Defence R&D Canada – Centre for Security Sciences

Most people on first thought immediately assume that biometrics belongs to the realm of counter-terrorism, border control, and futuristic science fiction, as depicted in the popular media. While indeed, this is understandable — given that biometrics were initially conceived and intended for the law enforcement world, and are playing an increasingly important role in the wake of 9/11 — the implications of biometrics for the future of health care in Canada and other countries are staggering, and revolutionary. This is especially relevant in our era of limited resources and demographically-pushed demands.

In this article, I will very briefly introduce the concept of biometrics, the various types of biometrics measurements including the current state-of-the art, and then digress into some projections and applications to health care and medicine.

What are Biometrics?

The term biometrics is a combination of the Greek Bio (life) and Metron (measure); measuring life. But it goes farther than this. The basic principle is that every living entity on earth is genetically-unique, with its own pattern and signature. This applies to trees, moss, dogs, tree frogs and humans. These differences, which we all can understand, announce our individuality on the planet…they define our faces, body shape, voice, personality and personal physiology. The vast diversity and variation of the almost 6.5 billion Homo sapiens on Earth is mind boggling – all made possible by manipulating the permutations of a just few base-pairs of genetic material in the human DNA! This makes biometrics ideal for identity verification in many applications. We instinctively use biometrics: instantly sorting faces we recognize out of crowds. Animals are particularly proficient users of their olfactory senses to perform countless identity verification operations.

So, essentially, your biometric is more that who you say you are (like the signature on a cheque– which can be forged); more than your bank PIN number (which is what you know – which can be forgotten or stolen from you – along with your identity without you even realizing it); rather, it is what you say you are!

The central notion of biometrics, is that an individual’s biometric is initially obtained (or “enrolled”) and subsequently stored in an electronic repository, or database. If this measure is then obtained at some other future time from a special scanning device, and electronically compared to the initial record, if the match is confirmed, you would be considered to be “The Same Person”.

Certainly, the most immediately recognized biometric by the general public is the fingerprint – a staple of the law enforcement world. The classic and universally-recognized swirl of the fingerprint is unique to everyone. Previously obtained by rolling the fingers on an ink pad, it can now be acquired by sophisticated imaging and scanning techniques. Law enforcement agencies around the world possess and share enormous databases of suspects and “bad-guy” finger print records. However, the fingerprint is time- consuming to record (especially the acquisition of all 10 prints), and can be easily spoofed by the clever criminals. It would not be to difficult for the average knowledgeable and technically competent cheater to spoof the fingerprint reader at Disney World, allowing access to the amusement park multiple times…The palm print is a cousin of the finger print, and is actually more commonly found at crime scenes, but can usually only be compared to a small comparison set from specific crime scenes.

As biomedical engineering knowledge, combined with advances in optics and computing have improved vastly in the past decade, other options for biometric markers have emerged.

The unique pattern of the pigmented smooth muscle of the Iris allows us to acquire this as a biometric. Captured with high-resolution digital photography, and corrected for lighting, eye morphology, iris scans are used in some Canadian airports (an example is the recently introduced NEXUS program) and are being used routinely in many international airport border control settings. Sometimes, with first-generation systems, the cooperation from the subject during the initial (enrolment) and second (comparison) scan is required. However, recent and advances in optics and computing has vastly improved these systems, with some manufacturers producing systems that scan and compare within 1 second, and are virtually spoof-proof. Very shortly, iris scanning systems will be introduced that allow stand-off detection as far as 2 meters, allowing their use in high volume applications, like airports, fixed border crossings and perhaps transit system access points.

The pattern of arteries and veins on the retina are also a viable biometric, but are more difficult to acquire. However, the patterns formed by veins on the back of the hand can be scanned, and are already in use in the Port of Halifax to verify employee access.

The variety of new and emerging biometrics is phenomenal (below). Facial recognition is perhaps the most impressive and promising for use in many applications – and may even be applied to previous older photographs. Everyone has a photo on their health card, drivers licence, etc. and there are advantages for use of photographs in Canada due to the vagaries of our privacy laws and public acceptance. New imaging techniques and computerized algorithms can control for lighting, shadows, profile, and resolve spoofing attempts. Some investigators are making progress in 3D head and face scanning systems.

Biometric Techniques

While DNA is of course, the ultimate biometric (obtained from a bucal swab), processing time is in the scale of days and weeks, making the instant comparison impractical (this may change in the next 10-15 years and miniaturization, enabled by nanobiotechnology allows lab-on-a-chip technologies, and real-time DNA analysis).

Other promising and intriguing techniques, using non-invasive, unobtrusive, and reliable metrics include gait analysis, speech recognition techniques, and physiological signatures, like the electrocardiogram (ECG) and electroencephalogram (EEG). The ECG is unique to each individual, as is the EEG, which will infer different emotional states during relaxation, stress or concentration. Techniques are being developed to covertly and non-invasively measure blood pressure, which can be linked to emotional stress indicators.

However, the introduction of these new biometric techniques also bring along the potential for privacy issues, negating their utility in society. These issues will no doubt undergo considerable public debate as the science matures.

How might biometrics benefit medicine and Health Care in the future?

Imagine that you are in a long-term geriatric long-term care facility, and you become confused and lost. You attempt to leave your room and floor, somehow wandering past the staff, out of the establishment, and onto the street. You make it several blocks from the hospital, and suffer a seizure and collapse. You have no identification on you. The paramedics, although confirming your vital signs are stable, they are unable to immediately determine your identity, any drug interactions/contraindications, and your medical record. Meanwhile, your diabetic condition is not spoken for, and you are two hours overdue for several medications, including your insulin……

A simple biometric – finger, iris - would allow paramedics to immediately access your complete health care records, even when indisposed. But there are more applications than just identify management: A biometric on your drivers licence (in conjunction with a smart card chip) would allow immediate identity management plus encoded health care information (blood type, existing medical conditions, next of kin, etc…). It is perhaps not unreasonable to consider the use identity verification using biometrics in the operating room.

Biometrics are being introduced in critical and sensitive infrastructure access control, screening employees and certified visitors. The same technology might be instituted in hospitals and other health centres to ensure security, and augment and enhance (vs. what most would intuitively consider a risk to) personal security with regard to sensitive medical records, billing, and health card fraud. Billions of dollars are lost to the system each year due to Provincial health card fraud and identity theft – despite efforts to introduce security “elements” on the cards.

What does the future look like?

Looking out to 30 years, we will see stunning advances that will merge the fields of biometrics with nanotechnology and computing: The futurist Ray Kurzweil estimates that computing power will approach the power of the human brain by about 2040. This, perhaps in addition to being difficult to imagine, will afford real-time DNA analysis, using the next generation nanomedicine-enabled lab-on-a-chip technologies. Immediate blood typing will be possible, designer gene therapies, personalized therapies, designer pharmaceuticals and nutriceuticals, based upon your personal genetic make-up, and seamless telemedicine will all become realities.

What about privacy?

Recent surveys in Australia indicate that the tide of public concern regarding the use of biometrics has turned; most respondents would willingly enrol their biometrics to a government agency or institution, if it expedited their movement through a line-up, or ensure their personal well-being. This trend was apparent, not surprisingly, after 9/11. Proponents of biometrics for public safety and security believe that privacy is in fact, enhanced - not compromised - using biometrics.

This is of course, dependent upon the reliability of the institution we entrust our biometric to – whether it be transportation security agencies, or your local health clinic. Outside the criminal justice system (which is a separate discussion entirely), privacy laws in Canada allow distribution of photographs. As such, by using a high-resolution camera and sophisticated tracking and computer algorithms, the face can be used as a biometric; to determine that what you say you are is in fact, what you are. Clearly, public education and privacy laws need to advance in order to keep pace with these technological changes. In considering biometrics in the health care system, this no doubt be the case as well.