broad uses of technology that may have high probability of negative
impacts on health, and that is not ready for a broad adoption. Health risks need to be
evaluated and well understood prior to taking this technology on the market and beyond
experimental use. Technology and data issues need to be resolved first by having well
established industry standards organizations on international level that will support,
enable and sometimes mandate certain standards related to the maturity of technology,
and data behind it including standardized data structures and content, and
interoperability standards.
Another significant ethical issue in my opinion is a potential for mandatory tagging by
the RFID implants. There is a perceived benefit of implanting RFID tags in elderly,
particularly Alzheimer’s and other patients that can easily be disoriented or lost, and in
children particularly those that are at high risk of being abducted. Privacy and basic
human rights demand a written consent for any implants to be placed in someone’s
MED INF 407: Karin J. Lindgren, Esq. Legal, Ethical & Social Issues in Medical Informatics Northwestern University
Research Paper Student: Biljana Spasic
17
body or removed from it. The elderly and children are especially vulnerable when it
comes to making their own well informed decisions.
In 2007 the American Medical Association (AMA) published their code of ethics
related to the human implantable RFID microchips. “The AMA's report identifies three
specific recommendations: The informed-consent process must include disclosure of
medical uncertainties associated with these devices; physicians should strive to protect
patients' privacy by storing confidential information only on RFID devices utilizing
informational security similar to that required for medical records; and physicians should
support research into the safety and efficacy of RFID devices implanted in human
beings, and examine the role of doctors regarding the nonmedical uses of the
technology.
The recommendations now serve as ethical guidelines for physicians and caregivers,
explains Steven Stack, M.D., a member of the AMA's board of trustees, and are
officially part of the AMA's medical ethics code. While not law, the AMA's code of ethics
has long served as a standard of conduct defining the essentials of honorable physician
behavior.” (17)
In the future there is an expectation that RFID implants will support tracking
functionality. This is not a big difference from other new technology that is being used
on regular bases, such as cellular phones or GPS systems. Many people are not aware
that they can be tracked by their cell phone at all times. In my opinion there is a subtle
yet huge difference between voluntarily carrying a piece of equipment that can be
tracked, or having one implanted and therefore always with a person. Some authors go
MED INF 407: Karin J. Lindgren, Esq. Legal, Ethical & Social Issues in Medical Informatics Northwestern University
Research Paper Student: Biljana Spasic
18
as far as calling this human tracking geo-slavery which indicates not only loss of control
that is passed to someone else and enables new forms of surveillance, but also loss of
privacy and limitation of free movement. (8)
Loss of control over personal data, its availability, accessibility, privacy and
confidentiality directly affects human dignity. This is yet another ethical issue that needs
to be resolved, an umbrella to other mentioned ethical concerns.
7. Legal
The literature provides insights into several legal violations that the RFID technology
and particularly implantable microchips are enabling.
First, the unprotected personal health information is made available within RFID
microchips to the unknown systems and people without any knowledge or consent from
the patient. The data is not encrypted or protected in any other way. This is a clear
violation of the HIPAA regulation.
Additional privacy and security set of issues are related to the ability of implanted
RFID tags to provide tracking capabilities. This is a known problem with other mobile
technologies that enable tracking of the individuals at all times. Any technology,
including RFID that enables human tracking violates the Fourth Amendment. “The
Fourth Amendment provides that: “The right of the people to be secure in their persons,
houses, papers, and effects, against unreasonable searches and seizures, shall not be
violated, and no Warrants shall issue, but upon probable cause, supported by Oath or
affirmation, and particularly describing the place to be searched, and the persons or
things to be seized.” U.S. CONST. amend. IV.” There are special cases of tracking that
MED INF 407: Karin J. Lindgren, Esq. Legal, Ethical & Social Issues in Medical Informatics Northwestern University
Research Paper Student: Biljana Spasic
19
are not violating the Fourth Amendment, such as police tracking someone outside their
homes. (8)
The Federal and State legislators have not yet made clear legislations to regulate
personnel ID cards and other identification devices with tracking capabilities although
these cases or personnel tracking may be considered invasions of privacy. The State
common laws however recognize the invasion of privacy rights and the support bringing
lawsuits for damages against those who violate it. (8)
Identification, branding and tracking enabled by RFID technology represent a form of
so called geo-slavery and violate the Thirteenth Amendment. “The Thirteenth
Amendment was never intended to be limited to ending the enslavement of African-
Americans. In 1911, the United States Supreme Court highlighted the amendment’s
broad breadth when it described the amendment as “a charter of universal civil freedom
for all persons, of whatever race, color or estate, under the flag” that was intended to
abolish both slavery as well as all vestiges, badges, and incidents of slavery. In addition
to outlawing slavery, the Thirteenth Amendment also prohibits involuntary servitude.” (8)
Any mandatory insertion or removal of identification implants would also be in
violation or the Thirteen Amendment. “In addition, mandatory tracking, identification
implants, or attachments on another human being would be subject to court challenge
under the Thirteenth Amendment. Such devices are the technological equivalent, in
many respects, to various slaveholder tools, including branding, utilized to keep African-
Americans from escaping bondage or as punishment for such escapes. Therefore, the
use of such devices to establish geo-fences and even impose corporal punishment
MED INF 407: Karin J. Lindgren, Esq. Legal, Ethical & Social Issues in Medical Informatics Northwestern University
Research Paper Student: Biljana Spasic
20
would constitute a vestige of slavery. In addition, the imposition of physical injury or
threat of physical injury emanating from a tracking device would be subject to challenge
as a form of involuntary servitude especially if the electronic punishment is aimed at
forcing an individual to continue working.” (8)
Conclusion and Recommendations
I am a strong proponent of the RFID technology in general, but do not see the value
in RFID implants. RFID is good for tracking and additional control of moving goods,
assets, even people to some extent. Because of its ease of use and speed of
processing it has a significant impact on simplifying and streamlining appropriate
processes. For example there is an improvement in speed and accuracy of supply chain
operations, medication tracking, even personal medical information within a hospital
setting. In order to make RFID more prevalent in healthcare this technology needs to be
followed by a strong set of regulations to protect privacy, address health concerns, and
address major legal issues, primarily those related to limitations of basic human privacy
and liberties.
VeryChip as the only manufacturer of human implantable RFID microchips was
facing a number of issues, and since 2004 when their product was approved by FDA
has not managed to make it broadly accepted. They put their human implantable
product on hold. Instead, they moved to other ways of using RFID on patients, and even
MED INF 407: Karin J. Lindgren, Esq. Legal, Ethical & Social Issues in Medical Informatics Northwestern University
Research Paper Student: Biljana Spasic
21
created an integrated system for identification and keeping of medical records for
sailors, an extremely mobile workforce.
The technology has ways of renewing and reinventing itself, and coming back vastly
improved. I believe that this will be the case with RFID. For any broad use of this
technology in healthcare there has to be a strong and standardized foundation in terms
of technology and interoperability, new legislation, and preferably new agency on the
federal level to control implementation and adherence to legal and other regulatory
requirements.
Some authors suggest spending some time and effort in defining what identity and
privacy are. These terms have been used many different ways, and need clearer
definition in order to better regulate new technology.
The new legislation should include provisions for personal choice when it comes to
any devices that may impact privacy, dignity, and basic human rights and liberties.
There has to be a balance though if we want to see the healthcare take advantage of
new technologies, improved processes, and better care. There must be alternative
administrative and other methods for fulfilling functions that the person chooses to forfeit
a new technology for.
Using RFID tags for patients within hospitals can improve care through streamlined
and faster processes and additional built in controls, but personal identification does not
need to be taken out of this setting. The legislation should address the use of RFID as
tracking devices and limit their use for particular purposes and within particular settings.
MED INF 407: Karin J. Lindgren, Esq. Legal, Ethical & Social Issues in Medical Informatics Northwestern University
Research Paper Student: Biljana Spasic
22
The new legislation needs to address responsibility for any data loss, misinterpretation,
or any other miscommunication arising from technical issues.
Having removable rather than implanted identification devices would minimize the
use of personal data for purposes other than medical care. Nevertheless, the new
legislation should include the desired and undesired use of identity data, methods for
obtaining this data, and consequences of non compliance. There are a few states,
California is one of them, that banned mandatory implants. Any such regulation needs
to be brought up a level and become federal legislation. All issues concerning privacy,
personal liberties, and health require a federal law and an agency to oversee its
implementation.
This leaves a question of tracking medical providers via RFID in the hospitals and
other places of medical care. Although there are new integrated solutions, such as one
by GE and Cisco, that provide tracking, movement control and availability or patients,
assets and personnel, there were numerous complaints by medical providers that such
control limits their privacy and provides unfair advantages to some. This, I believe is the
internal issue that each healthcare organization needs to address since the issue is
within their premises. Personally I would not like to work in an environment where my
every step is monitored, and others may not agree with it too. It will have to be up to
each organization to decide how best to manage its personnel and continue to improve
care and control costs.
MED INF 407: Karin J. Lindgren, Esq. Legal, Ethical & Social Issues in Medical Informatics Northwestern University
Research Paper Student: Biljana Spasic
23
References:
(1) Author unknown, “An Overview of RFID Technology”, DataFlows Dimensions, INC, Retrieved on Aug 18, 2011 from http://www.dataflows.com/RFID_Overview.shtml
(2) “Six Sentence About RFID For Library”, LibBest, Retrieved on August 18, 2011 from http://www.google.com/imgres?imgurl=http://libbest.com/images/rfid_e01.jpg&imgrefurl=http://libbest.com/rfid.html&h=650&w=1024&sz=174&tbnid=tlpCk5-6tMPesM:&tbnh=95&tbnw=150&prev=/images%3Fq%3D&hl=en&usg=__x66MHN25qd7RPCijiQmubZaR4oM=&sa=X&ei=66xKToXLDtTWiAKh1f23Bw&ved=0CF4QnwkwAw
(3) “RFID Technology”, 12 Manage The Executive Fast Track, Retrieved on August 18, 2011
from http://www.12manage.com/methods_rfid_technology.html
(4) “The Cisco Location-Aware Healthcare Solution”, Cisco, Retrieved on August 18, 2011 from http://www.cisco.com/web/strategy/docs/healthcare/CLA_HealthcareSolution.pdf
(5) GE Healthcare And CISCO to Offer Hospitals a New Mobility Technology Platform for Improved Patient Flow and Asset Management “, GE Healthcare, Retrieved on August 18, 2011 from http://agiletrac.gehealthcare.com/enterprise/ge-healthcare-and-cisco-to-offer-hospitals-a-new-mobility-technology-platform-for-improved-patient-f.php
(6) Beth Bacheldor, “InfoLogix Regenerates SurgiChip”, Health Care News, March 5, 2008, Retrieved on August 18, 2011 from http://www.rfidjournal.com/article/view/3955/
(7) Author unknown, “How RFID Can Add Value in Healthcare and Pharmaceutical Tracking and Tracing”, Avery Dennison, Retrieved on August 18, 2011 from http://www.rfid.averydennison.com/online-press-kit/white-papers/RFID-Healthcare-Pharma.pdf
(8) William A. Herbert, “No Direction Home: Will The Law Keep Pace With Human Tracking Technology to Protect Individual Privacy and Stop Geoslavery?”, A JOURNAL OF LAW AND POLICY, Retrieved on August 18, 2011 from http://lawprofessors.typepad.com/laborprof_blog/files/HerbertISArticle.pdf
(9) Leah Altaras, “Follow that Car! Legal issues arising from installation of tracking devices in leased consumer goods and equipment, 3”, Shidler J. L. Com. & Tech. 8 , Feb. 14, 2007, Retrieved on August 18, 2011 from http://digital.law.washington.edu/dspace-law/bitstream/handle/1773.1/392/vol3_no3_art8.pdf?sequence=1
(10) D. Zachary Hostetter, “When Small Technology is a Big Deal: Legal Issues Arising From Business Use of RFID, 2”, Shidler J. L. Com. & Tech. 10, Dec. 16, 2005, Retrieved on August 18, 2011 from http://digital.law.washington.edu/dspace-law/bitstream/handle/1773.1/374/vol2_no3_art10.pdf?sequence=1
(11) Radio ID Tags for US Drugs (RFID), MedicineNet.com, Retrieved on August 18, 2011 from http://www.medicinenet.com/script/main/art.asp?articlekey=40579&page=2
(12) Mark Roberti, “Doctors Weigh In on Human RFID Implants”, RFID Journal, 07/03/2007, Retrieved on August 18, 2011 from http://www.rfidjournal.com/blog/entry/3455
MED INF 407: Karin J. Lindgren, Esq. Legal, Ethical & Social Issues in Medical Informatics Northwestern University
Research Paper Student: Biljana Spasic
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(13) Molly Merrill, “Future hazy for implantable medical records”, Healthcare IT News, June 30, 2009, Retrieved on August 18, 2011 from http://www.healthcareitnews.com/news/future-hazy-implantable-medical-records
(14) “Information Security: Radio Frequency Identification Technology in Federal Government”, U.S. GOVERNMENT ACCOUNTABILITY OFFICE (GAO), GAO-05-551, May 2005, Retrieved on August 18, 2011 from http://gao.gov/new.items/d05551.pdf
(15) Donna-Bea Tillman, FDA Letter, Department of Health & Human Services, Oct 12 2004 Retrieved on August 18, 2001 from http://www.spychips.com/devices/verichip-fda-letter.pdf
(16) “VeriChip RFID”, Truth Exposed, modified on 13 November 2009 Retrieved on August 18, 2001 from http://www.truthexposed.com/index.php?title=VeriChip_RFID
(17) Beth Bacheldor, “AMA Issues Ethics Code for RFID Chip Implants”, RFID Journal, July 17, 2007, Retrieved on August 18, 2011 from http://www.rfidjournal.com/article/view/3487/1
(18) Timothy Baldwin, “National Healthcare Will Require National RFID Chips”, New American, 25 March 2010, Retrieved on August 18, 2011 from http://thenewamerican.com/usnews/politics/3193-national-healthcare-will-require-national-rfid-chips