Diagnosing Healthcare Security

Diagnosing Healthcare Security

Multi-site deployment requires centralized monitoring, diverse security technologies

Healthcare systems represent one of the most challenging environments to secure. The need to balance an appropriate level of security while providing a welcoming environment geared towards patient care is essential. Video security deployments for hospitals often share characteristics such as being a multi-site deployment requiring centralized monitoring and the need to integrate a diverse but complimentary set of security technologies. These requirements drive planning and design considerations of video surveillance and enterprise VMS deployments.


Hospitals are unique in that security challenges specific to particular industries are all brought together in one organization. In addition to general areas, hospitals often have restaurants, gift shops, pharmacies, holding cells for the treatment of inmates and psychiatric treatment areas—all presenting unique technology requirements. As a result, the blend of security technologies is often broader than with other types of organizations. Video, access control, point of sale integration, millimeter wave weapons detection, body-worn cameras and other tools may be deployed and integrated together in a hospital’s security program.

The trend toward integration of video and access control has become standard practice in modern hospital deployments. One example of the need is the frequent incidence of tailgating, or holding the door for someone who has not presented an authorized credential to enter a secured area. When access control is integrated with video, each access event is linked to a video recording from the corresponding camera at the time of the event. This makes visual verification of who entered an area very simple, which in the case of tailgating can be the only record of the person’s entry when investigating an event.

Infant security systems, which track infant location and family association, can be setup to alarm the VMS system and cause video to call up automatically on monitoring computers. As one of the more significant security concerns for hospitals, infant abduction requires real-time, proactive response. Integration provides an instant visual of who is with an infant when an alarm triggers which can display on many computers simultaneously using a VMS pop up video alarm capability.

Cafeteria and gift shop areas benefit from integration with the point of sale system. A POS and video integration allow investigators to visually verify transactions. Receipt data is recorded and associated with the video recording from the closest camera. Bringing together receipt data with the video makes it simple to identify incidents such as a customer leaving with more merchandise than was purchased or if a return was processed without a customer present, both common causes of retail fraud.

If weapons detection and patient perception are concerns, portable millimeter wave weapons detection systems (similar to body scanning systems at airports) are unobtrusive when concealed within a planter or other enclosure and can provide weapons detection at higher risk entrance points in hospitals, such as the emergency room. With integration to the VMS, video from a corresponding camera can pop up, alerting monitoring staff that a person has entered who may be armed.


Liability concerns can necessitate that a hospital’s video security design require higher frame rate recording and redundant coverage. A frequent concern is staff and patient confrontations. High resolution and higher frame rate recording can capture important details needed to determine how an altercation started and which party is responsible for escalating to a physical confrontation in such cases.

Ample camera coverage and high resolution recording of the target events are equally important as higher frame rate recording. Covering an area from multiple angles can be a key factor in determining what happened in the event of a liability claim. As an example, this strategy may involve camera coverage at both ends of a hallway to capture details from two angles. Ensuring the camera resolution will provide enough details of security events is a key element when planning camera coverage. If existing analog cameras are in place, consider strategically replacing those with HD CCTV or high definition IP cameras in areas of greatest concern; commonly where confrontations are more likely to take place, such as the emergency room waiting area.

The target video retention time may vary depending on the location being monitored. Retaining video for more than the customary 30 days may be necessary in a drug or supply storage area for example. An inventory check may be the only time that theft is detected. The retention time for these areas may need to be increased by 50 percent more than the time between inventory counts to allow for missing inventory to be reported and an investigation and export of evidence to take place before video evidence is overwritten. In addition, the best practice is to plan for long term retention of exported video evidence of any security event. Liability claims may come months or years after an incident takes place and lack of video evidence can compromise the defense of a claim.


Parking areas require special consideration. Being a 24-hour a day operation, hospital parking areas can experience constant activity, making suspicious behavior more difficult to detect at night. Besides preventing thefts and other crimes, making sure employees and patients feel secure is a top priority.

The first line of defense is good lighting in all parking areas. Poorly lit areas should be eliminated, which can be difficult in larger outdoor parking lots. In these cases, guard patrols are commonly used to augment the lack of lighting. IR Lighting can dramatically enhance camera image quality at night, however visible lighting provides the same benefit and also acts as a deterrent.

Having a designated employee parking area provides the opportunity to add extra video coverage for employee safety. Guards can “virtually” escort employees to their cars by watching them on video and can immediately dispatch assistance if trouble is detected.

Emergency phones and call boxes can be placed near lit areas on paths towards the main facility. Many higher end models provide built in cameras allowing callers to be viewed and recorded.


Patient privacy and confidentiality needs must be taken into account when planning access to monitoring and investigation tools in the VMS. HIPAA privacy regulations require health care providers to develop and follow procedures that ensure the confidentiality and security of protected health information. While it is not the intent to store Protected Health Information in recordings, the video system may capture sensitive information depending on camera placement. Staff members who export video must understand HIPAA regulations.

Within the VMS, limiting permissions for users who can take snapshot images or export recordings is the first layer of protection against unauthorized export of video surveillance data. With a smaller number of users with access to exporting evidence accountability is increased.

Users with access to live monitoring can still take a screen shot or screen snipping tool to get a snapshot of what is being presented on the screen, which can bypass VMS user permissions. Disabling and removing these tools in the operating system running client software is a best practice. Limiting internet access helps to prevent users from sending files outside the local network. Physically securing the computers in a locked cabinet can prevent using USB or other media to remove files.

None of these steps can prevent a user from recording the computer screen with a smartphone or camera. A policy preventing staff from bringing smart phones or other video recording devices into security monitoring rooms is a good first step. Some hospitals deploy surveillance cameras in monitoring rooms to record the activity of the security staff. If a video clip or screen shot is removed and made public, the recording of user activity can be used to identify the responsible party.


Healthcare system deployments are generally comprised of multiple facilities that are part of a larger network managed under a single security program. Deploying a system with centralized monitoring capability, allowing video from multiple sites to stream back to a centralized monitoring center, as well as centralized system administration are important considerations.

When planning for centralized monitoring, the bandwidth available between each site and the monitoring location may be a limiting factor. Streaming high-resolution video from many cameras at a single site often requires a considerable amount of upstream bandwidth at the site to be available for use by the security system. Modern VMS platforms may provide features that save bandwidth when streaming video for live display. Two more common methods are multi streaming and transcoding. With multi streaming, multiple streams of video are pulled simultaneously from each camera at different resolutions. The high resolution stream is recorded but a lower resolution stream is transmitted for live display, saving bandwidth. This works well because often video is displayed at a much smaller size on screen that what is pulled from a camera for recording. Transcoding works by taking a single stream from the camera at high resolution, then resizing it to the exact resolution necessary for live display. This has the benefit of pulling only a single stream from each camera and sending the exact correct size image for display, often saving more bandwidth than multi streaming capable systems.

With any expansive multi-site deployment, the time involved in system administration is a key consideration. Software updates and system configuration should be centrally manageable, so administrators can perform tasks across multiple systems from a single interface and across multiple systems simultaneously. Centralized health monitoring tools allow administrators to verify that all components of the video security system are functioning properly, and provides notification if a camera or VMS server has a problem so troubleshooting can begin immediately.

Integration capabilities and management tools of enterprise VMS are top considerations and can have a big impact on proactive response, speed of investigations and administration time.

This article originally appeared in the June 2016 issue of Security Today.

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