Ethical Use of RFID in for the Surveillance of People and the Tracking of Things in Healthcare Delivery

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1 Ethical Use of RFID in for the Surveillance of People and the Tracking of Things in Healthcare Delivery By Michael J. Wilson M.Sc. ehealth Candidate McMaster University Canadian Bioethics Society Conference 2009

2 Toward an RFID Acceptance Model in HHS Hospitals By Jen Lawson, Mike Sowerby, Michael J. Wilson Health Research Methodology 724 Dr. Ann McKibbon December 9, 2008

3 Common Everyday Applications Checking out and tracking library books Transponders on highways, parking lots Identity cards for subways, enhanced driver's licenses, gas and credit cards (1 billion Chinese ID Cards) Supply chain management, factory pallet to transport (sea & land) to store shelve and container tracking ID for 50 million + house pets - kitty flap Store shelve item inventory and customer billing

4 Common Healthcare Applications Asset tracking, i.e. hernia meshes, lost surgical sponges, medical devices like pumps, operating room supply automated inventory management Patient monitoring Blood product and drug prescription tracking 5 Rights right drug, route, patient, dose, time Dementia patient wandering and seniors falling Pandemic surveillance of patients and healthcare staff whiteboard as electronic tracking system

5 Technical Overview Tag types Passive, active and semi-passive Memory Readers Operational spectrum Standards EPCGlobal Internatonal Standards Organization (ISO)

6 Barriers to RFID Adoption Hardware and tag costs Systems integration Issues Project complexity Data volume and quality Privacy, security and ethical considerations Perceptions of the use of RFID as a new technology, i.e. the Big Brother is watching scenario Anti -RFID consumer lobby

7 Privacy, Ethics & Security Privacy Legislation, Ethics & Guidelines The Privacy Act, The Canadian Standards Association Privacy Code PIPEDA, PHIPA Professional Codes of Ethics Privacy Commissioners Federal and Provincial Research Ethics Tri-Council Policy Statement CIHR: Best Practices for Protecting Privacy in Health Research Tracking, GPS, Surveillance Research

8 Privacy and Security of RFID

9 Privacy vs. Security Privacy by Design, Privacy & Security Ann Cavoukian Privacy Commissioner of Ontario RFID and Privacy: Guidance for Health- Care Providers, 2008 Standards for RF security in Healthcare & danger of EMI, (Electromagnetic Interference) Concern for private health information data in wireless transmission to EHRs

10 Public Perception of RFID Katherine Albrecht - Subcutaneous chip implants the VeriChip Bodily Integrity Act Public Surveys of Attitudes Toward RFID technology Nurses attitudes towards surveillance

11 A Business Model for Healthcare? Walmart or FedEX supply chain management model applied to Healthcare patients and processes as tagged and tracked objects Data mining linkage to personal information Ubiquitous wireless tracking and blanketing of people and things

12 Concerns of Healthcare Professionals Jane Sparks, RN, Msc. Ehealth student I don't want to use my hands Wearable computers, i.e. RFID tags threaded into clothing Indonesian Health Minister wanted to RFID chip implant all HIV/AIDS patients in Indonesia 2008

13 Clinical Trials & Social Dimension Subcutaneous Implant class II medical device clinical trials involving RFID use with Alzheimer's patients, and preventing seniors falling Administrative efficiency vs. healthcare practitioner reality Gap in literature and research on social acceptance of RFID in Canadian heathcare systems

14 Subcutaneous Chip Implant John Halamka, MD, MS Has a Verichip implant Chief Information Officer of the CareGroup Health System CIO and Dean for Technology at Harvard Medical School, A practicing Emergency Physician. New England Journal of Medicine NEJM, Straight from the Shoulder

15 The Future of RFID in Healthcare Can RFID applications be implemented ethically in healthcare? YES Can privacy and security concerns for RFID in healthcare be surmounted? YES Will RFID technology be accepted and will it increase efficiency, reduce errors etc.? YES

16 The Future of RFID in Healthcare Will we all be implanted with RFID chips for Healthcare reasons? ANSWER: Ray Kurzweil is right. We are approaching the Age of Intelligent and Spiritual Machines THE SINGULARITY - so it really doesn't matter.