For The Record

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March 16, 2009

Is RFID Technology Too Nosy?

By Lindsey Getz

For The Record

Vol. 21 No. 6 P. 20


There are a lot of good reasons why healthcare organizations should
implement RFID technology, but privacy and security issues raise debate
about its
worthiness.

Well established in the business world as a means of tracking inventory or as
a key component in employee security cards, radio
-
frequency identification
(RFID) technology has been on the market for decades. However, only recently has it begun t
o show
up in other areas of everyday life. RFID technology can now be used to track pets, monitor vehicle
traffic, or even follow pharmaceuticals to prevent counterfeiting.

And it has been rapidly gaining interest for its potential applications in the hea
lthcare industry. The
technology is being considered not only to track equipment or data but people, too. It can be used to
track hospital patients or even remotely monitor patients from their homes. However, it is these types
of applications that have cau
sed some to denounce it as a “Big Brother” surveillance tool.

There are certainly a lot of useful ways that RFID technology could be integrated into healthcare
operations, but concerns about privacy and security have continued to linger. And these aren’t i
ssues
that have eluded the rest of the world either. When Nike and iPod first released their joint Sport Kit,
which allowed runners to track statistics such as time, distance, and calories burned, privacy concerns
were also voiced. Fueling the fire was a d
emonstration in which University of Washington researchers
showed that they were able to create a surveillance system that could track people through the Sport
Kits. Although the RFID chips provide no personal identifying information, they could still be u
sed as a
means of surveillance to keep track of people’s whereabouts

and that had a lot of people questioning
whether that was a fair trade
-
off.

Keeping track of inanimate objects, such as hospital medical devices and property, through the use of
RFID tech
nology isn’t quite as controversial on the privacy front. Hospitals often have a difficult time
keeping tabs on equipment such as pumps, IV stands, and defibrillators. RFID can help because it
essentially works like a GPS system, showing hospital staff whe
re to find what they’re looking for. A
small tag or device is placed on the equipment and emits a radio wave that can be read by the
hospital’s network of receivers. The location of the equipment then shows up on the network.

The benefits of tracking medi
cal equipment are plentiful. Knowing where a particular machine is
located ensures that it is readily accessible when needed. It also reduces the possibility of it being lost
or stolen. And easy access can even keep daily operations flowing smoothly.

“Jus
t being able to find your assets quickly provides a hard dollar return on investment,” says Matt
Perkins, chief technology officer of Awarepoint, a company offering RFID asset tracking and real
-
time
location system solutions for the healthcare industry. “F
or example, if a pump is needed and the
hospital has made use of RFID technology, an Internet browser would pop up and indicate where the
nearest unused pump could be located. Because hospitals can’t literally keep an eye on equipment
that is constantly mo
ving around, this is a way to provide visibility to all their assets. They will no
longer have any shortage of equipment, and they’ll also know where things are located.”

Perkins adds that implementing RFID can also reduce the need or cost of rentals. “A l
ot of equipment
has to be rented to keep up with the hospital’s needs, but it may be unnecessary,” he explains. “For
instance, if the nurses report they don’t have enough fluid pumps, they’ll just do a quick rental, but
they may already have pumps availabl
e that they simply couldn’t locate. Another issue involved with
rentals is that they’ll keep the rented pump around for longer than needed because they’ll forget they
have it or it, too, becomes lost. Both situations are costly, and RFID technology could h
ave prevented
them from happening.”

Tracking Patients

Keeping track of patient data or records using RFID technology can also be useful and even prevent
errors. Hospitals often deal with errors associated with incorrect identification, says Rajit Gadh, PhD
, a
professor and the director of UCLA’s Wireless Internet for Mobile Enterprise Consortium, whose lab has
been developing various healthcare applications for RFID technology. Gadh refers to a report from the
Institute of Medicine that found the cost of me
dical errors, including the expense of additional care
necessitated by the errors, disability, and lost income and household productivity, to be between $17
billion and $29 billion each year for hospitals nationwide. “I believe that RFID can be a key enabl
ing
technology in helping drive down preventable errors,” he says.

Gadh offers a potential scenario in which RFID could prevent a crucial mistake. “If a non

English
-
speaking patient comes to the radiology department of a hospital and shares the similar nam
e of a
fellow patient, x
-
rays could get switched, and there could be an incorrect diagnosis,” he says. “But you
could use RFID to track the x
-
ray plates and the patients themselves. As the patient and the x
-
ray
plates move around the hospital, it becomes e
asy to keep track of them and ensure the correct data is
attached to the correct patient.”

Using RFID technology to track patients’ whereabouts for their own safety, as well as to limit the
hospital’s liability, is also a consideration. “Alzheimer’s patien
ts are prone to wandering, so this
technology can be used to keep an extra eye out on them,” says Perkins. “You can make sure they
haven’t wandered into an area where they shouldn’t be. It’s really a way to keep them safe.”

Similarly, Gadh says his lab ha
s been developing PediaTrak, a technology that would track newborns
in a hospital’s nursery. “If there were any unauthorized movement, like the baby heading toward a
door when it should not be, then the hospital could quickly locate the situation and deal
with it,” he
says.

In addition to monitoring patient movement, some RFID enthusiasts say that tracking employees
could add to the technology’s attractiveness. For example, RFID applications could allow healthcare
organizations to locate the whereabouts of
doctors during an emergency. Perkins also says that the
data collected from RFID tracking could actually prove that a particular hospital is understaffed in
certain departments or that staff in certain areas are being overworked. “It’s a great way to prove

what’s really happening instead of just making the claim,” he says. “So it ends up being a positive
thing.”

Concerns

Not necessarily, according to privacy advocates, who say it is this type of use

where people are being
tagged and tracked for surveillance

that raises flags. They argue RFID is ideal for tracking inventory
or perhaps pets but that when it starts monitoring the movements of human beings, a line has been
crossed.

“With each new technology that becomes more and more invasive, I’d argue that an
yone concerned
with issues of privacy needs to push for stronger privacy rights,” says Sue A. Blevins, founder and
president of the Institute for Health Freedom. “This chip of technology changes the issues dramatically
because it’s no longer just data abou
t the patient that’s being tracked but also the patient’s actual
whereabouts. It adds a greater level of concern.”

However, Gadh says a randomized ID number placed on the RFID tag should alleviate privacy
concerns. Under this premise, the randomly assigned

number is meaningless to anyone who doesn’t
have access to the hospital’s database. “Privacy issues are alleviated because the person reading the
tag would have to get past a firewall to log on to the database and interpret the information,” he says.
“And

only with proper authorization and HIPAA compliance would that information be released to
anyone else.”

However, this would require that institutions work to set their own guidelines to ensure that
employees

especially those with access to the database

ar
e acting ethically, says Blevins. This is
generally a bigger concern with high
-
profile patients. For example, Cedars
-
Sinai Medical Center
recently told the Los Angeles Times that approximately three or four workers are terminated annually
for trying to pee
k at patients’ records.

But even for the average patient, there are frequent news stories of patient data being stolen or
compromised. Last year,
The Wall Street Journal

reported that nearly 50,000 patient records had
been breached at NewYork
-
Presbyterian

Hospital/Weill Cornell Medical Center. And last summer, the
FBI reported investigating a theft of medical records at Grady Memorial Hospital in Atlanta.

“Stealing paper hospital charts was not easy to do in the past,” says Blevins. “I can remember
working

as a nurse, years ago, and paper hospital charts were stored on a rack where many
physicians and nurses could access them. But I don’t recall ever hearing of a stolen hospital chart
where I worked. However, moving those charts online could make it easier
for hospital records to be
stolen if strong security measures and privacy rights are not in place.”

Additionally, privacy rights are essential to gaining a patient’s trust, adds Blevins. “Trust really
matters,” she says. “Polls have shown that if a patient

does not trust their privacy will really be
protected, they will not be as forthcoming with information. That’s a concern not only on the individual
patient level but also because studies are often based on patients giving their own medical history or
des
cribing symptoms. In the end, if privacy rights are not upheld, quality data won’t be obtained and
the quality of healthcare and research could suffer as a result.”

While these privacy and security concerns are real, it seems most institutions are still st
rongly
interested in adopting RFID technology in one form or another. A study recently conducted by
BearingPoint and the National Alliance for Health Information Technology found that nearly three
quarters of healthcare organizations plan to invest in RFID

technology during the next two years. As
they transition toward adoption, hospitals will also have to work toward establishing their own set of
regulations and guidelines to keep the technology strictly controlled. It may have some people anxious
about a
possible slippery slope, but it seems inevitable that the technology will be widespread
throughout the healthcare industry.






Lindsey Getz is a freelance writer based in Royersford, Pa.