Imagine Dylan, a bureaucrat working in a foreign embassy. Dylan approaches a security door, arms overflowing with confidential reports. Dylan leans toward the door’s access sensor and is authenticated. The door is now unlocked and can be easily pushed open with one shoulder, without the need to put down the documents and fumble for his keys or an access pass. Dylan has an insertable device implanted subcutaneously in his hand that interacts with the transponder at the office door.
This may read as science fiction, but it has been possible since 1998, when Kevin Warwick first inserted an RFID chip into his arm [1]. Warwick used this chip during his weeklong experiment to access his office, turn on office lights, and have his computer “greet” him. Hobbyists, bio-hackers, grinders, and other early adopters have been experimenting with these insertables since 2005 [2,3,4,5]. In 2005, Amal Graafstra inserted an RFID chip into his hand with the aid of a cosmetic surgeon friend [2]. He decided to get “chipped” because he had an automatic locking door and was often going in and out carrying computer equipment, much like Dylan, our fictitious bureaucrat.
Needless to say, digital devices have become smaller and more powerful. So much so that computer components are now small enough to be inserted into a human body. Mobile devices have progressed from luggables, digital devices that can be carried with some effort, to wearables, devices that can readily be worn on a person, to insertables, digital devices that go through the skin, under the skin, or inside a person. We use the term insertables to refer to devices contained within the boundaries of the human body. This includes devices that can be inserted into, and removed from, cavities of the body. Insertables can be self-fitted or inserted by medical professionals or qualified body-modification artists.
The use of insertables is already seen in pets. Microchipping is common, a legal requirement in many states and countries that assists in the identification and management of stray animals. This practice has been widely adopted with no sound evidence of harm [3]. Microchips are now being repurposed in pets to allow them to open cat flaps on doors and to provide access to feeding bowls (https://www.sureflap.com) without adding bulky RFID tags to the collar. If insertables are good enough for Fluffy and Fido, perhaps the idea of human insertables is not so far-fetched.
People too have already adopted insertables in certain areas of human activity. In optometry, for example, people of antiquity would carry gems or glass vessels of water (i.e., luggable object) to magnify objects. These devices transitioned to wearables, in the form of spectacles or monocles, around the 13th century [4]. We have now progressed to contact lenses placed on the surface of the eye.
In another example, contraceptives exist in the form of insertable devices such as diaphragms, intrauterine devices (IUDs), and sub-dermal contraceptive implants. More recently, the Bill and Melinda Gates Foundation has sponsored a project by MicroCHIPS to design digital sub-dermal contraceptive implants that will remain implanted for 16 years (http://microchipsbiotech.com). These contraceptive implants can be switched on and off. Should a woman wish to become pregnant, she could switch off her contraceptive insertable rather than have it removed. Afterward, the insertable can be switched back on. In addition to avoiding invasive medical procedures, this would provide extraordinary control over reproductive behaviors. It also introduces extraordinary challenges for interaction designers. How do we best interact with technology inside our bodies?
Getting Under the Skin
Unsurprisingly, many people experience the “ick” factor when first introduced to the notion of insertables. However, humans have long been using items within the body for improvements to their life. In addition to contact lenses, examples include sanitary items, body jewelry, capsule pills, and assistive internal medical devices such as prostheses, pacemakers, cochlear implants, and dental implants. Digital objects now made of bio-inert materials can be safely inserted into the body (passive RFID chips and NFC chips). While some implantable medical devices (IMDs) are essential for health, other items used within the body are purely for convenience. Convenience insertables include contact lenses, sanitary items, and insertable contraceptives, where individuals may choose to use devices based on personal preference, not on medical recommendation.
We are particularity interested in voluntarily inserted devices. We are looking at individuals who have opted to insert a gadget in, under, or through their skin, for reasons that are not medical or otherwise essential.
If insertables are good enough for Fluffy and Fido, perhaps the idea of human insertables is not so far-fetched.
Insertable devices are fitted with one of two methods: the scalpel or the syringe. The scalpel method involves making an incision in the skin, creating a pocket with the blunt end of the tool, and placing the device into this newly created pocket. The syringe method uses a large-gauge plunger needle, similar to those used in pet microchipping. The needle is inserted in to the skin and, once in place, the plunger depressed to insert the microchip into the newly created pocket. Our research has found that both methods are used by professionals or by people who are self-inserting or getting friends or family to insert. Professionals who can do the inserting include medical professionals, tattooists, piercers, and body-modification artists.
Common Insertables
Our research explores the current use of insertables for non-medical purposes. The research aims to understand the current use of insertables and people’s motivations for doing so. Our research has discovered three different types of commonly used insertables: passive RFID chips, NFC chips, and neodymium magnets.
Passive RFID.
The passive RFID (radio frequency identification) chip is activated when it comes into range of a corresponding transponder, ranging from a few centimeters distance up to a few meters, depending on the frequency, and communicates information over radio waves to the transponder. The passive RFID chips that are inserted into individual’s hands and forearms have a much shorter read range of a few centimeters. Wider uses of passive RFID include warehousing and supply-chain tracking of goods, in store anti-theft mechanisms, toll-collection passes on roads, pet microchips, contactless payment credit cards, and modern passports.
NFC.
Near field communication (NFC) chips use a technology based on RFID that also communicates via radio waves. These types of chips are often found in smartphones and can be used to share contact information between phones, use phone payment systems like Apple Pay and Google Wallet, and can also be found in cards in your wallet, such as many transportation and access card systems. NFC chips inserted into the hand are being used for sharing contact details, launching apps, and unlocking phones, doors, and cars.
Magnets.
Neodymium magnets are magnets made from rare earth metals. This type of magnet is generally inserted due to its strength — they are the strongest magnet commercially available — and durability. Magnets vibrate when they come in contact with electromagnetic fields, and the insertion of them under the skin allows the implantee to sense these fields. Individuals with magnets inserted near nerve endings (typically on finger tips) can “feel” electromagnetic fields. The magnets can also be used to pick up small metallic objects and identify whether wires are live or not.
Motivation for Using Insertables
The reason for inserting a device under the skin is unlikely to be cosmetic. Insertables are typically not visible to the naked eye, keeping their existence hidden from an unaware observer. Insertables also allow individuals to entirely eliminate a visible interface or tangible device. People, through devices in their body, in effect become the interface. Insertables used in this way allow digital interactions with the physical world in the way they were before convoluted security measures changed the way we use doors. Our findings suggest that the reasons for using insertables fall into two categories: convenience and extending human senses.
Convenience.
Insertables for convenience are used to control and gain access to devices or areas without the need for wearables, luggables, or the burden of remembering passwords. They are used to simplify this hectic modern world, creating one less thing to concern yourself with. Users feel as if they are “beyond wearables.” Wearables are just another item to manage in your life, to remember to turn on and charge, and an annoyance, pain, or discomfort to the skin. For many, insertables are a permanent solution that becomes part of their body and enables them to interact in their daily life without the interruption of other modalities. One will not forget or misplace their keys when they are in the form of an insertable.
Extending human senses.
The other motivation for getting an insertable device is to extend human capabilities. These individuals are not satisfied with a normal human body. They want to experiment with extending their senses, such as feeling electromagnetic fields. One of our participants explained: “I’m not satisfied with the purely biological body. I want to basically have more functional stuff. Having implants is just the very first step I suppose. It’s what’s currently available today, rather than just science fiction, which is maybe one day but is not available right now.” Some feel that insertables may be the first step in the next stage of human evolution, stating that we “should be able to enhance the senses that we have naturally instead of just improving senses when they’re not working as well as we’d like.”
Risks and Concerns
The risks of insertables are not what you might think. For example, privacy is not seen as a concern because passive RFID and NFC chips cannot be location-tracked. Rather, the three main areas of concern are health, social stigma, and ethical issues.
Health risks.
The health risks are similar to those of body piercings: infection and rejection. However, none of our participants experienced health issues. While a microchip may break inside the body, causing bodily harm, this will occur only if the area of the body suffers a severe impact. In such circumstances, it is likely that the event that caused the chip to break would have caused greater harm to the body than the broken microchip.
Social stigma.
It is common to experience stigma for being “weird.” Others have been the targets of abuse from religious groups believing that they are carrying the so-called mark of the beast based on an interpretation of Bible passages [6]. Some participants report receiving hate mail and death threats, videos posted online containing hate speech about them and other online abuse, and friction or dissolution of personal friendships and relationships.
Ethical concerns.
The use of insertables raises many ethical issues. It is easy to conjure Orwellian scenarios of government tracking. However, this concern is unjustified. As anyone who has ever lost a beloved microchipped pet will know, passive microchips cannot be used for location tracking and are able to provide data only when interrogated with the correct proprietary transponder at a very close distance.
The popular press often argues for the tracking of prisoners (especially sex offenders) and patients confined to hospitals, but without tracking capabilities this seems futile. This could be technically feasible, but only if individuals pass through receiver scan points in their daily routines. However, is it ethical to insert these devices without consent, or when a patient cannot provide consent?
The ethics of access to insertables is also significant. Currently, it is difficult to reprogram an insertable. While NFC chips can easily be programmed to share contact details and to open specific Web pages or apps by using a free app on most Android devices, this is not possible with current iOS devices. Apple has not made its NFC chip available for use other than with Apple Pay. RFID chips generally require more sophisticated technical skills to program the chips and face interoperability issues, with certain transponders able to read only certain chips. Standards must be adopted to allow easier programming of chips and the ubiquity to use one chip for multiple purposes.
HCI Challenges
Insertables create fascinating challenges for HCI researchers and UX designers alike.
How do you configure the insertable?
The programming issues could possibly be addressed with an easy-to-use platform or standard programming environment. Programming could take two approaches: adding the ID of the chip to existing systems or cloning the information and access tokens to the chip. Each chip has its own unique identifier, which could be added to systems; this same identifier would be added to every system the individual is using. The second approach would add a unique identifier for each system to the chip, allowing the number to be matched to a record in individual databases behind systems. The latter approach avoids the issue of branding people with numbers.
Where do you insert the insertable?
The placement of the insertable on the body is an issue. We need to consider sensor placements that cater for a variety of insertion locations and individuals of different heights and with different body types. For example, current door-access systems are usually located to the side of the door, but if insertables are placed within the webbing of the hand, these could be placed within the door handle itself, allowing for a more natural interaction.
How do you upgrade/update the insertable?
Cycles of innovation may not translate to insertables, as it may not be reasonable to expect individuals to upgrade their chips every two years. Just as veterinarians must still be able to identify lost elderly pets, access systems will need to authenticate individuals with older insertables. If insertables are predominantly used as a switch to trigger other devices, then the age doesn’t necessarily matter. In our study, we have spoken to participants with 10-year-old insertables that are still functional. As RFID and NFC chips have no moving parts and no battery, they can in principle last a lifetime. The only reason to upgrade would be technological advancements of the chip itself. Our participants have experienced the replacement of older generation chips with new ones that have greater read frequencies. Removal is quite simple, as the magnets and chips do not bind to the body. A small incision is made and the insertables are squeezed out by hand or pulled out with tweezers. This is reportedly less painful than insertion, and a new device may be inserted in the same session, similar to the process of replacing sub-dermal contraceptives.
As these issues of standardization, programmability, and configuration and usability concerns are addressed by HCI professionals (and others) it is likely that insertables for non-medical purposes may soon come out from the basements of hobbyists and into a tattoo parlor near you.
This research is ongoing; if you have an insertable device and wish to be interviewed, please contact Kayla Heffernan. For interested researchers, a workshop on insertable and implanted technologies is to be held at the DIS 2016 conference in Brisbane, Australia. For more information about the workshop, and to submit to attend, see https://insertables.wordpress.com
References
1. Warwick, K. Cyborg 1.0. Wired 8, 2 (Feb. 2000).
2. Graafstra, A. HANDS ON-With a chip implanted in each of his hands, one hobbyist made RFID a way of life. IEEE Spectrum 44, 3 (2007), 14.
3. Cheer, L. Australian man who’s had a microchip inserted into his hand so that he can do more with the iPhone 6…maybe. Daily Mail. Sept. 7, 2014; http://www.dailymail.co.uk/news/article-2746648/Australian-man-microchip-inserted-hand-use-iPhone-6.html
4. Kriss, T.C. and Kriss, V.M. History of the operating microscope: From magnifying glass to microneurosurgery. Neurosurgery 42, 4 (1998), 899–907.
5. Monks, K. Forget wearable technology, embeddable implants are already here. CNN. Apr. 9, 2014; http://edition.cnn.com/2014/04/08/tech/forget-wearabletech-embeddable-implants/
6. Revelation 13:16–17 and 14:9,10.
©2016 ACM 1072–5220/16/01 The Digital Library is published by the Association for Computing Machinery. Copyright © 2016 ACM, Inc.
Reproduction of our piece that appeared in ACM Interactions
Kayla J. Heffernan, Frank Vetere, and Shanton Chang. 2015. Insertables: I’ve got it under my skin. Interactions 23, 1 (December 2015), 52–56. DOI=http://dx.doi.org/10.1145/2843588 Available http://interactions.acm.org/archive/view/january-february-2016/insertables