Surveillance serves many uses in hospitals

YARMOUTH, Maine—A health care professional might tell you that people are generally not at their best when they enter a hospital as a patient. A security professional would agree.

The contrast in perspectives, however, is dramatic. Health care professionals are potential targets for crime, while security professional try to see the whole picture with video surveillance.

It's not a pretty picture, in terms of hospital safety nationwide. For video surveillance providers, however, hospitals are big business.

Gary Buss, the health care account manager at Tech Electronics, a St. Louis-based integrator, said hospital security systems are an important reason why his company - which made its name by designing and implementing fire alarm systems - has seen a 100 percent growth in overall revenue and volume over the past five years. The improvement in video technology, lower price point of network cameras, and rising crime rates in hospitals have created a perfect storm, so to speak, for integrators and manufacturers of video surveillance systems.

“The technological advancement (in IP camera technology) has led to our fiscal growth,” said Buss.

Buss and other integrators do not mince words when discussing how cultural and societal changes have created a boom market for video surveillance in hospitals. The anecdotes can be frightening and the statistics blunt.

A 2012 crime and security trends survey published by the International Association for Healthcare Security & Safety reported that 154 shootings took place inside health care facilities nationwide between 2000 and 2011. The survey also reported that more than 98 percent of all health care facilities in the U.S. "experience violence and criminal incidents."

"Although the public's view of health care facilities is that they are inherently safe and secure, it is not an entirely accurate one," the IAHSS reported.

Integrators can rattle off long lists of sections and scenarios where hospitals find video surveillance critical for survival and success. They include employee and patient parking lots, document storage areas, pharmacies, cafeterias, gift shops, obstetrics and emergency rooms, for starters. Even Alzheimer's patients make it almost impossible to recount situations without a video record, given their unpredictable and random behavior, along with their medical needs.

Tom Catagnus, director of sales and marketing at Integrated Security and Communications, based in Toms River, N.J., recently accompanied a friend to an emergency room in Newark, where he encountered a common experience at hospitals across the nation—a nine-hour wait.

“You wouldn't believe what I saw,” said Catagnus. What he saw was an overwhelming need for security. “The amount of violence in hospitals is unbelievably huge,” he said.

“It's not always the best clientele,” noted Carole Dougan, vice president of sales and marketing of megapixel IP-camera provider Arecont Vision, based in Glendale, California. “Emergency rooms are high stress areas. You might have someone who was turned away, no insurance, or someone irrational. You can have a gang shooting. It's extremely volatile.”

Hospitals have always had security mechanisms, Dougan noted, but analog cameras came up short when trying to identify license plate numbers or when covering a large area with humans moving unpredictably.

“The technology is now almost limitless,” said Shawn Reilly, head of health care security training and risk evaluation at Tech Systems, an integrator based in Duluth, Georgia.

Digital cameras with high-definition, megapixel cameras can scan, zoom and essentially recreate scenes for investigators and hospital supervisors trying to figure out what went wrong in the sprawling campuses of big-city hospitals, industry experts say. (Barnes Jewish Hospital in St. Louis has 600 cameras and 1,500 secured doors, according to Buss.)

Analytics within the software of the latest video platforms make detection of crime scenes, security breaches and potential problem areas indispensable for high-quality patient care. Reilly offered this scenario: A PTZ camera in the pharmaceutical storage area of a hospital can be set to focus on a drug storage cabinet after hours. Any movement that causes a pixel change activates an alarm at the security department; the camera scene comes up on a monitor, where the dispatcher assesses the alarm, and dispatches a response force. Using a camera in this capacity eliminates the need to run cabling and hardware for a contact alarm, according to Reilly. The advances in HD cameras and enhanced video platforms make video systems more and more important in the open environment of healthcare facilities.

The quality of security in hospitals can affect the hospital's ability to attract workers, Dougan said. The nationwide nursing shortage creates a need for more security, she said. The best hospitals are competing for candidates coming out of nursing school; it's a seller's market. The quality of security that job applicants can expect during future shift changes—walking at 2 a.m. across a parking lot or in a garage to their cars—figures into a nurse's decision to accept a job.

Tech Systems' Reilly concurs. “Hospitals benchmark themselves against each other,” he said. “They see one create an environment where candidates can apply and feel safe working there,” and try to match or improve those features.

Crime detection and safety precautions are at the top of everyone's list when citing the need for video surveillance, but they are far from the only reasons.

Regulatory requirements, such as HIPAA (Health Insurance Portability and Accountability) also play into the demand for video surveillance in hospitals.

“You can't look at a person's medical file,” Catagnus said. “You can protect an organization against a HIPAA violation. You can mask out an area (of patient information) covered by HIPAA.”

The software capability of his mask-out is not unusual, but implementation depends on the needs and the judgment of the hospital security directors, who will inform integrators whether they want that feature installed and where they want it, according to Catagnus.

For systems integrators, said Buss, “HIPAA is a double-edged sword.”

“As a patient, I want my privacy protected,” he said. “If a patient in the ER complains about a staff person, or a staff person complains about a patient, we have the technology to monitor these areas.”

“The challenge is, who is able to see the video, and who has accessibility to that video,” Buss continued, noting that while hospital security directors are the ones responsible for HIPAA protocols, integrators need to adapt their systems to hospital policy. “The challenge is providing a heightened level of security but limiting accessibility.” Buss reiterated Catagnus' point—access is ultimately the hospital's call, while integrators must be mindful of how HIPAA might affect a project before implementation begins.

Security is a no-nonsense industry that needs to adapt in order to protect other industries, such as health care, that value sensitivity.

“You want family and friends of patients to come to your [hospital] campus,” said Catagnus. “It's open, but that causes problems for security because there are more choke points.”

Video monitoring, he says, maintains that open culture by minimizing the need for security guards.

“You don't want a fortress or prison environment,” said Reilly, who worked at Greenville Hospital Systems in South Carolina as director of security and chief of police before he joined Tech Systems. “Hospitals are at risk because they are an open environment. Letting everyone through the doors creates vulnerability.”

“All crime statistics will show you that any hospital that has been around for awhile has seen an increase in crime, “ Reilly said. “Greenville Hospital Systems has been around for 100 years. As the population grows, crime rate goes up.”