Running head: Biometrics in Healthcare
Biometrics in Healthcare
John Richardson
Ferris State University
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Abstract
Today biometrics is the use automated sophisticated technology that identifies and records a
specific unique individual characteristic of a human to be used to then identify that person in the
future. The healthcare industry is beginning to utilize this evolving technology to meet the
growing need to keep information secure and to accurately identify the consumer. There are
several benefits and liabilities discussed that are associated with this technology.
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Biometrics in Healthcare
The practice of identifying an individual by their unique characteristics has been used as
long as humans have existed. Hair and eye color, stature, gait, voice tones along with many other
unique traits are all used to differentiate ourselves and others. Biometrics is the term used to
describe this process. It is “derived from the Greek word bio (life) and metrics (to measure)”
(Smith, 2006). The National Science and Technology Council (NSTC) gives a history of the use
of biometrics, tracing it back to fingerprints in clay used in 500 B.C. by Babylonians in business
transactions.(Smith, 2006). Today the term biometrics is more commonly applied to complex
automated systems used to identify individuals. The healthcare industry is beginning to utilize
this technology for both staff and patient recognition.
Biometric science
Biometrics is a science that focuses on the statistical analysis of physical or behavioral
traits to determine individual identity. Any human biological or behavioral characteristic can be
used as long as it meets four characteristics according to Mordini and Massari: “1) collectability
(can be measured): 2) universality (exists in all persons): 3) unicity (must be distinctive to each
person): 4) permanence (remains permanent over time)” (Mordini & Massari, 2011). There are
many characteristics that are currently being used or are in the process of being investigated for
use, these include but are not limited to: fingerprints, iris, palm, palm veins, facial recognition,
voice recognition, keystroke, body odor, neural wave analysis, skin luminescence and tissue
electrical signal.
The process of identification through biometrics is much the same as it has been over the
centuries. A unique feature is identified, recorded, and then retrieved so that an individual may
be differentiated from any other. In her history of biometrics, Smith from the NTSC, describes
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the first such known system in France, where court systems used height, arm length and other
parameters to record and track offenders. Today the use of biometrics involves many more
complicated processes enabled through automation and the connectivity of computerization. The
specific trait is processed through the appropriate technology and converted to a recordable set of
data. The data is then stored in a data base. Once the data is there the next time the individual
utilizes the technology the stored data is compared to the current data and a match is achieved,
successfully identifying the individual.
Healthcare Applications
There are two primary applications for biometrics in healthcare; recognition of the
healthcare consumer and recognition of the individuals involved in providing healthcare. There
are unique reasons and difficulties involving the use of these technologies for both of these
populations.
Providers
The healthcare industry has a need for a reliable cost effective means to provide specific
access to only certain information, physical entry to areas and access to medications. This need is
a result of stringent laws and regulations that govern and limit the access to the consumers
themselves, medications and medical information. The major piece of legislation the puts forth
these requirements is The Health Insurance Portability and Accountability Act of 1996 (HIPAA).
HIPPA‘s “goal was to make health insurance portable from one job to another and secure the
privacy of medical records” (Burke & Weill, 2009). At the same time the federal government has
placed a national goal of all medical records to be electronic (EMR) by the year 2014(Burke &
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Weill, 2009). The accessibility to an interconnected EMR with the penalties placed by HIPPA
has made the security a priority.
Traditionally access to electronic health records has been secured by password logins.
Most health systems have multiple systems with unique password requirements. As a result
passwords are commonly written down by providers, compromising their security if lost, or are
simply forgotten. Forgotten passwords are a great cost for health systems.
Access to secured cabinets or doors to buildings or specific areas has been another issue
for the healthcare industry. Keys, keypads, and key cards have all been utilized in attempts to
maintain security and limit access. Each of these methods has their limitations, keys and
keycards can be lost or stolen, combinations compromised. Biometrics gives the healthcare
industry a viable option to replace these older technologies with newer more secure methods of
providing security. Biometric applications are available for all of these applications and are being
currently utilized by a limited number of healthcare settings.
Consumers
The need to identify correctly identify patients is another issue in healthcare. There are
consumers that are unable to identify themselves for a variety of reasons that include many
things from emergency situations in which the consumer is unconscious to cases of fraud in
which individuals attempt to seek treatment or access information through either an alias or by
using another individual’s identity. Using biometrics to identify individual consumers would
offer a feasible option to resolve these issues.
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Issues
The use of biometrics has several issues that have made the healthcare industry resistant
to its adoption and implementation. The major issues surrounding these technologies are cost,
accuracy, infection transmission and ethics.
Costs
The costs of the initial investment in the hardware or equipment for biometric systems
can be substantial. In the current economy with governmental and insurance cost containment
measures, health systems are having a difficult time justifying investment in biometric
technologies despite their advantages. However, according to several sources, the entire industry
may actually financially benefit from the use of these systems. Mooney gives the example of the
cost effectiveness at Aspirus Wausau Hospital in Wisconsin. The hospital switched to hand
readers for their employees. After doing a cost analysis it was determined that the Hospital had
been spending more than $2,000 monthly on replacing smart cards for its 3,000 employees. Wisz
points out that insurance agency may be interested in assisting with the cost to help minimize
fraud. He goes on to say that “according to The Medical Group Management Association,
leveraging such technologies should save approximately $1 billion dollars annually by reducing
repetitive data entry and transcription errors” (Wisz, 2009).
Accuracy
Biometric systems have varying degrees of accuracy. Their use and implementation need
for specific applications. Current fingerprint technology is fairly limited; it is approximately
“99.9% accurate, with that rate declining after the age of fifty years old” (McBride, 2005). It is
commonly utilized to replace passwords in a login system. More accurate, but more expensive
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technologies include “the living palm” in which an infrared scan is performed mapping the veins
of the hand. This technology “has a false acceptance rate of 0.00008 percent” (McBride, 2005).
In his article A New Application for Biometrics Martin gives an account of an early
unsuccessful implementation of iris scanning technology at Eagleville Hospital in Pennsylvania.
In 2003 the hospital installed iris scanning technology. The 100 bed hospital installed desktop
cameras at 100 computers. The initial scanning was time consuming, taking up to twenty minutes
for each employee. Once the initial scan was done, the employees were having a difficult time
logging in. there were multiple daily calls to the IT department for assistance. When the hospital
contacted the vendor, they were informed that it was because of the cameras and just needed to
replace all of them. The hospital elected to go back to using passwords.
Ethics
The use of biometrics has many ethical dilemmas associated with privacy. By the nature
of the technology biometrics collects more data than needed for its application. Face recognition
records information that can be interpreted for emotion, race and other deviations. An
individual’s movements can be tracked. Some technologies record other indications of biology
and disease, such as neural wave analysis and body odor recognition. Mordini and Massari
discuss several of these ethical dilemmas. They define functional creep: “is the term used to
describe the expansion of a process or a system, where data collected for one specific purpose is
subsequently used for another unintended or unauthorized purpose” (Mordini & Massari, 2008).
A current comparison is the data mining done by both facebook and Google, profiting off of their
unwitting user.
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Infection transmission
Several of the early technologies such as finger prints were discouraging for health care
because of the need to minimize the spread of infection. The sensitive nature of the devices often
precluded them for being cleaned with the necessary chemicals. This problem is especially a
concern for the use in patient recognition. Newer non-touch technologies that include iris
scanning and infrared palm readers are helping to alleviate this issue.
The future
The future of the science of biometrics is in bi-modal operations; which simply means
that two factors or more characteristics are used simultaneously to increase accuracy. Neural
wave, skin luminescence and odor detection are the newest technologies in development,
offering increased specificity for each individual. While the technologies continue to be driven
by other industries such as the military and other governmental needs implementation in the
healthcare industry remains questionable. In an interview with Craig Rush, the IT director at
Pennock Hospital (appendix A), he echoed the rest of the health care industry, explaining that it
was too costly and not in the future plans of the hospital.
Summary
Biometric systems offer a feasible means for the healthcare industry to comply with laws
and regulations that demand electronic medical records while also requiring absolute security to
that information to maintain privacy. This technology also offers a method to identify individuals
to minimize fraud and data errors. Although many obstacles exist, the implementation of
biometrics will continue to make its way into the healthcare industry because of the unmatched
advantages that it offers.
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References
Burke, L., & Weill, B. (2009). Information technology for the health professional. Upper Saddle
river. N.J.: Pearson.
Gates, M.A. (2007). And the password is..biometrics. For The Record, 19(16), 14.
McBride, M. (2005). What you know, what you have, what you are: state-of-the-art biometric
authentication senses living body parts to ensure positive identification. Health
Management Technology, 26(12), 10. Retrieved from EBSCOhost.
Mooney, J. (2008). A handy prescription. Healthcare building ideas, 4(4), Retrieved from
http://www.healthcaredesignmagazine.com/ME2.Sites/Segemnts/Publications/Print.asp?
M
Mordini E, Massari S. Body, biometrics and identity. Bioethics [serial online]. November
2008;22(9):488-498. Available from: CINAHL Plus with Full Text, Ipswich, MA.
Accessed March 14, 2011.
Shin, Y., Kim, J., Lee, Y., Shin, W., & Choi, J. (2008). Formal implementation of a performance
evaluation model for the face recognition system. Journal of Biomedicine &
Biotechnology, Retrieved from EBSCOhost.
Smith, K. National Science and Technology Council(NSTC), Subcommittee on biometrics.
(2006). History of biometrics Washington, DC: Retrieved from
biometrics.gov/Documents/BioHistory.pdf
Williams, R., Barr, M., & Haimes, E. (2008). The bioethics of security. Bioethics, 22(9), ii-iii.
Retrieved from EBSCOhost.
Wisz, M. (2009). The eyes have it. Health Management Technology, 30(3), 34-35. Retrieved
from EBSCOhost.
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Appendix A
Interview
Craig Rush, IT Director Pennock Hospital Hastings, MI
1)
What type of biometrics that are used at Pennock?
a.
CR- We utilize finger scanning technologies with our Pyxis medication dispensing units.
– No other at this time.
2)
Does Pennock use a main system like Meditech or Cerner?
a.
CR – Pennock utilizes an EMR (Emergency Medical Records) Management System
called Meditech. It has been around for quite some time, but is not widely utilized in larger
health systems such as Sparrow or Spectrum.
3)
What departments utilize this type of technology?
a.
CR – Pennock is deploying EMR throughout the health system including our physician
practices. The timeline for completion of deployment is 2013, although it is going much slower
than anticipated.
4)
What are the advantages and disadvantages of these technologies?
a.
CR – One of the advantages is the fact all of the medical records are typed into the
system and do not require additional entry or interpretation of writing by someone else. Also an
advantage is the speed in which records can be both retrieved and printed out. These records are
also saved electronically in the system and there is less cost for long term retention.
Disadvantages include training a population of care givers that has never used a computer for
keeping medical records. Most do not like the system and insist it slows down their ability to
provide proper medical care.
5)
Are they reliable and what are the back-up systems in case of failure?
a.
CR – Pennock maintains an off-site data storage facility that has replication of all
Meditech records through a fiber optic connection – the fastest a business can purchase.
Pennock also utilizes tape backup systems that each night stores all of the data on tape for
retention and recovery. Many of the key systems are also covered by 24x7x365 support
agreements. It is costly to maintain, but a requirement for Pennock to provide proper services
and care to patients.
6)
Is Pennock looking at further use of biometrics? If so what are the short term and long
term goals for the development and implementation?
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a.
CR – There are not currently any plans for biometrics, short or long term, at Pennock.
There has been discussion of use possible SMART card or proxy card technology to embed into
employee badges, but the use of biometrics is difficult with universal precautions. You cannot
scan your fingerprint with gloves on, after all!