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Welcome to the Smart Cards and Health Care mini wiki at Scratchpad!
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The purpose of this wiki is to educate readers about the use of Smart Cards in the Health Care Industry; the advantages, disadvantages, and potential implications that may arise as these cards become more widespread throughout the Health Care Industry.
What are Smart Cards? and What Do They Store?
Smart Cards are plastic cards with computer chips embedded inside them. Smart Cards can hold up to 64 kilobytes of data including:
- Personal Identity
- Medical History
- Insurance Information
- This information can only be accessed by specialized readers.
No one can read what is contained on the smart card’s microchip or use the card to access computerized records without a personal identification number and authorized hardware and software.
Have the ability to disaggregate data and encrypt information can protect an individual’s right to privacy while still allowing multiple healthcare facilities to share patient information more efficiently.
- These chips can store information: Memory Cards
- They can also process information: Microprocessor Cards
Smart card manufacturers offer a variety of both "contact" and "contactless" cards.
- Contact cards feature a metal plate that physically engages electronic contacts within a card reader.
- Contactless smart cards transmit and receive data via radio frequency technology at distances ranging from a few millimeters to several inches.
Recently, card manufacturers have developed "combi" cards, which offer the functionality of both contact and contactless technology. A batch order can cost just under a dollar each, much cheaper than when they first appeared at $15 per card.
Advantages of Using Smart Cards in the Health Care Industry
- Speedy communication in the event of a medical emergency.
Smart Cards allow a doctor to pull up a patient's entire medical history in seconds.
- Increased Productivity in the medical work force.
Since Smart Cards can store a patients entire medical history as well as their health insurance plan,it allows health care workers to spend more time caring for patients and less time wading through endless paper forms.
- Reduced Operating Costs.
The reduction in operating costs has also allowed patients to save money as well because these costs would otherwise be passed on to them.
Disadvantages of Using Smart Cards in the Health Care Industry
The only way a Smart Card can be updated is if a cardholder currently vists a physician or hospital. Therefore, it may cause the need for a fall back plan such as being able to look up the patient in question in a nationwide database.
- Infastructure Changes/Adaption
This new technology is only useful if a medical facility updates its infastructure to suit the new technology. Therefore, if a cardholder enters a facility that does not have the proper reading equipment, the card is useless.
This section will explain the possible implications that may arise in our society as this technology becomes more widespread throughout the Health Care Industry.
- PRIVACY ISSUES
As more and more hospitals and physicians offices begin to adapt to this new technology, access to an individual's health records will be made easier and faster than ever. This technology also allows health care systems to share information about a patients at opposite ends of the U.S.
- A stranger with access to a portable reader can scan a person's card and find everything out about their health care history, including their insurance information.
- Some companies such as insurance agencies and employers may offer monetary means for information accessed from Smart Cards.
For example, if one is applying for a job or a new insurance policy, they may be declined because of what was information was found on their card.
Who's to say that a health care employee with access to a patient's information can be trusted. Some may act unethically by illegally solicting vital health records about a person of interest to companies in order to make a quick buck.
- Given the proper reading equipment, medical companies may have access to our health information.
This could allow them to use it in order to develop a wide customer database for the sale of their products.
- The Government may have access to this information and use it in ways that may jeopardize our Constitutional rights.
For example, it may be possible to use these cards as a tracking device on individuals with contagious diseases.
- IMPACT ON OUR PERSONAL LIVES AND BEHAVIOR
Some may not want to in engage in friendships or serious relationships with cardholders because of the information that they discovered from their card.
Only time will tell if people will be willing to jeopardize their privacy by using smart cards in order to better insure proper care in the case of an emergency and perhaps spare them a few minutes while awaiting medical care.
Expert Opinion: PRO
- Al Marino, CIO Queens Health Network,New York, said patient Saftey was the main reason they adapted to the new cards.
"Smart card technology showed some potential to remove costs at Queens Health Network, but the underlying motive was patient safety," says Marino. "It had the potential for improving patient care."
Expert Opinion: CON
- John Quinn, a senior executive in New York-based Accenture's health and life sciences consulting practice says,
"The key tests are human behavior-whether card users and caregivers are willing to change the way they do things to accommodate this medium-and how much money providers can spend on the technology.They do fit for portability, capacity and capability. But we haven't seen a business driver, in other words, people saying we can do this faster by using smart cards. Some people just dont want that kind of information about them to be that easily obtained."
- CrytoCard's McTaggart says,
"Perhaps the biggest obstacle to U.S. smart card adoption--for consumers and businesses alike--is the lack of cultural acceptance.Why has North America been that much slower than elsewhere to embrace smart cards technologies as a whole? The reason is that consumers aren't feeling deprived of being able to do something because they don't have smart card technology, and because they don't feel deprived, they don't rush to adopt them. The technology purist will suggest, 'Yes, but with smart cards we can do all these multifunction cool things.' That's true, but the consumer says, 'So what?"
- Nancy Libin, staff counsel at the Center for Democracy and Technology, a privacy advocacy group says,
"Most people, if given a choice of one key that would open their house, open their car, start their car, and open several other locks, would likely choose to carry multiple keys because of the fear of losing the one multi-use key. Likewise, a smart card that includes a national ID, multiple credit card accounts, and other data could cause many problems if it was lost."
- University of Pittsburgh Medical Center
UPMC found it difficult for their technology infrastructure to keep up with their 20 hospitals, over 5,000 doctors and 400 offices.Following a successful two-year pilot project, the UPMC smart card, called the Healthcare Passport, has now been distributed to 2,000 UPMC patients. For the patient, the immediate benefits include speeding the check-in process during office visits.
- Mississippi Baptist Health Systems.
70,000 current card-carrying members of their system. MBHS hopes to reach new levels of patient convenience, safety and privacy with the smart card program. Their goal is to replace all legacy cards within two years of the institution of the new program. The cards will contain a subset of the patient's medical record and demographic information. When visiting a doctor's office, emergency room or clinic, upon presentation of the patient's card, a form specific to the site visited will print out.
- Briggs,Bill. Are Cards Really A Good Bet? Health Data Management.com. April 17,2007.<http://www.healthdatamanagement.com/html/current/CurrentIssueStory.cfm?articleId=12884>.
- Briney,Andy. A Smart Card For Everyone? Information Security.
- HIPPAAdvisory: Smart Cards. HIPPA Advisory.com. April 2006.
- Gilbert, Aloria. Patient Smart Cards Get Boost at N.Y. Hospital. C.Net News.com.
- Gross,Grant.Smart ID Cards Debated.PCWorld.September 2005.
- Moore,Roy. Smart Card offers ease,opportunity for health care industry.
Nashville Business Journal.com. March, 2006. <http://www.bizjournals.com/nashville/stories/2005/03/07/focus5.html>.
- Rapid Expansion of Smart Cards in Government Evident as Smart Card Alliance
Conference Concludes. Smart Card Alliance.com. April 17, 2007. < http://www.smartcardalliance.org/articles/2007/04/17/rapid-expansion-of-smart-cards-in-government-evident-as-smart-card-alliance-conference-concludes>.
- Smart Cards in U.S. Healthcare. Smart Card Alliance.com. February 2007.
- Smart Health Cards: HIPPA and Beyond. August 2005.