The article posted on this page appeared on the CNN website on March 15, 2010. It tells of the use of iris scanners in a low income Bronx health clinic to prevent mix-ups among the patients. The high tech scanner, usually seen only in airport security systems, is an important and useful tool for the Bronx clinic, and a welcomed one in an under-served community.
At the same time, this article is yet another reminder that technology advances in the health field have the potential to leave people with disabilities behind. If you don’t have an iris, an iris scanner cannot help you.
Accessible Electronic Medical Records: Now is the Time
The Bronx Clinic’s iris scanner is a close cousin to electronic medical records at the center of the increasingly important issue of Health Information Technology (Health IT). Today, billions (yes – billions with a “b”) of dollars are being spent to convert old fashioned paper records to electronic medical records. The conversion is part of a comprehensive effort to avoid medical errors that result from handwritten notes, lost files, and the lack of instant access to a patient’s medical history.
On March 15, 2010, disability and civil rights organizations around the country are submitting comments to the Department of Health and Human Services explaining that “meaningful use” of electronic medical records must include full accessibility requirements.
These comments will explain that not everyone can use a mouse, read standard size font, or access video without captions and will emphasize that people with disabilities must be able to access their personal medical records on line just as sighted people do. Medical professionals with disabilities need access as well. On-line content that meets the Web Content Accessibility Guidelines will ensure that this happens and must be integrated into all Health IT standards.
Every person working on technology designed to protect the privacy — and in turn the health — of American consumers must remember that the public includes people with a wide range of disabilities. An iris scanner to prevent medical mix-ups is good, but not without the recognition that it won’t work for everyone, and the alternative solutions that go along with that recognition.
At Bronx Clinic, the Eyes are Windows to Medical Records
CNN (March 15, 2010)– Rafael Fernandez walks into the Bronx, New York, medical clinic, with his eyes wide open.
Checking Fernandez in, a clinic employee scans his eyes using a handheld camera. Within seconds, the camera reads his iris patterns, and a computer locates his medical record.
Such iris identification technology is usually seen in international airports to allow registered passengers to fast-track through passport checks and immigration.
But far from the sleek European airports, the South Bronx clinic that receives federal funding and operates in one of the most impoverished U.S. areas uses the instruments to prevent medical record mishaps.
Fernandez, a patient of five years at the Urban Health Plan clinic, said the iris scanning makes his visits more convenient.
“It’s a shorter wait,” said the 72-year-old. “I wait less, and it’s more efficient. Everything is on computers. It’s faster, and I don’t have to stay too long. It’s in and out.”
Urban Health Plan, which serves mostly the uninsured and underserved, fully integrated iris identification to match patients to their medical records in 2009.
With a heavily Hispanic client base, where some of their 37,000 patients speak limited English and only a few provide Social Security numbers, the clinic encountered cases of mistaken identities.
It had 50 Maria Hernandezes, 66 Maria Gonzaleses, 55 Jose Gonzalezes, 83 Carmen Rodriguezes and 103 Jose Rodriguezes, according to the clinic.
If a health worker is “busy and doing a couple different things, it’s easy to click on the wrong one,” said Alison Connelly-Flores, the clinical system administrator at Urban Health Plan. There were ways to check the patient’s birth date, but “it was still possible to make a mistake.”
There are many patients with similar names and you want to make sure you get the right patient. In health care, risk management is an important thing. You want to avoid medical errors. You want to make sure you treat the right patient. You don’t want to give the wrong medication. — Dr. Samuel De Leon, the chief medical officer at Urban Health Plan.
With growing concerns about such errors, medical identity theft and insurance fraud, health technology experts say more hospitals are looking for better identification tools.
So how do you solve a problem like too many Marias?
A few hospitals use biometrics such as palm, eye or vein pattern readers, which are methods to recognize a person based on unique biological characteristics, according to companies that create the technology.
By using the eye scanner at Urban Health Plan, Maria Hernandez would get her specific medical record and not get mixed up with another person who has the same name.
“We are in the poorest congressional district in the country,” Connelly-Flores said. “Being able to use this kind of technology is impressive.”
In 2006, De Leon contacted a small iris identification company in Chantilly, Virginia. He was looking for ways to reduce errors at the clinic.
The clinic photographed its patients, but that was imprecise. De Leon didn’t want to use fingerprints, because some patients associated that with the police and crime. He didn’t want to use palm readers that required physical contact because that would easily spread germs. So he set his sights on iris scanners; it didn’t require touching and didn’t carry the negative connotations.
But the iris technology back then was bulky and too expensive for the health clinic — as De Leon described, “cool but impractical.”
The clinic formed a partnership with the company Eye Controls to develop a more user-friendly model, consisting of a handheld iris camera and software to reduce identification errors.
“The acceptable error rate is zero, because we’re talking about people’s lives here. People can get hurt and die,” said Evan Smith, Eye Controls’ chief executive officer.
The iris, which is the colored ring of the eye, is unique for every human being. The company tested the iris scanner with simulated IDs and found zero errors in 8 million transactions, Smith said.
Using a New York Department of Health grant, Urban Health Plan purchased the newer iris scanners in 2008 and fully integrated it the next year.
It immediately changed the clinic, De Leon said.
“You don’t have to worry so much about having the right chart and making the mistake of continuing to use that chart,” he said. “It’s safer for the patient. It’s much, much harder to make a mistake.”
“We’ve also prevented duplicate records from being opened,” Connelly-Flores said. “A lot of times, patients forgot they were here, and we would open another chart for them, so we would have two charts for them at our facilities, or four or five.
“It makes sure we’re using the same records for the same patient. We’ve been able to prevent benefits fraud.”
The clinic’s efforts won recognition from the Healthcare Information and Management Systems Society this year.
“I’m surprised they’re using iris,” said Anil Jain, a computer science professor at Michigan State University about the clinic’s use of the scanners. “It’s very accurate, but the system is a little more expensive than a fingerprint reader or palm print reader.”
Jain, who researches biometrics, said there are additional issues for the clinic.
“How long will they keep the data?” he asked. “How will they protect it? Will they share it with authorities if they demand it? There are privacy issues.”
So far, patients have been very receptive to the scanner. Rarely does anyone decline having a picture taken of his or her eyes, De Leon said.