Balancing Safety Security and Privacy
How network video and audio are helping hospitals elevate patient care and workplace safety
- By Paul Baratta
- Jun 18, 2020
Hospital safety and security is a series of if-then
scenarios. If we can prevent patients from falling
out of bed, then we can avoid serious, costly injuries.
If we can prevent workplace violence, then
we can reduce staff stress, burnout and resignations.
If we can continuously monitor critical patients remotely,
then we can spot subtle changes and avert health crises. To
achieve those desired outcome hospitals are embedding sophisticated
surveillance technology – a tightly integrated solution of
network video, audio and analytics – into day-to-day operations.
Most hospitals initially invested in video cameras for security
purposes. As they’ve become more proficient with the technology,
they’ve begun exploring other ways to benefit from their investment.
With the advent of sophisticated video and audio analytics,
hospitals are discovering they can use their network cameras to
augment patient care and raise workplace safety and security to a
whole new level. Because video analytics can process and analyze
images with surgical precision, they can provide hospital staff
with actionable information in real time.
Audio analytics are adding another valuable layer to situational
awareness. With alerts from cameras enhanced with intelligent eyes and
ears, hospital staff are reacting more quickly and decisively to potential
threats like verbal aggression, breaking glass, gunshots and more.
Today we’re finding healthcare managers using the technology
to help them assess and mitigate risks, oversee adherence to
patient care standards and plan staff allocation. In the event of
a pandemic surge, cameras will allow clinical staff remotely observe
patients and manage their care while minimizing the risk of
face-to-face interaction.
Hospital security managers are drawing insights from their surveillance
systems to help improve overall safety and security as well
as allocate resources more effectively. For instance, in choosing to
deploy intelligent cameras at lower-risk entrances, they’re able to free
up manpower for more critical locations like behavioral wards and
emergency rooms. They’re adding audio analytics to provide early
warning of potentially explosive events so that they can respond proactively
and diffuse the situation before it can escalate out of hand.
To help you appreciate the broader contribution surveillance
cameras could make to your hospital operations, let’s look at a
few innovative applications.
PREVENTING INJURY
One leading issue for hospitals is mitigating patient falls. According
to research accumulated by the Joint Commission Center for
Transforming Healthcare (JCCTH), U.S. hospitals report an average
of six patient falls a month. With over 70,000 falls occurring
in hospitals across the country annually, the financial impact to the
healthcare industry is significant. Patient falls can cost an average
hospital more than $1.6 million annually – an expense that’s not
reimbursable through private insurance, Medicare or Medicaid. If
cases of severe injuries, where patient stays could increase by six
days or more, the amount could be considerably higher.
To mitigate these events, some hospitals are using network cameras
as virtual patient watchers. With analytics, they’re capable of detecting
and alerting staff to patient activity that might lead to a fall.
And if a fall does occur, the cameras can immediately trigger a coded
alarm for a rapid response team. This is critical because statistic show
that early detection ensures the best outcome for the patient.
So how does this work? The video analytic can be programmed
to automatically alert when the patient crosses a specific boundary,
such as the edge of the bed. Should this happen, a message is
immediately sent to a nurse’s station, a remote patient monitoring
control center, or a care team member’s mobile phone along with
real-time video of the situation.
If audio analytics are employed, the cameras can detect the
sounds of patient stress and provide an early warning of concern.
Using network cameras in this role is especially useful for
patients in private rooms or where staff-to-patient ratios are being
stretched to the limit.
Medical facilities like Lee Health and Nemours Children’s Hospital
in Florida are good examples of this type of deployment.
REDUCING VIOLENCE
Another major concern for hospitals is workplace violence. Healthcare
workers can be easy targets for patients or family members’ rage,
confusion or anxiety. In fact, workplace violence is four times higher
for hospital staff than any other profession – everything from verbal
abuse to physical assault. According to the Becker’s Hospital Review,
a publication for hospital decision-makers, over 66% of nurses report
having experienced workplace violence. This has led to a negative impact
on patient care due to stress-related absences and burnout.
To counteract the problem, hospitals are deploying intelligent
surveillance system to better protect staff and patients. They’re
integrating their network cameras with their access control systems
to ensure only authorized personnel enter restricted areas
like operating arenas and pharmacies. They’re adding video analytics
to detect and prevent tailgating incidents and suspicious
loitering at entry points and fire exits.
They’re linking network cameras with network audio systems so
that security monitoring the cameras can direct verbal warnings over
network loudspeakers to anyone engaging in negative behavior. They’re
quipping their cameras with intelligence audio analytics like aggression
detection that can instantly notify security staff of potentially dangerous
interactions —far faster than the time it takes to phone for help or
activate a panic button – so o that responders arrive on the scene faster
and hopefully defuse the situation before it escalates.
Martin Luther King, Jr. Community Hospital in Los Angeles
is a good example of this type of deployment.
MITIGATING LAWSUITS
To fend off accusations of misconduct, some hospitals are equipping
their public safety officers, emergency responders and ambulance/
transport staff with body worn cameras (BWCs) to
document their interactions with patients, visitors and the general
public. These wireless-network cameras are like those used
by law enforcement and serve a similar purpose: defend against
complaints and reduce the risk of costly litigation.
Despite the obvious advantages, many hospitals have been reluctant
to adopt BWC technology due to concerns about HIPAA
compliance and individual privacy. The easiest way for a hospital’s
security technology team to allay these concerns is to establish procedures
to handle BWC footage the same as any other video captured
by hospital cameras and stored on hospital servers. This means configuring
the video management system to only allow HIPAA-compliant
personnel to watch streaming video and review stored footage
and instituting strict policies and procedures for access.
PRIVACY CONCERNS
While there’s often little expectation of privacy during a hospital
stay, some hospitals are configuring their camera systems to help
them intrude less frequently on their patients without sacrificing
the quality of care. Nemours Children’s Hospital is a case in
point. Paramedics continuously monitor the vital signs of highrisk
patients from a tactical logistics center. If a concern arises,
like a sudden spike in temperature, the paramedic turns on the
bedside network camera to see how the patient is doing.
If the situation warrants, the paramedic alerts a rapid response
team to address the problem. If patient is fine, the camera
is turned off. Since an LED light automatically illuminates
whenever the camera is live, it affords the patient some privacy
while assuring that their health is being closely monitored even
when medical staff isn’t in the room. This arrangement also
helps dramatically reduce false alarms and avoid unnecessary
code blues.
Remote video monitoring can also be used to independently
verify that clinicians are following procedural checklists, administering
the correct dosage of medication or performing other clinical
activity on a timely basis. It’s this kind of checks and balances
that not only assures proper patient care but also averts potential
problems that could lead to litigation.
When it comes to the privacy of employees and the general
public, other rules may apply, depending on the hospital and the
state in which it operates.
For instance, many states require that hospitals publicly post
that the premises are under active video and audio surveillance.
In most states, anyone committing a crime or trespassing in restricted
areas automatically relinquishes their right privacy in
reference to being recorded. Employees, on the other hand, are
sometimes protected by union rules and therefore have some expectation
of privacy in carrying out their duties.
In some states there is a two-party expectation of privacy regarding
audio recording. In the case of audio analytics, however,
HIPAA concerns don’t apply since the microphones are only listening
for specific sound patterns, rather than conversations, and
the audio isn’t being recorded and stored.
To ensure compliance with HIPAA, local and state regulations,
hospitals should always implement a strong policy regarding
virtual patient observation and viewing, storing and releasing
recordings from conventional and body worn cameras. Furthermore,
those policies should be developed with input from the
hospital’s risk management and/or legal department to ensure
HIPAA compliance and reduce any liability.
MULTIPLYING THE ROI FROM NETWORK CAMERAS
As network cameras continue to advance, it’s clear that their value
can extend far beyond hospital security. The situational awareness
they provide – whether through virtual patient observation,
traditional surveillance of activity using conventional and body
worn cameras, or video and audio analytics – can help hospitals
respond more quickly and decisively to critical
events, reduce patient falls and injuries, improve
patient care, avert costly litigation and safeguard
the welfare of patients, staff, and visitors.
This article originally appeared in the May/June 2020 issue of Security Today.