Diagnosing Healthcare Security
Multi-site deployment requires centralized monitoring, diverse security technologies
- By Brian Carle
- Jun 01, 2016
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.
SECURITY CHALLENGES AND INTEGRATION
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
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
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.
EXPORT AND PRIVACY
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
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
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.
BRINGING IT ALL TOGETHER
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
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
This article originally appeared in the June 2016 issue of Security Today.