Micro Management

This medical trend might leave you with a chip on your shoulder.



Not too long ago, one of my doctors in Memphis referred me to a specialist in St. Louis. Before I went, I gathered up all my medical records from various doctors here. It was time consuming, to say the least.

But, as it turns out, I could have done something much simpler. For just about $200, I could have a tiny microchip implanted in my forearm. The doctor in St. Louis -- or St. Tropez, for that matter -- could scan my arm and instantly retrieve all the information they needed about me.

In October 2004, a company in Delray Beach, Florida, called Applied Digital Solutions received FDA approval to implant high-tech devices called VeriChips in patients. Using a syringe, the chips are injected under the skin, usually in the back of the upper arm. Doctors can simply scan the device to pick up a 16-digit number -- in effect that person's "serial number" -- which they can use to access the patient's medical records stored on a national electronic database.

There's just one problem: That national database doesn't exist yet.

Visit your doctor today, and he or she will probably bring in your chart, which in most cases is a manilla folder crammed with all sorts of papers, x-ray reports, test results, and other information. And that's just whatever that one doctor has compiled about you. Visit another doctor or specialist, and you will find the same thing -- another stack of papers that grows thicker with every visit. No one has yet figured out a good --which means reliable, up to date, and, just as important, private -- way of combining all these scattered records into one place. After all, what person in that doctor's office gets the happy task of typing or scanning hundreds, if not thousands, of patients' records into a computer?

"That's the main issue," says Dr. Jack Buchanan, associate professor of biomedical engineering, medicine, and physiology at the University of Tennessee Health Science Center. "Creating the medical records to start with. The microchip thing is just a key, or an index. It's no different from a library card, or a credit card. It's sort of 'gee whiz' because you can put it under your skin, but to me the hard part is assembling the records."

Buchanan explains that efforts are currently under way to create an electronic health record system.

"But in order to do that, it all has to be in the same format, and there are some standards being developed. The major one is called HL-7, or Health Records 7, which would create a standard for the interchange of electronic health records. But still, one of the big issues is, who is going to pay for it? Does the doctor pay to do all that?"

The VeriChip system has its proponents. A Washington Post article featured a 77-year-old retired naval officer, who carries a VeriChip in his arm. "If you're unconscious and end up in the emergency room, they won't know anything about you," he told the reporter. "With this, they can find out everything they need to know right away and treat you better."

In an article on WebMD, Scott Silverman, the CEO of Applied Digital, claims, "If you ask people whether they would have a VeriChip implant to identify their medical records in an emergency, the positive response goes to 80 percent."

But that was the result of the company's own survey. The WebMD article, however, pointed out, "The devices won't do much good unless hospitals buy scanners." And not just any scanner, but a device designed and sold by Applied Digital expressly to pick up the serial number on the VeriChip.

The concept also raises privacy issues: what else does that little chip tell about you? The Washington Post article cited the co-author of a book on radio-frequency technology, who said, "It may seem innocuous, but the government and private corporations could use these devices to track people's movements."

To do so, those government agents would have to stay pretty close to you, since the VeriChip only works within about a foot of the scanner. Even so, implanting anything in their body worries some people, and Buchanan says it's really not necessary.

"Once you get the records assembled -- and again, that's the hard part -- you could just carry a card with the I.D. number on it," he says. "Or access it with fingerprints. Even if you are unconscious, there are fingerprint readers."

Implanted medical chips have actually been around a long time. Veterinarians routinely inject them in cats and dogs so people can track down lost pets. Inserting them in people -- with all the medical, legal, and ethical issues that brings up -- is another matter entirely.

Several medical facilities in Memphis already store their records electronically. A patient who visits Campbell Clinic in Germantown can see one of their doctors at their Midtown office, and the records are instantly available at either location. Turning that into a national database is the challenge.

"One way or another, we are eventually going to have some kind of national electronic health records," says Buchanan. "But how you keep track of it, how you access it -- there's going to be a lot of discussion about that before it happens." 

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