There have been many changes in the healthcare environment over the past decade. The Affordable Care Act has been established, severe weather events are on the rise, violence along with active shootings continue to increase, behavioral health patients present treatment challenges and hospitals continue to consolidate to increase purchasing and service capabilities. Over the next decade, healthcare will continue to transform. Emphasis will be on financial reform, violence response, emergency preparedness, the proper care and handling of behavioral health patients and service efficiencies.

Current Issues Affecting Healthcare Security

Violence in healthcare continues to pose the greatest risk to hospital staff. Several key healthcare organizations have published information to assist security directors in the reduction of violent incidents.

The International Association for Healthcare Security and Safety (IAHSS) publishes security and design guidelines specific for healthcare facilities. These resources provide valuable and internationally recognized practices and standards for addressing healthcare violence. The IAHSS Foundation (IAHSSF) publishes an annual crime and incident survey analyzing violence in healthcare.

The American Hospital Association (AHA) recently published a webpage specifically to assist in the mitigation of violence. ASIS International has published several whitepapers addressing healthcare security; specifically violence related to behavioral health patients and disruptive and violent behaviors in healthcare. The Occupational Safety and Health Administration (OSHA) website offers numerous tools and resources pertaining to workplace violence and safety with a section devoted specifically to the healthcare industry.

Possibility Of Healthcare Workplace Violence Prevention

At the time of writing, the Republican Party had not figured out how to change the Affordable Care Act (ACA) while still making healthcare more affordable. Most likely changes in health care will occur within the expanded purchasing options, Health Savings Accounts (HAS’s), Medicare reimbursement and the use of government exchanges. The indoctrination of the ACA included increased investigation to Medicare fraud and audits to hospitals for billing errors. In 2016, the Federal government collected over three billion dollars in fraud and reconciled billings to Medicare.

Violence will continue to challenge the healthcare sector in the future
Domestic violence, child abuse, behavioral health, drug and alcohol abuse will all continue to challenge hospital staff

The Joint Commission issued Sentinel Alert 57. This alert focuses on the role of leadership in developing a safe culture. The Occupational Health and Safety Administration (OHSA) contemplated issuing a healthcare workplace violence prevention standard. This standard required healthcare institutions to have a clearly defined prevention program in place.

This year, a total of 25 states have legalised marijuana. This legislation will dramatically change how we care for patients and deal with patients, employees and visitors who are using the substance and may be impaired at work and within the hospital, and who may request continued use while being an in-patient within a facility that is smoke free.

The Future For Healthcare Security

In the future, healthcare security professionals will have to deal with a variety of events from severe weather, violent and active shooter incidents, terrorist attacks, and continued changes to healthcare reimbursement. Severe weather has the potential to impact all healthcare systems across the globe. Specific attention must be directed at knowing the weather threats common to specific geographical locations. A Comprehensive Emergency Management Plan (CEMP) must be current and thorough for disaster response. Performing exercises is a valuable tool in staff education and opportunity to reinforced skills for those assigned to incident command positions.

The Hazard Vulnerability Assessments helps in defining risk severity and identifying historical
patterns of violence

Violence will continue to challenge the healthcare sector in the future. Domestic violence, child abuse, behavioral health, drug and alcohol abuse will all continue to challenge hospital staff in the Emergency Department, Women’s Health, and behavioral health areas. The Hazard Vulnerability Assessments (HVA) along with facility wide risk assessments helps in defining risk severity and identifying historical patterns of violence.

Active Shooting Incidents

According to the FBI, an analysis of 2014 and 2015 active shooter incidents identified 20 incidents in each of these years. This annual tally is an increase from 17 in the year 2013. In a John Hopkins study entitled, “Hospital-based Shootings in the United States: 2000 to 2011,” Hopkins identified 154 hospital related shooting events (26.6 events per 1,000 hospitals) in 148 hospitals, affecting 235 victims (0.79 per 1,000,000 population). The risk of experiencing an active shooter incident is increasing. Hospitals must be prepared to not only deal with their own active shooter incident, but any that could occur in their service community.

Changes in terrorist tactics now present a new challenge for the healthcare security. According to Homeland Security, hospitals play a major role in the response for terrorist-related incidents and terrorist activities within the United States. Today, incidents are comprised of local combatants whose goal is to kill civilians in crowded areas like restaurants, concerts, and other mass gatherings. Attacks in the past have focused on first responders and their ability to treat victims. Healthcare institutions need to be ready to again accept victims of terrorist events and prepare for the potential for becoming victims of an event as well.

Trump Care

At the writing of this article, “Trump Care” is still being debated. However, certain things seem clear. In the future, Medicare reimbursement will probably be reduced leaving hospitals with less money within their payor mix. Trump Care may also see increased State control over the reimbursement process, allowing each State to decide its own fate when it comes to Medicare and Medicaid payment rates. This could provide hospitals with less revenue, leaving hospital security departments with budgets struggles for both staffing and technology.

Severe weather, violent and active shooter incidents and terrorist attacks all affect healthcare security
Today, incidents are comprised of local combatants whose goal is to kill civilians in crowded areas like restaurants, concerts, and other mass gatherings

Staff recruitment will remain amongst the most challenging endeavor. The need for qualified and skilled security staff will challenge the best of talent recruiters. Competitive wages and benefits will require continual focus for attracting skilled labor. Recruiting practices and personal skill screening tools will be of benefit. Some systems find outsourcing their security department the best option. Hybrid models are options as well as contracting with local law enforcement for additional presence.

Training For Healthcare Security Staff

A key factor of success for security in healthcare is training. Providing staff with the necessary tools and skills will afford significant return on investment with quality and satisfaction outcomes. Healthcare security staff should receive training focusing on patient safety, patient experience, customer experience and quality of service. Awareness and understanding of behavioral health, aggression management and de-escalation talents, crime prevention and customer service abilities and aptitudes are a must. The International Association for Healthcare Security and Safety (IAHSS) offers several educational certification levels designed specifically for healthcare security officers.

 Importance Of Robust Security Department

Utilising concepts and dynamics of lean tools, technology options, clinical throughput, and Standard Work all influence security services. The concept of Standard Work is popular in the business world. Utilising this concept is beneficial to security. Standard Work can identify staffing needs, work flow process, consistency in service levels, and maximum utilization of technology resources and equipment. Striving for the right person doing the right work with the right skill set is the desired outcome. Often the same concept will hold true for identifying the right department providing the right service for the right reason.

Data will be of extreme importance in the distribution of those resources. Security departments need to collect relevant data on all aspects of security services from reported crime data, security calls for service, annual risk assessments and benchmarking data. Hospital security departments must create a data-driven environment that can help to demonstrate service needs and improve processes over time. The real success of using data is the analysis of data to determine patterns and trends that can demonstrate the need for and successes in security services.

Methods for managing healthcare security are driving factors. A robust security department will implement and utilize security technology to support and influence safety, security and quality outcome measures. Return on investment (ROI) and the ability to show quality metrics and positive influence in life-safety, security and patient satisfaction scores will be core in driving positive capital decisions. Challenges of healthcare security in the future will require continued education and knowledge of current trends, guidelines, and standards within the healthcare security industry.

By Ben Scaglione and David LaRose

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What Do You Need To Know About Thermal Imaging Cameras?
What Do You Need To Know About Thermal Imaging Cameras?

As businesses, schools, hospitals and sporting venues look to safely reopen in a COVID-19 world, thermal imaging systems will play a critical role in helping to detect and distinguish skin temperature variations in people. Thermal surveillance, a mainstay of traditional physical security and outdoor perimeter detection, is now being deployed to quickly scan employees, contractors and visitors as part of a first line of defense to detect COVID-19 symptoms. In the coming weeks and months, the security industry will look to implement thermal camera solutions for customers, yet many questions remain as to the differences between different system types and how to properly install thermal imaging cameras. In this Q&A, Jason Ouellette, Head of Technology Business Development for Johnson Controls, answers several of these questions. Q: What are some of the different thermal imaging solutions available in the market to detect an elevated temperature in a person? For the general market, there are three types of these thermographic screenings. There is the handheld device, which is typically lower cost, very portable, and very easy to use. Typically, this is a point and shoot type of device, but it requires you to be three feet or less from the person that you're screening, which, in today's world, means the user needs to wear protective personal equipment. For the general market, there are three types of these thermographic screenings The second type of solution would best be described as a thermal camera and kiosk. The advantage of this system over a handheld device is this can be self-service. An individual would go up to and engage with the kiosk on their own. But many of these kiosk type solutions have some integration capability, so they can provide some type of output, for either turnstiles, or physical access control, but not video management systems (VMS). Some of the downside of this type of system is that it’s less accurate than a thermographic solution because it does not have a blackbody temperature calibration device and the readings are influenced by the surrounding ambient temperature, called thermal drift. So instead of being able to achieve a ±0.3ºC accuracy rating, this system probably provides closer to ±0.5ºC at best. Some of these devices may be classed as a clinical thermometer with a higher degree of one time accuracy, but do not offer the speed and endurance of the thermographic solution for adjunctive use. And then there are thermal imaging camera systems with a blackbody temperature calibration device. These types of systems include a dual sensor camera, that has a visual sensor and a thermal sensor built right into the camera, along with a separate blackbody device. This provides the highest degree of ongoing accuracy, because of the blackbody and its ability to provide continuous calibration. These systems can provide much more flexibility and can offer integrations with multiple VMS platforms and access control devices. Q: When installing a thermal imaging camera system what is the most important element to consider? Camera placement is critical to ensure the system works as expected, however the placement of the blackbody device which verifies the correct calibration is in place is equally as important. If the customer wants to follow FDA medical device recommendations for camera placement, both the height of the camera and the blackbody as well as the distance between these devices should comply with the product installation instructions. This takes into account the device focal range and calibration parameters in addressing the distance from the person undergoing the scan. Also, integrators should minimize camera detection angles to ensure optimal accuracy and install cameras parallel with the face as much as possible, and again in compliance with installation instructions. Integrators should minimize camera detection angles to ensure optimal accuracy The blackbody should be placed outside of the area where people could block the device and located more towards the edges of the field-of-view of the camera. You need to keep in mind the minimum resolution for effective thermographic readings which is 320 by 240 pixels as defined by the standards. To achieve this, you would need to follow medical electrical equipment performance standards driven by IEC 80601-2-59:2017 for human temperature scanning and FDA guidelines. Within that measurement, the face needs to fill 240 x 180 pixels of the thermal sensor resolution, which is close to or just over 50 percent of the sensor’s viewing area typically, meaning a single person scanned at a time in compliance with the standards for accuracy.  Along with height and distance placement considerations, the actual placement in terms of the location of the system is key. For example, an expansive glass entryway may impact accuracy due to sunlight exposure. Installations should be focused on ensuring that they are away from airflow, heating and cooling sources, located approximately 16 feet from entry ways and in as consistent of an ambient temperature as possible between 50°F and 95°F. Q: Once a thermal imaging camera system is installed, how do you monitor the device? There are several choices for system monitoring, depending on whether the solution is used as standalone or integrated with other technologies, such as intrusion detection, access control or video systems. For standalone systems, the ability to receive system alerts is typically configured through the camera’s webpage interface, and the cameras include abilities such as the live web page, LED display for alerting, audio alerts and physical relay outputs. When done right, these features will all follow cybersecurity best practices which is important for any network solution today, including changing default passwords and establishing authentication methods. The ability to receive system alerts is typically configured through the camera’s webpage interface These types of thermal cameras can also integrate with turnstile systems, VMS platforms and access control systems. This is typically done through the integration of a relay output, activated by a triggered temperature anomaly event on a thermal imaging camera which can then be used for activities such as locking a turnstile, or through access control and video systems to send an email or provide an automated contagion report for contact tracing. These capabilities and integrations extend the monitoring capability above that of the standalone solution. The camera can be configured to monitor a specific range of low and high alerts. Users can determine the actions that should be taken when that alert exceeds the preset low or high threshold. These actions include things like a bright and easy-to-see LED can provide visual notification through pulsing and flashing lights as an example. Q: What about system maintenance? Does a thermal imaging camera require regular service in order to operate accurately? First it’s important to make sure the system is calibrated. This can be done after the unit stabilises for at least 30 minutes to establish the initial reference temperature source known as the blackbody. Calibrations conducted before this warm up and stability time period can throw off accuracy. Also, as part of your system maintenance schedule you will want to perform a calibration check of the blackbody device every 12 months, along with following recommendations of the FDA and IEC. If you install the solution and don’t perform maintenance and the blackbody calibration certificate expires, over time there’s a risk that the device will experience drift and a less accurate reading will result. There’s a risk that the device will experience drift and a less accurate reading will result Q: What final pieces of advice do you have for either an integrator who plans to install a thermal imaging camera system or an end user who plans to invest in this solution? Before you buy a thermal imaging camera check to see if the manufacturer ships the camera with a calibration certificate. Also, become familiar with FDA’s guidance released in April 2020, Enforcement Policy for Telethermographic Systems During the Coronavirus Disease 2019 (COVID-19) Public Health Emergency. This document places thermal/fever products for adjunctive use under the category of a Class I medical devices and subject to its regulatory control. Driven by these regulations and categorisation, users need to understand specifically what is required to meet the required level of accuracy for successful detection. While thermal imaging camera systems are more complex than traditional surveillance cameras, they can prove to be a valuable resource when set up, configured and maintained properly.

Functionality Beyond Security: The Advent of Open Platform Cameras
Functionality Beyond Security: The Advent of Open Platform Cameras

The coronavirus (COVID-19) pandemic marks the biggest global disruption since World War II. While the ‘new normal’ after the crisis is still taking shape, consumers are apprehensive about the future. According to a recent survey, 60% of shoppers are afraid of going grocery shopping, with 73% making fewer trips to physical stores. Returning to the workplace is also causing unease, as 66% of employees report feeling uncomfortable about returning to work after COVID-19.  Businesses and employers are doing their best to alleviate these fears and create safe environments in and around their buildings. This also comes at tremendous costs for new safety measures and technologies – including updates to sanitation protocols and interior architecture – that protect against COVID-19. Costs in the billions that most businesses will face alone, without support from insurance and amidst larger, macroeconomic challenges. Saving costs and increasing security But what if building operators, retail shop owners, and other stakeholders could save costs by leveraging new functionality from their existing security infrastructure? More specifically, expanding the use of current-generation security cameras – equipped with AI-driven image analysis capabilities – beyond the realm of security and into meeting new health regulations. This is exactly where video analytics algorithms come into play. And in the next step, a new evolutionary approach towards open security camera platforms promises new opportunities. Security cameras have evolved from mere image capturing devices into complex data sensors Over the past decade, security cameras have evolved from mere image capturing devices into complex data sensors. They provide valuable data that can be analyzed and used in beneficial ways that are becoming the norm. Since 2016, Bosch has offered built-in Video Analytics as standard on all its IP cameras. On one hand, this enables automated detection of security threats more reliably than human operators. And on the other hand, video analytics collect rich metadata to help businesses improve safety, increase efficiency, reduce costs, and create new value beyond security. Expanding Camera Functionality Beyond Security Today, we have ‘smart’ security cameras with built-in video analytics to automatically warn operators of intruders, suspicious objects and dangerous behaviors. The rich metadata from several cameras on the same network can also be consolidated by making use of an intelligent software solution. It offers so-called pre-defined widgets to provide business intelligence by measuring area fill levels, counting building occupancy and detecting the formation of crowds. In combination with live video stream data, these insights enable heightened situational awareness to security operators. What’s more, operators are free to set their own parameters – like maximum number of occupants in a space and ‘off limit’ areas – to suit their needs. These user-centric widgets also come in handy in dealing with the coronavirus pandemic. Specific widgets can trigger an alarm, public announcement or trigger a 'traffic light' when the maximum number of people in a space is exceeded. Building operators can also use available intelligence such as foot traffic ‘heat maps’ to identify problem areas that tend to become congested and place hand sanitizer stations at heavily frequented hotspots. At the same time, the option to perform remote maintenance on these systems limits the exposure of technicians in the field during the pandemic. Again, the underlying camera hardware and software already exist. Cameras will be able to ‘learn’ future functionality to curb the spread of the coronavirus Looking ahead, cameras with video analytic and neural network-based analytic capabilities will be able to ‘learn’ future functionality to curb the spread of the coronavirus. For instance, cameras could monitor distances between individuals and trigger voice announcements when social distancing guidelines are violated. Facial recognition software can be trained to monitor personal protective equipment (PPE) compliance and sound alerts for persons entering buildings without masks. The technical requirements are already in place. The task at hand is to deliver these new functionalities to cameras at scale, which is where open camera platforms hold the key. Why Open Camera Operating Systems? When it comes to innovating future camera applications that extend beyond security, no hardware manufacturer should go at it alone. Instead, an open platform approach provides the environment for third-party developers to innovate and market new functions. In essence, an open platform principle allows customers and users to change the behavior of devices by adding software afterwards. This software can either be found in an app store or can be self-developed. For a precedent, we can look at the mobile phone industry. This is where software ecosystems like Android and Apple’s iOS have become the norm. They have also become major marketplaces, with the Apple App Store generating $519 billion in billings on 2019, as users use their phones for far more than just making phone calls. In the same way, intelligent cameras will be used far beyond classic video applications in the future. To get there, adopting an open platform principle is essential for a genuine transformation on an industry level. But establishing an open platform principle in the fragmented video security industry demands a cooperative approach. In 2018 Bosch started a fully owned start-up company, Security & Safety Things, and became one of five founding members of OSSA (Open Security & Safety Alliance). With more than 40 members, the Alliance has collectively created the first Technology Stack for “open” video security devices. This includes the OSSA Application Interface Specification and Compliant Device Definition Specification. An open camera platform for innovating future functionality  Based on OSSA’s common APIs, collective approach on data security and core system requirements for video security cameras, the first camera manufacturers were able to build video security cameras that adopt an open platform principle. Further fueling innovation, OSSA focused on driving the creation of one centralized marketplace to unite demand and supply in the market. Camera devices that are built in accordance with OSSA’s Technology Stack, so-called “Driven by OSSA” devices, can benefit from this marketplace which consists of three pillars: a development environment, an application store, and a device management portal. Security & Safety Things has advanced OSSA’s open camera platform concept, built this marketplace for the security and safety industry and has developed the open OS that powers the first “Driven by OSSA” devices. Making it quick and simple to customize security solutions by installing and executing multiple apps This year, Bosch, as one of the first camera manufacturers, introduces the new INTEOX generation of open platform cameras. To innovate a future beyond security functionality, INTEOX combines built-in Intelligent Video Analytics from Bosch, an open Operating System (OS), and the ability to securely add software apps as needed. Thanks to the fully open principle, system integrators are free to add apps available in the application store, making it quick and simple to customize security solutions by installing and executing multiple apps on the INTEOX platform. In turn, app developers can now focus on leveraging the intelligence and valuable data collected by analytics-equipped cameras for their own software developments to introduce new exciting possibilities of applying cameras. These possibilities are needed as smart buildings and IoT-connected technology platforms continue to evolve. And they will provide new answers to dealing with COVID-19. The aforementioned detection of face masks and PPE via facial detection algorithms is just one of manifold scenarios in which new apps could provide valuable functionality. Contact tracing is another field where a combination of access control and video analytics with rich metadata can make all the difference. Overall, open camera platforms open a future where new, complex functionality that can save lives, ensure business continuity and open new business opportunities will arrive via something as simple as a software update. And this is just the beginning.

Recognizing The Importance Of Security Officers To Promote Safety
Recognizing The Importance Of Security Officers To Promote Safety

The general public doesn’t give much thought to the important role of security officers in creating and promoting safer environments. The low-profile work of security officers is vital to protecting people, places and property. During the pandemic, newer aspects to that role have emerged. Security personnel have been called on to perform diverse tasks such as managing queues at the supermarket, safeguarding testing centers and hospitals, ensuring food deliveries, and supporting police patrols. The British Security Industry Association (BSIA) and two other organizations in the United Kingdom are joining forces to raise awareness of the work of security officers and to recognize the vital importance of the duties they perform. BSIA, a trade association, includes members who are responsible for 70% of privately provided UK security products and services, including security guarding, consultancy services, and distribution and installation of electronic and physical security equipment. BSIA, the Security Institute and the Security Commonwealth Joining BSIA in the awareness campaign are the Security Institute, a professional security membership body; and the Security Commonwealth, which is comprised of 40 organizations from across the security landscape with common objectives to build professionalism, raise standards and share best practices. “The recognition of security officers as key workers is the start of a re-appraisal of what service they provide to the community in keeping the public safe and secure,” says Mike Reddington, BSIA Chief Executive. “As we exit lockdown and have to navigate public spaces again, [security officers] will have a crucial role in supporting public confidence. We are working closely with the Police and all other public bodies to find the best way to achieve this.” Security officers acknowledged as key workers The campaign will showcase security professionals as a respected, valued, professional service provider and a key worker that is acknowledged and embedded in daily lives. The British Security Industry Association (BSIA) and two other organizations in the United Kingdom are joining forces to raise awareness of the work of security officers “Great effort has been invested in the professional standards and capabilities of frontline [security] officers, and they have proven their worth during the coronavirus crisis in the UK,” says Rick Mounfield, Chief Executive, the Security Institute. “They, along with the wider security sector, deserve to be recognized, respected and appreciated for the safety and security they provide across the United Kingdom.” “[We are working to] build professionalism, raise standards and share best practices, and I hope this campaign can make more people recognize the changes we have all made and continue to make,” says Guy Matthias, Chairman of the Security Commonwealth (SyCom). The industry will be reaching out to companies, professionals, and organizations in the sector to participate in the campaign. The hope is that, over the coming weeks as lockdown is eased, the industry can play its part to ensure that the country emerges with confidence to start to recover and build for the future. Private security more important than ever The campaign will showcase security professionals as a respected, valued, professional service provider Across the pond in the United States, law enforcement professionals are facing a crisis of confidence during a time of civil unrest as protestors call to “defund the police” and to otherwise undermine and/or recast law enforcement’s role in preserving the peace and ensuring public safety. If an upshot is that public policing is starved of resources, the role of private security to supplement their mission is likely to increase. In short, the role of private security is more important than ever on both sides of the Atlantic. Public recognition of that role is welcome, obviously. In any case, the importance of their role protecting people, places and property has never been greater.