September 1, 2007
Health care is one of the largest and fastest growing markets for security systems. To limit liability, comply with regulations and provide better conditions for patients and health care professionals; hospitals and other health care facilities are implementing a wide range of new security applications. In this article, we look at some of the most popular of these security applications, and at emerging applications that will drive future growth in this area â€” and unveil new opportunities for security dealers and systems integrators.
Lock-down areasGang violence is an unfortunate reality of life in many parts of the U.S. today â€” and while many citizens do their best to insulate themselves from it, that’s not possible for the doctors, nurses and other medical professionals responsible for treating victims of gang violence admitted to hospital emergency rooms. Sometimes the very same people who inflicted the wounds have been known to pursue their victims â€” who often are gang members themselves â€” all the way into the hospital in hope of causing even more pain.
In response to security concerns such as these, more hospitals are implementing “lock-down” capability, according to our experts. Burnsville, Minn.-based Trans-Alarm is one systems integrator that has built lock-down rooms in trauma treatment areas at local hospitals. As David Dalby, Trans-Alarm vice president of operations explains, such rooms typically include an access control system with high-security magnetic locks and doors, as well as CCTV. “The CCTV has to be tamper-resistant,” Dalby adds.
When appropriate, Dalby explains, an authorized nurse or administrator would initiate a lockdown using a keyswitch, palm switch or special card reader dedicated for that purpose. “On-staff security would be notified and the recording rate might be higher,” Dalby says. During the lock-down, only a handful of authorized staff would be able to gain entry to the protected area, and only by presenting the appropriate access credentials.
Another hospital that has a lockdown system is McAllen Medical Center of McAllen, Texas, which has implemented a broader system. “We can lock down the entire building,” notes Marco Castor, safety officer and engineering director for the medical center. “The system controls all perimeter doors on the first floor.”
The system already was used once â€” in response to a bomb threat, according to Castor. Although the threat was a hoax, the system was helpful in limiting access to the premises during the incident.
Infant protectionAnother threat for hospitals today is infant kidnapping. Many states now require all new hospitals to include an infant protection system. Infant protection systems typically include a pair of wireless tags â€” one of which is worn by the mother; the other is worn by her baby.
“When the nurse is ready to bring the new baby to the mother, it gives a green light that says, ‘This baby belongs to this mother,’” explains Steve Manwell, integrated sales manager for the commercial division at Superior Alarms of McAllen, Texas. If anyone other than the mother tries to leave the area with the child, a lockdown is initiated. An authorized hospital employee can put a code in to get out, but no one else can leave the area. Superior Alarms has installed an infant protection system, such as this one described, from Secure Care Products of Concord, N.H. at several local hospitals.
Protecting patient privacyThe Health Insurance Portability and Accountability Act (HIPAA) has created numerous opportunities for systems integrators. The legislation, which is aimed at protecting patient records, imposes five-figure fines on health care organizations that lose records or have them in the wrong place, notes Mark Goldstein, senior product manager for Tyco’s Software House unit, Lexington, Mass. Additionally, he explains that the use of any system containing patient names must be traceable.
To support these requirements, hospitals and health care organizations are turning to access control â€” and typically, they look for systems that provide an audit trail. As Goldstein explains, “They want to know who got into what place when, and what administrators gave access to what place when.” One customer that uses Software House to comply with legislation is Beth Israel Deaconess Medical Center of Boston, which was attracted by the manufacturer’s system capabilities that were well suited to a hospital environment â€” such as a feature that enables system administrators to give visiting doctors access to research areas, but not to patient areas.
McAllen Medical Center in Texas already had an access control system, but it was keypad code-based and was not traceable. To provide an access trail, the keypads were replaced with proximity readers. “Now we have a history of where a person has traveled throughout the building,” Castor explains. One measurable benefit is that security personnel no longer find people wandering on floors that are off-limits, he says.
But as Tom Biondi, a principal with manufacturer’s rep firm BCS Sales of Hartford notes, the cost of interconnecting numerous doors using a typical access control system can be beyond the reach of some hospitals. As a result, Biondi has seen strong demand from hospitals for a stand-alone system from Napco that provides an audit trail. “This product retrofits to the door and instead of four to five hours to install each opening, I’m talking 30 minutes.”
Asset trackingLosing wheelchairs or diagnostic equipment to theft is a great expense and significant risk for health care organizations. To help hospital clients protect such assets, Portland, Ore.-based systems integrator Selectron has used wireless RFID technology, which uses small transmitters attached to the protected equipment that communicate with the client’s access control system. The access control system can be set up to track equipment as it moves through various protected doors and based on that, can detect when a piece of equipment is headed out of the facility and alert security personnel. Alternatively, a limit can be placed on the amount of time a wheelchair is left outside the facility, with a backup camera at the exit area. If the wheelchair fails to return on time, it’s usually easy to determine what happened to it by reviewing the video associated with that camera, notes Selectron senior sales engineer Gary Clark.
Goldstein of Tyco’s Software House notes, however, that some hospitals are wary of using RFID because of concerns about potential interference with critical equipment. Instead, he says that many organizations are simply installing video in more places throughout their facilities. With today’s sophisticated DVRs, security personnel often can quickly and easily search through time-stamped video archives to determine what happened to missing equipment.
So much video, so little timeAs hospitals deploy more video cameras, reviewing images from all of them can be an overwhelming task. “Even if you hire someone full time to monitor them, you won’t see everything,” notes John Rustick, associate administrator for Doctors Hospital at Renaissance of Edinburg, Texas.
To address this, Doctors Hospital implemented video analytics from Arteco Vision Systems of St. Louis. The system enables security management to put time limits on individual doorways. If someone goes through a doorway during off-hours, the system sounds an alarm and starts recording the video.
Video analytics also can be used as an alternative to RFID for asset tracking. “In the program you can highlight a piece of equipment,” explains Rustick. “The camera senses if the equipment moves, notifies security and starts recording at that point.”
Detecting patient fallsWireless pendants aimed at enabling senior citizens (or others that are at risk) to summon help have been around for years, and can be used in hospitals, nursing homes, and residences alike. But some people are reluctant to wear them.
As an alternative, more and more nursing homes and assisted living facilities are turning to a different application of video analytics that provides similar functionality without requiring the cooperation of patients or residents. These systems, such as one from Arteco, will trigger an alarm if the system detects that someone falls or is in a stationary position for too long.
Traditionally, nursing homes and assisted living facilities use video to monitor exits. “But now they’re beginning to understand they can use intelligent video in other ways,” notes Arteco vice president Steve Birkmeier, who adds that an intelligent video system is comparable in price to a high-end DVR.
Patient falls result in $19.4 billion in health care costs a year, according to Birkmeier â€” and that number is projected to grow to $32.4 billion over the next 15 years as the baby boomer generation ages.
Protecting personnelIn certain circumstances, doctors and other health care personnel may be at risk from their patients. To help guard against personal injury, Selectron offers the MyCall system from Ottawa-based Verichip that combines a wireless panic transmitter with a location system. “As staff members move through the facility, they can be tracked to within about 10 feet,” explains Clark. “If they’re jumped or have an altercation with a patient, they can trigger a panic button which, in turn, gives their location.” Alarms go to the main desk at the unit and to the security office.
Moving forward, that type of technology may become more and more popular, predicts Manwell, who also sees it as a means of helping health care facilities limit their liability. “If a patient says ‘The nurse never checked on me,’ the hospital can show that she came in,” Manwell says.
Patient observationAs the cost of video surveillance decreases and capabilities increase, hospitals and health care facilities are using video surveillance for patient observation. Selectron has installed such systems for emergency holding rooms at local hospitals. As Clark explains, such rooms often are used for patients under the influence of drugs who may try to hurt themselves. Accordingly, it’s important that the video cameras are vandal-resistant. Selectron uses a corner-mount model from Extreme CCTV of Burnaby, B.C., Canada. “There’s no way for the patient to grab a hold of it because of how it’s made and installed,” notes Clark. “The video from the camera goes to the nurses’ desk, where it’s viewed and monitored.” To help protect patient privacy, however, the video is not recorded, Clark adds.
In another application, Selectron has installed an infrared video camera from Extreme CCTV that can be used to monitor sleeping patients. That camera operates in the dark, and has even been used in a sleep study at some local hospitals.
Life safetyIn response to regulations imposed by a range of governmental organizations, health care organizations are more concerned than ever about life safety issues. Jennifer Toscano, director of health care markets for Ingersoll Rand Security Technologies of Carmel, Ind. notes, for example, that The Joint Commision, which accredits health care organizations, has put increased emphasis on making sure that doors close and latch properly.
Health care organizations also must comply with Federal Emergency Management Agency regulations for disaster preparedness, Clark says. One unique solution he has seen to help address these requirements is a system from Vasona Technology of Mountain View, Calif. “It takes alarms from the access control system and distributes them on the computer network to any PC, workstation or public display,” Clark explains. “If there’s a fire, it immediately puts evacuation instructions on public displays to enable people to vacate the premises. And it can provide different instructions to different staff members in response to an emergency.”
Securing the pharmacyExperts interviewed for this article, also mention that hospitals often want to provide an enhanced level of security for their pharmacies. Some state health boards require the pharmacy manager to be the sole administrator of access to his pharmacy, Clark says. To address that requirement, Selectron controls pharmacy access via a proximity card programmed by the security department and a PIN code programmed by the pharmacy manager.
But some health care organizations may be reluctant to hand over complete control to the pharmacy manager. To address their concerns, Trans-Alarm’s central station monitors some hospital pharmacies remotely. That way, “their own person can’t turn off the alarm system â€” it provides checks and balances,” Dalby explains.
Parking lot securityParking lots are another area where health care facilities are increasing security, often by installing video surveillance. As Jack Gin, president and CEO of Extreme CCTV explains, “If an incident were to occur in a hospital, it usually is associated with a vehicle, and authorities have evidence to work with.”
Installing infrared cameras work well for parking lot applications, Gin says. Many models available can capture license plate numbers or other such details in low-light conditions.
Future growth areasSources interviewed for this story expect to see growth in security installations in this vertical market. In addition, several pointed to some emerging applications that are likely to see increased adoption over the next few years.
First off, biometrics, including iris or fingerprint readers are likely to gain in popularity for hospital access control systems, predicts Steve Manwell, integrated sales manager for the commercial division at Superior Alarms. “Doctors think doors should open for them without them showing anything; they don’t carry cards half the time,” Manwell says.
Infant protection systems could be enhanced through the use of facial recognition, notes Lee Duncan, branch manager for ADI, Melville, N.Y. The downside of today’s systems is that they can be foiled by hospital personnel, who can issue credentials to unauthorized individuals, he says. “Facial recognition and biometrics can alert security to someone who is not recognized,” Duncan says.
Lastly, asset tracking technology, such as RFID, could follow pharmaceuticals from production to the end-user, thereby helping to prevent counterfeiting, notes Toscano, of Ingersoll Rand Security Technologies. “We’ll see growth in that area in the next five years,” she predicts.
Sidebar: Tips and Advice for Closing the Health Care DealOne of the challenges in selling to health care organizations is that many decision makers may be involved for just one project. “There are four different people you have to get,” explains Steve Manwell, integrated sales manager for the commercial division at Superior Alarms, McAllen, Texas. These include the director of nursing, the director of engineering, the security chief and the head of information technology. Additionally, the chief operating officer is sometimes involved, Manwell says. “Trying to get all those people is like herding cats,” he adds. “Generally you have to have multiple meetings prior to installation to cover all their concerns.”
In making presentations to health care clients, Manwell advises, “Do not go in there without knowing the client.” For example, he notes that the needs of hospitals that take patients without health insurance can differ substantially from those that require health insurance.
Understanding local and national codes also is critical, says Lee Duncan, a branch manager for security distributor ADI, headquarted in Melville, N.Y. State-funded hospitals typically fall under state codes, while privately funded hospitals typically fall under city codes, explains Duncan, who is certified by the National Institute for Certification of Engineering Technologies (NICET). “If you understand what the facilities manager is going through, he’s going to rely on someone who’s sharp on the codes and understands the codes.”
Health care decision makers will view a proposal more favorably if the security company can show that productivity will be enhanced, says Jennifer Toscano, director of health care markets for Ingersoll Rand Security Technologies, Carmel, Ind. She notes, for example, that an access control system can boost productivity by helping to ensure that only authorized people are in secured areas. “Personnel can spend more time doing their job and less time keeping track of people,” she says.
Another challenge in selling security to health care organizations is that the client may not be able to measure a traditional return on investment, says David Dalby, vice president of operations for Trans-Alarm, Burnsville, Minn. Instead, he says, “You have to persuade them that the system will reduce liability.”
Prompt response on service calls also may have strong appeal for hospitals. Using hospital jargon, Manwell says, “When a hospital says ‘stat,’ that’s what they want out of their alarm company, too.” Recognizing that, he says his company quotes different prices for different guaranteed response times.
Customer references may be particularly important to health care decision makers, adds Manwell. “Have something in the bag â€” another hospital they can call,” he advises. “These people do network among other hospitals.”
Sidebar: Regulations On LineHealth care organizations must comply with a wide range of regulatory requirements. Learn about four of the most critical of these regulatory requirements and get an edge on the competition when talking to health care organizations.
Centers for Medicare & Medicaid Services (CMS)
Federal Emergency Management Agency (FEMA)
Health Insurance Portability & Accountability
The Joint Commission (JAYCO)