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„The Patient Must Remain in Charge of Its Data“
MEDICA.de talked to Oliver Koch of the department of Business, Communication, Management at the Fraunhofer Institute of Software and System Technology (ISST). The topics: how RFID is supposed to work with people suffering from dementia and how data protection should be handled in the European Union.
MEDICA.de: Mr. Koch, RFID has already put into everyday use. In Germany, the rail card 100 is equipped with an RFID-chip as well as the electronic passport. In Spain, guests visiting a disco agree to a chip implant voluntarily in order to avoid paying drinks at the bar and only once when exiting the bar. In which areas will RFID come into action when it comes down to healthcare?
Oliver Koch: Above all it will make sense during the automation of documentation processes. At the moment, information must be listed in several databases. The health insurance, for example, wants to know which and how much material was used during surgery. Physicians and nurses must also enter the same information into another database so that new material is ordered in time. These processes require a lot of staff which is expensive. However, if the material contains an RFID chip, the information be read once by a scanner and can then be transferred to different databases automatically. In addition, RFID can also make sense for the care of people with dementia. Some retirement homes use RFID bracelets that are carried by demented people with information on their rooms. If an inhabitant leaves its floor and passes a sluice, the system will release an alarm.
MEDICA.de: Are these all examples of a study that you carried out two years ago taking a close look at RFID in healthcare?
Koch: Yes. We examined 16 very different RFID research projects in Germany and Austria.
MEDICA.de: Any other interesting examples you investigated?
Koch: RFID was also used to trace back the journey of blood preservation in order to monitor who donated the blood, where it was stored and who received it. There are even considerations to integrate temperature readout into the chip for checking whether the blood units were stored with the correct temperature. However, this project, like many others too, is still in research phase. Another example is the use of RFID by hospitals on the newborn nursery. Mother and child received an RFID-bracelet directly after birth. When mother and child leave the ward together the system recognised that they belong together, but when a stranger leaves the ward with the baby, the system released an alarm.
MEDICA.de: And this also makes sense?
Koch: Since only very few babies are being kidnapped from a ward according to statistics, this does not really make sense. Such a system only uses a psychological level by creating a reassuring feeling for the parents. Using RFID in such a way is rather a pure marketing strategy.
MEDICA.de: What was the aim of the study you conducted?
Koch: We wanted to determine which areas can profit from RFID. Head physicians often demand better patient care with high quality and security. We wanted to find out whether RFID can help.
MEDICA.de: Why did you not resort to experiences from the USA? RFID is already used in some medical centres to save time and costs.
Koch: It is not possible to transfer such knowledge to other countries one to one. The health system in the States is quite different from that in Germany, Austria and other European countries. Moreover, implanting a chip with data on the patient’s medical history as happens in the States is - from our point of view - not really necessary. A bracelet with an RFID chip on the other hand may be useful in order to better identify the patient that is next on the operating table.
MEDICA.de: Data security officials criticise RFID. They fear that confidential information can easily be accessed by unauthorized people.
Koch: These are legitimate concerns. Therefore, the federal data protection act is concerned with such issues in Germany and at EU level a commission also deals with questions concerning data security. The reality so far is that the chip – in its elementary form - only contains a number that needs to be fed into a system on a computer, for example, before it coughs out the patient’s name making the number useless to unauthorized people. It is more difficult when other information about the person or medical history is collected on the chip – the patient must always approve to such a process beforehand. In these cases, more consideration is needed on how the data channels and the data itself on the chip can be encoded preventing unauthorized people from reading information that is being transferred. Moreover, it must be determined who is authorized to read the data and the system in which the data is stored must be secure. The patient must remain in charge of his data.
MEDICA.de: Do you think that RFID will become part of everyday life in hospitals in future?
Koch: I do think so. Some questions remain open, though. For example, an RFID infrastructure costs a lot of money and hospitals will consider where the technology is advantageous and where not. The decision for RFID certainly will be easier if manufacturers sponsor such projects. And we have to determine where RFID can be put into practice without disturbing medical equipment. Some studies show that RFID radiation can influence medical devices.
The Interview was conducted by Simone Heimann.
What is RFID?
An RFID system is made up of a recordable microchip, an antenna and a scanner. RFID stands for Radio Frequency Identification and means radio transmission. It is an alternative to the bar code in the supermarket. Its specific quality: An RFID chip can be recognised through a distance of up to some metres.
Moreover, products or living beings which carry an RFID chip can be identified. A chip on a drug packaging, for example, provides information about which product it contains, when it has left the storehouse, how long it was stored and when a patient took it.