Hello, Mr. Chips

Remember, it’s for your own good:

When I was a resident in emergency medicine, I spent many hours uncovering the identities of John Doe and Jane Doe patients who were unconscious, disoriented, or mute. I searched their belongings for receipts that included an address or scanned their clothing labels for a clue. Sometimes this worked. Often, hours or days passed before a family member was found who knew the patient’s medical history and health care preferences. By that time, substantial worry had been endured, and often possibly unwanted medical interventions had occurred.

Today, I lead the information-technology efforts at an academic health center, and I have recently encountered an innovative use of technology that could minimize such difficulties. The Food and Drug Administration has approved an implantable device that can store the medical identifier of a patient. Last December, one of these chips was placed in my right upper arm. Implantation was virtually painless – a few milliliters of local anesthesia and the insertion of a device about as large as a grain of rice. It sits in the posterior aspect of my right arm, between the elbow and the shoulder. The days after the implantation were uneventful: no pain, no infection, and no restriction of activities. Now, when a scanner is passed within 6 in. (15 cm) of my arm, my medical identifier is displayed on the screen of a radiofrequency-identification (RFID) reader, and any authorized health care worker can turn to a secure Web site hosted by the manufacturer and retrieve information about my identity and the name of my primary care physician, who can then provide details of my medical history.

“Secure website hosted by the manufacturer.” Right. Secure how?

A guy named Gary McKinnon is fighting extradition from England to the U.S. after he allegedly “hacked into computer networks belonging to NASA, the US Army, US Navy, Department of Defense and the US Air Force” back in 2002. One hopes that the military networks, one of which was based at the Pentagon, would be a bit more secure than the system at Applied Digital.

I also presume that Dr. John Halamka, the author of the article in July’s New England Journal of Medicine, is not an idiot. Therefore he is either very naive or a bald-faced liar.


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