Brave new medical MICROCHIP

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microchip the size of a long grain of rice encased in a tiny glass capsule and injected into the upper right arm could, in an emergency, save a person's life.

The device, called VeriMed by its manufacturer, contains a series of 16 numbers -- a code -- that when read by a hand-held scanner can reveal key computerized medical information to properly registered people. The device is meant to help with treatment and prevent giving needless or possibly harmful medication to patients unable to talk to health care workers about their medical history and condition.

Admirers see it as a technological convenience no different from bar codes in supermarkets or the electronic EZ-Pass in one's car. Detractors say it has dangerous implications for civil liberties.

The problem is getting enough scanners and trained personnel in hospitals while simultaneously persuading enough people to be implanted with the chip, which is known as a passive radio frequency identification device, or RFID. The cost of an implant is between $150 and $400, and insurance does not yet cover the procedure.

"It's a three-prong approach, and all three [doctors, hospitals and patients] have to come together," explains Dr. Jonathan Musher, a Bethesda physician. He works for the manufacturer, VeriChip Corp. of Delray Beach, Fla., a subsidiary of Applied Digital, building what he calls "the network" required to make the chips effective. He says he was convinced of the device's merit before he joined the company and always has mixed his clinical practice -- geriatrics and adult medicine -- with what he calls "an administrative component."

Dr. Musher has about 260 doctors in his network and has implanted about 30 chips to date, mostly in elderly people who he says are those most likely to need the device -- especially the senior population in assisted-living facilities and anyone suffering from mild dementia. About 2,200 patients have been implanted worldwide since the chip was introduced in 2004, he says.

"If someone presents to an emergency room who is comatose, he gets scanned, and important information comes up," Dr. Musher says, giving one example of how the chip would function to save time and avert mistakes. An authorized person would put in his own identifying number and, with a password, be able in five to 10 seconds to learn a patient's name and pertinent medical history.

"Let's say, worst case, someone can do that who is not authorized and they come up with a name, certain allergies, diagnoses and the fact [the patient is] on three or four medicines and has an advanced directive not to [take extreme measures] to resuscitate. I say, 'So what?' Everything in life is a risk-benefit. That is low risk versus the benefit."

Dr. Musher equates the procedure to getting an injection halfway between the right arm's shoulder and elbow, with a local anesthetic used to numb the site. "The body physiologically forms a cocoon around it," he says, adding that "the chip is not visible as it might be in the shin.

New medical data is added and old data changed by using a special password in the computer program that stores the information.