Security cameras monitored at CoxHealth in Missouri.
Image courtesy of the authors
Approximately 25 years ago, the first internet protocol (IP) camera was invented by Swedish inventor and entrepreneur Martin Gren. His original vision was that networks would grow and the need for IP solutions would grow along with them. The Internet of Things was just a dream then, but Gren recognized that video and audio solutions — along with useful analytics — were the wave of the future.
Today, connectivity has become the standard and, in hospitals, traditional security cameras are now being used to enhance the patient experience and improve the quality of patient care. These highly integrated systems feature smart cameras and audio speakers, with edge analytics devices on the hospital’s infrastructure providing a unified solution that keeps people and property safe. Further uses, including improved patient monitoring and telemonitoring, alongside integration with electronic medical records, have also improved operational efficiencies.
Thanks to improvements in image quality, processing power and analytics, security systems are no longer a purely reactive tool used primarily for reviewing incidents after the fact. The “smart hospital” is now a reality — and video, audio and analytics all play a role in revolutionizing health care operations and security.
Video and audio solutions
Modern cameras and sensors provide opportunities for real-time intervention when a potential security incident is detected, but they can also serve purposes that go far beyond security and response capabilities. Video can be used to track patient movements, allow doctors to communicate freely with patients from a safe distance, issue automatic security alerts and more. Best of all, improvements in technology and accessibility have placed these video solutions within reach of any health care facility, regardless of its size.
A pan-tilt-zoom camera maintains watch on a campus exterior.
Image courtesy of the authors
In previous times, health care facilities consistently bumped up against one major limiting factor: staffing. No matter how observant or responsible a security team member is, human beings will inevitably miss things. After all, that’s where the term “human error” comes from. They might overlook a visitor heading toward a restricted area or fail to notice the signs of a patient in distress.
What’s more, doctors and nurses were limited by their ability to only be in one place at a time. Their ability to observe or converse with patients was limited by how often they could be physically present in the room. For health care providers juggling potentially dozens of patients, this could lead to both overworked doctors and patients feeling slighted or overlooked.
Modern audio and video devices have changed that substantially. For starters, cameras are no longer limited to traditional surveillance cameras on the walls or ceilings. Yes, traditionally fixed ceiling cameras can still provide a valuable perspective into patient rooms, but today’s options include wireless carts, mobile wall mounts and even IV pole-mounted cameras. This makes it easier than ever for patients to communicate with their health care providers, but it also makes it easier for those providers to observe their patients directly and get a better sense of what is going on.
Best of all, these solutions don’t require personnel to be physically present — something that was particularly important at the height of the COVID-19 pandemic. This makes it significantly easier for doctors and nurses to check in on their patients from anywhere and at any time. Because they don’t need to be physically present in a patient’s room, they can interact with a greater number of patients with more regularity, improving not just their standard of care but patient morale as well.
Planning for installation
Before implementing a new solution or technology, planning for the installation process is critical. This means having good policies and guidelines in place, as well as understanding the limits of the technology. Good planning means understanding any limitations the information technology (IT) staff may have, how the technology will be used, and what immediate and long-term costs will be associated with it, among other factors. For health care in particular, both internal hospital and external building and installation permits may be required. Understanding those needs and accounting for them will be critical.
Well-trained staff members can go a long way. They need to be trained on the solution, informed of its capabilities and given clear guidelines on how to respond to an alarm or event. It is important to effectively convey how to respond to alerts, what the technology is expected to accomplish and all procedures associated with its safe operation. It is also critical to establish appropriate expectations for what the technology can accomplish and ensure that users understand what it can and cannot do. Finally, maintaining the solution with preventive maintenance and licensing should also be planned, as this is a major consideration that can sometimes be overlooked.
Bridging the gap between security and IT is also an essential element of creating and maintaining a strong security strategy. In many health care facilities, the IT department often has a larger budget, better processes and greater mastery of the technological infrastructure. As a result, it makes sense for security to work directly with — and build upon — the established expertise in IT to create a more comprehensive plan. Ultimately, everyone involved in health care security has the same goal: to create a secure, smoothly operating hospital that provides optimal levels of patient care and safety. Partnering with IT is the best way to achieve this goal.
One final element to consider during the installation process is life cycle management. Cycling out old devices — or updating them with improved software — is an important part of staying up to date with modern surveillance technology and ensuring that the best possible solutions are still in place. Creating a structured and organized platform to easily visualize the age and status of each device within the network is an essential part of building a security system that will last.
Real-time monitoring
While improving communication between patients and caregivers is important, today’s IP camera technology really shines in a safety and security context. Thanks to modern analytics, cameras can now be programmed to automatically detect and alert on certain objects, movements, behaviors, sounds and other factors, eliminating the human error factor and turning cameras into a proactive solution rather than a reactive one. This automatic alerting also helps further address the staffing issue.
Video systems make it easier for nurses to check on their patients from anywhere and at any time.
Image courtesy of the authors
Monitoring high-risk patients is a perfect example of how the technology provides a measurable improvement over prior solutions. Patients deemed a risk to themselves or others require careful monitoring. This could sometimes be performed via camera feeds, but most hospitals found that a single individual could reliably monitor no more than three or four patients at a time. Some particularly high-risk patients even required one-on-one monitoring, with an individual present in the room with them always. This is not without reason: a significant portion of all slip, trip and fall cases result in injury. This is not only bad for patient outcomes, but each of those injuries can cost the health care facility significantly. Monitoring these patients is essential.
Modern analytics have made it possible to effectively monitor all patients in real time. Today’s cameras can be programmed to detect when a patient attempts to leave their bed, exit the room or simply cross a predetermined line in the room. The system can then generate an instant alert, a provider can access the camera and observe the patient, and help can be dispatched immediately. Just by reducing slip, trip and fall cases, and reducing or eliminating the need for human monitors, health care facilities can save a significant amount of money. In effect, the technology can pay for itself.
This is just one example of how the technology can serve an impactful security purpose. Today’s cameras can detect people loitering around hospital access points or heading toward restricted areas and trigger automated messages warning them to keep clear. Acoustic analytics can be trained to detect certain noises, including gunshots, breaking glass, raised voices and signs of patient distress like coughing or gasping for air.
In a health care context, the ability to instantly detect these danger signs and instantly alert the necessary personnel can be the difference between life and death. Today, technology can further identify certain physiological monitor alarms, alerting clinical staff to a patient in distress. By decreasing response times, these devices can alert security to a potentially dangerous situation or help doctors and nurses get patients the help they need before the situation can escalate into a genuine emergency.
Health care is consistently ranked among the most hazardous fields. Some of this is because those who work in health care are naturally more likely to contract illnesses, but there are physical dangers as well. Patients sometimes become violent. Some may simply be scared or confused, while others might be in chemically altered states. Sometimes injuries are caused by attempting to move or handle a patient without sufficient support. Whatever the ultimate cause, health care facilities have a clear interest in identifying ways to cut back on potentially dangerous situations.
Body-worn devices are another part of the solution. CoxHealth, a major health care system in Missouri, recently invested in a body-worn camera system for its security personnel. By equipping public safety officers with cameras, CoxHealth hoped to improve its ability to de-escalate situations, as well as provide a more accurate picture of events as they happened and eliminate false claims of officer misconduct. In addition, the cameras have provided valuable footage to help educate security personnel on how to respond to workplace violence incidents in the future, allowing them to serve as a training tool as well.
Video and audio systems allow clinical staff to interact with patients from a distance.
Image courtesy of the authors
Modern audio and video solutions can help. In addition to detecting signs of patient duress, today’s analytics solutions can be trained to identify signs of aggressive behavior, such as raised voices or wild gesticulation. The system can then immediately alert security personnel, who can potentially arrive in time to de-escalate the situation. This is the very definition of proactive security, and it would not be possible without automatic incident detection and alerts. In some cases, facial or license plate recognition can also help by identifying potentially dangerous visitors before they can gain entry to the facility. This, too, can prevent a tense situation from arising.
Not all signs of danger are obvious, though. Health care facilities must also give their employees the resources they need to discreetly signal for help should the need arise. This might come in the form of a universal serial bus duress button, a network input box, a wireless input button, or a discreet or wall-mounted button.
These solutions can be tailored to not only signal for help but open a live audio or video channel to security personnel so that they can see and/or hear what is happening in real time. They can also be configured as silent alarms, allowing the caregiver to signal that they need assistance without risk of further escalating the situation. Body-worn devices are also part of the solution and can help provide an accurate picture of what is happening in a situation while holding both patients and hospital staff accountable for their actions.
One underappreciated aspect of modern video and audio solutions is the ability to streamline facilitywide communications — particularly regarding emergency announcements. Today’s solutions can generate automated alerts to specific security personnel, caregivers and other employees, but they can be integrated with the public address (PA) system to issue broader alarms when necessary. During a fire, active shooter or other emergency, tailored automated messages can be played. These messages can be customized for different zones, providing specifically tailored instructions or information. When needed, security personnel or facility managers can break in with live updates for those in affected areas.
Integrating these solutions allows health care facilities to build a more comprehensive approach to safety and security. Facilities managers can use access control solutions to allow firefighters into a restricted area. They can track the location of a suspected assailant across multiple camera systems and keep law enforcement updated on their location. They can even use more advanced capabilities, such as cellphone pinging, to obtain location data in an emergency and send specific alerts to individuals in harm’s way. In any emergency, the ability to convey information quickly and effectively to those who need it is paramount, and today’s integrated security solutions can do just that.
A comprehensive approach
The COVID-19 pandemic forced many health care facilities to modernize their operations and implement remote monitoring and communications solutions that will provide value long after the pandemic is over. Doctors and nurses can look in on their patients from anywhere with the touch of a button and communicate with them directly from any location. Better still, cameras and audio sensors can identify signs of distress in real time, issuing immediate alerts and lowering response times.
Workplace safety, emergency response and patient care are all critical concerns for health care facilities, and analytics solutions have given them the ability to detect potentially dangerous situations faster and more reliably than ever. From facial recognition and access control to PA announcements and aggressive behavior detection, today’s cameras and sensors can be equipped with the functionality that health care facilities need to improve both the standard of care and facility security. Integrating these solutions with tailored security alerts can ensure that the right people have the right information at the right time.
About this article
This article is based on a presentation given at the International Association for Healthcare Security and Safety Annual Conference & Exhibition.
Paul J. Baratta is manager for industry segments in the Americas at Axis Communications Inc., Chelmsford, Mass., and Tim Lee is vice president of sales at Lynx Systems, Richardson, Texas. They can be reached at paul.baratta@axis.com and tim@mitsi.com.
