Large Hospital Security: Technical and Physical Challenges

• By Brian Levy
• Oct 01, 2015

Large hospital environments present unique challenges for a surveillance integrator. Specifically, these challenges can include implementing IP surveillance technology, access control, or networking.

Many hospitals are currently using legacy analog surveillance systems and access control that may be at the end of their lifecycles. These facilities may wish to upgrade to newer technologies in order to take advantage of the benefits of new centralized IP technologies.

Beyond the technical issues, there are numerous physical issues that arise in hospitals, which include high visitor and employee traffic in work areas around emergency rooms and intensive care units, as well as the need to integrate existing IT departments for networking access and support. Furthermore, existing telecom and hospital infrastructure can make wire runs and penetrations time consuming. In some cases, existing security build-outs were never documented for legacy projects and current staff may have limited knowledge of what was done years before they were employed. Finally, regulating bodies such as OSHPOD and HIPAA require strict adherence to privacy policies that limit where cameras can be located and how access control can be implemented. 

When it comes to replacing legacy surveillance and access control, it is sometimes difficult for upper management to understand the large benefit IP systems offer because many of the advantages are technical in nature and the savings are not immediately apparent. However, when legacy equipment starts breaking down and replacement parts are either difficult to obtain or are no longer available, the limitations of outdated technologies become more clear. Hospitals are mission critical locations that cannot afford to have access control readers malfunctioning or pharmacy cameras failing due the high rate of narcotic theft. Digital and network recorders must be operational so security guards and management can keep a constant watch on the activity of the patients, visitors, and employees. Emergency room cameras are especially important due to sporadic violence and because some patients are under law enforcement custody. 

Recently, when the management of a large four hundred bed California hospital was considering ways to extend the life of their legacy system for another year, they were given a demonstration of a new high-definition IP technology platform and were so impressed that they decided to forgo their legacy system and chose to implement a brand new IP system. Due to the high resolution of the IP system, security personnel can more readily identify faces, vehicles, and equipment. 

The benefits of the IP system do not stop there. Over the last 5 years, IP surveillance technology has matured with a wide offering of 3MP, 5MP, and 12MP cameras and the ability to record ultra-high resolutions. This is especially beneficial for large areas like parking lots and building lobbies. Some manufactures are now including video analytics into their network video recorders, which can extend a security department’s overall awareness through smart detection and alarm notification.Multi-lens and 360-degree cameras also expand the possible options for integrators to capture surveillance imagery with the best camera for the project. 

One example of an NVR that supports a wide variety of ultra-high definition megapixel cameras and includes built in video analytics is the ICRealtime NVR-8256K-DR. The 8256K-DR was designed for large enterprise implementations and features support for 256 high definition channels. What’s especially unique is the NVR’s support for true 4K video output via the system’s 2 HDMI ports (and 1 VGA). The device also comes with native video analytics, which allows for various notifications and/or alarms for tripwire, intrusion, scene change, and more. The NVR has four gigabit Ethernet cards for network scalability and for fail-over in case the main network goes down. The device supports up to 256Mb/s of total camera bandwidth which allows for a variety of different camera resolutions. The NVR has plenty of internal storage with up to 144TB of HD space, and supports numerous RAID levels. When considering a NVR for large or medium hospital projects, integrators must make sure they have plenty of hardware flexibility and software features to insure capacity for future or unforeseen needs.

One major challenge that IP systems present is having to work with internal IT departments and receive their support to complete projects. In the days of analog CCTV, the system was a closed loop and integrators were not dependent on outside assistance from IT groups unless the project required Internet for remote access. With IP and its dependence on network infrastructure, interaction and support from internal IT departments becomes a necessity. Most internal IT and networking departments maintain tight control over their routers and switches for IT security reasons and do not want any non-approved manufacturer’s switch added to their network. These policies can halt project integration unless the integrator and the IT staff create a mutual solution before the project begins.

Many managed POE switches preferred by IT departments can cost approximately four to six thousand dollars, while many surveillance style POE switches cost as little as two thousand or less. While an integrator may be used to working alone and implementing a surveillance or access control project without outside support from the customer, this is no longer the case, especially in large hospitals where pre-existing switch standards and manufacturer selections are set by IT policy.

The need for support from internal IT groups is also relevant for external VPN access to the hospital’s network so that integrators can support their solutions remotely or react to problems via the Internet. Integrators may need to sign confidentiality agreements for remote access but the benefits are significant for both the integrator and the hospital. Having the ability to login and manage video and access solutions remotely can increase reaction time when problems arise and allows for instant support via the telephone. Some hospitals do not allow remote access as a matter of policy but this is rare.

Another important factor to consider is the amount of bandwidth high-resolution IP video uses on a network and how the surveillance cameras will affect overall network utilization. A two megapixel camera will utilize between four and six megabytes per second per channel, which means a twenty five channel system can reach an overall bandwidth 150Mb/sec, which can easily overwhelm some network infrastructures. Camera bandwidth can be fine-tuned based on networking needs by altering data bit rates, choosing low activity areas that use less storage, or lowering frame rates.

Many integrators will choose to build separate networks just to support surveillance and access control, and at minimum hospitals’ IT departments will choose to create a virtual local area network (VLAN) exclusively for security applications.VLAN networks create virtual segmentation from other non-security traffic. This means the integrators can only communicate with their cameras and devices and cannot connect or change external network traffic like standard hospital email and records.

Another option for managing large bandwidth requirements is to lower camera bit rates. This can be especially helpful on larger installations where cameras can scale into the hundreds. However, each installation is unique and will require some fine-tuning by the integrator to ensure network stability and component performance.

Returning to the numerous physical challenges facing the security integrator, these issues must be considered ahead of time as they can increase the time and budget of a project. Hospital can be extremely busy, particularly areas such as intensive care units and emergency rooms. It can be almost impossible to work in these areas if they are filled to capacity or the work is noisy and intrusive.

Further, the level of difficulty increases when working in sterile environments such as surgery wings because special body suits are required with head covers and booties. In addition, work areas require plastic tenting and floor mats in order to limit dust caused by drilling and penetrations. Much of the work in these environments must be done at night due to the high level of activity during daytime hours. The extra time it takes to put on the protective clothing, the difficulty of working in tented environments, and the level of care necessary can cost the integrator if proper risk factors are not included in the budget. It is also important to note that a facility’s era of construction may not be readily apparent as hospitals are frequently expanded or remodeled and may have a modern façade. Furthermore, hospitals are often built in phases and there may be decades of difference between individual wings or sections.

Sometimes, depending on the size and age of the facility, ceilings tiles will reveal large bundles of wires, ducts, and pipes, with no room for additional cable runs. This situation can be frustrating and time consuming because the installer must find viable paths for new cable. Some pre-war buildings have thick concrete walls and ceilings, which means there is no place to hide cable and coax and all runs must be installed with conduit along ceilings. In one case, a surveillance installation team discovered that a California hospital had a maze of ducting and conduit running across the building’s entire roof. It also had concrete walls, which made the installation much more difficult and costly due to the time it took to find a viable route and then snake the cable to the corresponding camera area from the server room NVR.

Extra effort should be made before quoting hospital work. Spend adequate time investigating every cable run and camera position, coordinating the project with IT, and adding sufficient time and costs to a project. A good rule of thumb is that work in these environments can take two times longer than what would be quoted for the same project in a non-medical building. If work is done in a sterile environment the time and cost requirements could be 2.5 to 3 times as much. Be sure to consider adding additional material costs if excessive conduit and construction materials are required.

Hospitals present a variety of specialized challenges, however, many of these can be overcome with good planning, investigation, and communication with internal departments. Despite the myriad of technical and physical factors covered, hospital surveillance and access control can be a rewarding place to work for surveillance installers. Plan out projects carefully and take the time to prepare realistic estimates, understanding that all surveillance installations have their challenges. Break up large projects into phases and manage one section at a time. All the pre-planning will pay off in saved aggravation and profit.

This article originally appeared in the October 2015 issue of Security Today.