July 2008

Study Reveals RFID Technology Can Interfere With Medical Equipment

Scientists have revealed that radio frequency ID (RFID) can interfere with medical equipment according to a controversial study published in 'The Journal of the American Medical Association' that warned hospitals to conduct urgent safety tests. RFID technology is commonly used in the retail sector as anti-theft devices on goods but is predicted to be used increasingly in health care. The tags are currently used in everything from security to TfL's Oystercard, of which 17 million cards have been issued. Hospitals are starting to become aware of the potential of the product that could be used to monitor temperature sensitive products such as blood or to track medical items and surgical tools. RFID tagged wristbands are currently used in some hospitals to ensure the correct procedures are carried out on patients, but the future of healthcare is likely to involve far more RFID-style technology. A recent Ofcom report predicted that in-body and on-body wireless networks could become the norm for monitoring patients over the next decade.

However, the study by six Dutch scientists at Vrije University, in Amsterdam found that RFID tags could interfere with equipment such as respirators, external pacemakers and kidney dialysis machines. The same group published a study last year indicating that mobile phones could also affect critical care equipment in a similar fashion. This shouldn't come as a surprise to anyone who's experienced interference from a wireless device of some kind. It is quite absurd that with all the different signals filling the air around us someone hasn't thought to test this before.

A series of tests conducted at the Academic Medical Centre in Amsterdam made the ominous discovery that electromagnetic interference (EMI) generated by 'track-and-trace' chips has not only the potential to cause disruption to medical devices, but also poses a hazard to patients. The research examined the effect of holding both passive (868MHz) and powered (125kHz) RFID systems close to 41 different medical devices found on intensive care wards, including dialysis machines and pacemakers. Three tests were carried out on each piece of medical equipment with passive systems requiring a reader device and powered systems transmitting active information. In a quarter of the 123 tests the signal emitted by the smart cards interfered considerably with a machine. According to a critical-care scale, twenty-two of the incidents were classed as 'hazardous' whereas two were 'significant.'

Alarmingly, fifty percent of the electrical equipment was so unstable patients were at risk when RFID chips were in the vicinity and nearly twenty percent of cases involved serious malfunctions. This included causing breathing machines to shut down; mechanical syringe pumps that stopped delivering medication; and external pacemakers, usually attached to heart attack victims to turn themselves off or to read a patient's heart rate incorrectly. The Dutch study found that passive RFID systems caused sixty-three percent of incidents compared with twenty percent of errors in active signals when held at an average distance of 30cm. However, some 'hazardous' incidents occurred when the RFID card was more than ten inches away.

The Food and Drug Administration (FDA) is testing some medical devices in response to the study with the aim of 'determining the vulnerability and to what extent such vulnerability may be a public health concern.' The FDA underlined that while they were aware of the potential problem they have never received reports of injuries directly caused by electronic interference with the devices.

The 'JAMA' editorial said hospitals should consider surveillance for interference problems that employees haven't noticed or reported. It was also recommended that regulatory agencies should determine if new safety measures are required. The report abstract stated, "In a controlled, non-clinical setting, RFID induced potentially hazardous incidents in medical devices. Implementation of RFID in the critical-care environment should require on-site EMI tests and updates of international standards."

Dr. Erik Jan van Lieshout, the study co-author and critical care specialist at the University of Amsterdam's Academic Medical Center urged hospitals and manufacturers to carry out thorough checks on RFID devices. "The results show that it's crucial for hospitals to test their wireless items before using them around equipment essential for keeping patients alive. New and unfamiliar technology has to be carefully managed in wards with complex medical equipment. Attention must be paid to these findings, it is of urgent significance."

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Implantable RFID Pellets & Syringe

It seems hospitals; manufacturers and regulators have some immediate work to do, not just regarding RFID tags but also to examine whether similar problems are occurring with wireless technology in other critical care units. However, some experts are suggesting the report is an overreaction and are seemingly reluctant to make drastic changes.

NHS computer specialists claim that the microchip-based 'smart' systems will eventually improve patient safety. A spokeswoman for NHS Connecting for Health, which manages various IT projects across the health service, said that RFIDs had the potential to reduce mistakes caused by the wrong identification of patients. She said, "Any product such as this which is for use in a healthcare setting has to meet a standard which means it is very unlikely to interfere with medical equipment. This risk is more likely to come from RFID tags from other sources - such as a travel card, a tag on clothing, or on another retail item."

Already at Heartlands Hospital in Birmingham patients heading for the operating theatre wear an RFID wristband so that even when anaesthetised their full identity including a picture, can be downloaded into a PDA held nearby. A spokesman for the Medicines and Healthcare Products Regulatory Agency said that the vast majority of machines used in hospitals had been thoroughly tested to ensure they could not be affected by electrical signals. He said, "the MHRA has received very few reports of adverse events caused by this problem over the last seven years or so. Of the incidents reported, only a very small number have been proven to be as a direct result of EMI.

There are some particularly sensitive pieces of equipment where you might expect there to be interference, but for everything else it would be impossible for RFID cards to cause this problem."

Some medical microchip manufacturers have dismissed the reports, suggesting the systems can improve patient safety and that for hospitals to reject such technology because of the new study would be short sighted. Of course, it is pretty obvious they have their own agenda to consider. But it's not just health risks for the medical industry to worry about. Scientists in Germany discovered that the smart cards could be easily breached using a normal computer and a card reading device. This is likely to end any interest that the British government had in 'tagging' persistent offenders with RFID implants, which could contain data on their identity and criminal records.

By Tom Tainton, Smart Card & Identity News





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