May 24 2006

By Susan Levine
Washington Post Staff Writer

At least three hospitals in Montgomery County and the District are now equipped to scan emergency room patients for a tiny electronic implant that can provide important medical information when an unconscious, incoherent or confused person cannot.

The VeriChip technology involves a microchip no bigger than a grain of rice that is inserted under the skin and a hand-held device that reads the 16-digit identification number it contains.

For an authorized physician or nurse, that number is the key to computerized records that could list a person's prior medical conditions, current medications, allergies and even directives on organ donation and other end-of-life issues.

Suburban Hospital in Bethesda trained about two dozen staff members to use the system this spring, and Shady Grove Adventist Hospital in Rockville has scanned one patient -- who, as it turned out, did not have a chip.

Washington Hospital Center also is set up to scan ER arrivals, although a spokeswoman said that it will not begin doing so until a large enough number of people in this area have signed on through their doctors.

Therein lies the most immediate challenge for the VeriChip Corp., which received government approval to manufacture and market the implant for human use about two years ago.

The Florida company says that just shy of 100 hospitals have scanners, which is about the number of people who are walking around with a microchip in the back of their right arms. About a quarter of those are in the Washington area; most are in their sixties or older, and half have some degree of dementia.

"I hope eventually it will be very popular," said Robert Rothstein, director of Suburban's emergency department. "It's got utility."

At least several times a day, Rothstein's department is faced with a patient who cannot list all the drugs she is taking or the date of his last tetanus shot or the findings of a recent EKG -- all details that can influence treatment by ER doctors and nurses.

An elderly person with Alzheimer's disease, brought in after wandering away from home, may not even be able to provide a name or address. But an implanted VeriChip could.

Suburban's scanner is tucked within easy reach in a marked, bright-purple folder. If and when the hospital begins using it routinely, Rothstein anticipates not just life-saving situations, but also instances in which the information gleaned saves time and costs and helps reduce medical errors: "It would be part of [the] lexicon: 'Scan 'em.' "

Shady Grove Adventist acquired its device because of requests from doctors in the community, said Debbie Foshee, the hospital's vice president of quality and medical staff services. She also sees the value of the implant, especially for someone with a complex medical history. But its true efficacy, she noted, "is really going to depend on the use of it by the public."

How quickly that might accelerate, or be dampened by privacy concerns about the data's security and possible misuse, is unclear. Even at the New Jersey facility that last year became the first to scan ER patients as part of its protocol, no chips have been detected.

"No hits," said Joseph Feldman, chairman of Hackensack University Medical Center's emergency trauma department. "It's so new."

Chevy Chase geriatrician Jonathan Musher remains optimistic. Sunday night, a local hospital ER that he would not identify called him about one of his patients. The staff member wanted to know medical specifics about the woman, who is in her late seventies with dementia.

"She has a microchip. You can scan her," Musher responded.

Only problem: The hospital wasn't ready with a scanner.