VA tests medical smart cards

The Veterans Affairs Department is piloting a program to put medical records on
smart cards to speed care for veterans outside VA’s health systems.

VA’s HomeCare program in Charleston, S.C., stored brief medical histories for 80
patients on smart cards with 8K of memory apiece. Card readers and software were installed
at Charleston-area hospitals and clinics where patients go for after-hours or specialty
treatment, and on portable computers used by home care providers.

DataCard Corp. of Minneapolis supplied the equipment for the six-month SmartRec trial.

“We want to look at the usefulness of having this information available
electronically to the health care provider,” said Dan Maloney, VA’s director of
emerging technologies.

If the trial succeeds, VA might add smart-card interfaces to its main computer systems.
More veterans also could get the cards. “We like to try things out on a small scale
to see how useful they are,” Maloney said.

VA already uses a Veterans Identification Card with a magnetic strip to identify
patients at its hospitals and clinics. It has a computerized patient record system that
makes records available throughout the department. But, Maloney said, “We tend to do
more and more outcare,” meaning patients receive treatment in their homes.

Charleston VA facilities close at 10 p.m. Veterans who need treatment after that hour
go to area hospitals or clinics. Such facilities must check with VA to verify eligibility
and wait to have medical records faxed.

If they had SmartRec readers, the cards could provide insurance information about the
patients and supply medical records immediately.

The card in the current pilot, which began last month, comes from GemPlus Card
International Corp. of Gaithersburg, Md., and runs the GemPlus operating system. Cards
with 16K memory are available and 32K cards are on the way, but the 8K card has enough
memory for the VA trial, said Michael Warthen, DataCard’s director of sales and

Although the VA card does not store diagnostic images such as X-rays, it does hold
demographic, insurance, immunization and medication information, Warthen said. There is
room for free text notes.

“That’s a pretty big amount of clinical information,” he said.

VA encodes the data to keep memory requirements low. For instance, a single character
represents a penicillin allergy. When the card is inserted into a GemPlus reader that
connects to a PC through a serial port, the coded information populates a records template
that can be read or printed out.

Improvements already are being planned, Warthen said. He said DataCard is alpha testing
Microsoft Corp.’s Smart Cards for Windows operating system.

“As soon as it is available, we will concentrate our efforts on that operating
system,” Warthen said.

Plans also are under way to put the SmartRec reader application on the Web. Inserting
the card in a reader would automatically open a browser and display the card data in the
Web application. “We want to get to the point of ubiquity,” Warthen said.

The current SmartRec card with a microprocessor also could be integrated with the
Veterans ID Card, a magnetic strip card.

An 8K smart card loaded with an operating system now costs VA $9 or $10, Warthen said.

About the Author

William Jackson is a Maryland-based freelance writer.


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