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, behavioural 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 behavioural 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 organisations 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 recognised practices and standards for addressing healthcare violence. The IAHSS Foundation (IAHSSF) publishes an annual crime and incident survey analysing 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 behavioural 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, behavioural 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 programme 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, behavioural health, drug and alcohol abuse will all continue to challenge hospital staff in the Emergency Department, Women’s Health, and behavioural 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 endeavour. 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 labour. 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 behavioural 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 utilisation 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 utilise 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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Thermal cameras and smart cities: Preventing COVID-19 in public places
Thermal cameras and smart cities: Preventing COVID-19 in public places

With the pandemic still in full swing and no certainty as to when exactly it will come to an end, the world has been battling anxiety for months now. And with each day, circumstances change quickly and almost make it impossible to predict what will happen next, how events will unfold, and what actions to take in light of a new situation. But one thing is certain: the world has been shut down and paralysed for way too long, and the eventual reopening is unavoidable – in fact, it’s well under way. In this situation, what is possible to control is how the world will continue reopening – and specifically, how to ensure the safest possible reopening that will ensure the return of some degree of normalcy to people’s lives and business operations, while also managing the risk of COVID’s spread in the most efficient way. 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With the help of a Computer Vision platform, staff will be able to divide customer traffic into those with normal body temperature and those who come in with elevated temperatures, as well as effectively monitor social distance norms. The goal of our potential client is to maximise the safety of customers in the post-pandemic period. Also, IREX is already deployed across hundreds of locations in the UK and will add health monitoring capability soon.

Why cloud-enabled physical security must be part of your long-term digital strategy
Why cloud-enabled physical security must be part of your long-term digital strategy

COVID-19 and the resultant lockdown saw an unprecedented demand for cloud-enabled technologies across Europe. Such services enabled people to stay connected and allowed some businesses to relocate personnel and continue to operate successfully. With enterprise-focused video conferencing mobile app downloads showing a weekly 90% increase in comparison to pre-COVID-19 figures, it’s clear that cloud services have proven invaluable in these challenging times. Now, as the benefits to business of cloud technology become apparent, and the grip of COVID-19 begins to loosen, senior decision makers must consider the learnings from the past few months and look to apply them to boost productivity, streamline costs or become more agile in the long term. Digital transformation presents some enticing advantages for those companies that have been slow to adapt. 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Built in analytics, for example, that utilise the data from network video cameras and smart access control devices, produce valuable business insights that help to inform and automate decision making. In the recent pandemic, frictionless access control has meant touch free access to buildings; while occupancy tools have helped retailers adhere to strict government guidelines on social distancing. And as more security equipment becomes connected to the wider IT network, the advantages have not been lost on the IT industry that is expressing more than a passing interest in the adoption and management of such systems. Morphean recently conducted a survey of 1000 IT decision makers across the UK and Europe, with the purpose of providing clarity around their security purchasing intent in the 2020s. 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Facial recognition: Contactless solutions for a safe, post-pandemic world
Facial recognition: Contactless solutions for a safe, post-pandemic world

Facial recognition technology has come a long way since it first came to market several years ago. Initially plagued with technical challenges and widely viewed as a futuristic solution, facial recognition is now firmly implanted in numerous consumer and business products and applications. New advancement in software, specifically in the areas of algorithms, neural networks and deep learning and/or artificial intelligence (AI), have all dramatically improved both the performance and accuracy of facial recognition, further expanding its use for an increasing number of applications. From a purely business perspective, facial recognition’s powerful identification and authentication capabilities make it ideal for two primary applications: first as a security tool, and second as a workforce management solution. 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As a workforce management tool, facial recognition helps preserve the health of employees checking into work, while providing management with an infallible means of documenting employee time and attendance while providing a detailed history of overall workforce activity and individual personnel tracking. Both of which have been longstanding challenges due to easily compromised time tracking systems and practices. Now, nothing is left to question based on hard data. With the growing popularity of facial recognition technology, there are many choices already available with more undoubtedly on the way. Selecting the right solution for your specific access control and/or workforce management application is dependent on a very wide range of variables. But there are a few core characteristics that you should look for when evaluating facial recognition readers. Wide and near-angle LEDs Most facial recognition terminals employ some form of IR (Infrared) technology to help ensure high visibility by the unit’s image sensor. This often limits where the unit can be installed such as outdoors or near windows due to strong ambient light. More advanced facial recognition readers employ as many as 80 wide-angle near infrared LEDs and 60 narrow-angle near infrared LEDs, allowing the unit to recognise faces even in full daylight and brightly lit environments (not direct sun). This enables installation at indoor locations near windows, lobbies and building entries. 3D pixel intensity distribution analysis Another facial recognition reader advancement to look for involves three-dimensional pixel intensity analysis. Ambient lighting contains ultraviolet rays which can negate near infrared LED lighting, and can also cast shadows making it difficult for a facial recognition reader to pinpoint the facial recognition points required for identification and authentication. Three-dimensional pixel intensity distribution analysis minimises the effects of ambient light when acquiring facial images by minimising lighting contrasts. As a result, it is easier for the algorithm to recognise the shape of the face, enabling it to extract more facial features and create higher quality face templates, which are critical for accurate facial recognition. Functional ergonomics This results in a faster, more comfortable, and convenient user experience The angle and position of a facial recognition reader directly impact the performance of the unit. Facial recognition readers with different viewing angles for built-in visual and infrared cameras allows users to stand at positions that are most suitable for facial recognition with little or no effort of contortions. This results in a faster, more comfortable, and convenient user experience. High performance processing Like any intelligent edge device, the performance of a facial recognition solution is directly reliant on its processing power. New advanced facial recognition readers deliver exceptional performance by employing enhanced face template extraction technology combined with powerful processor. For example, a facial recognition reader with a 1.4 GHz quad-core processor can perform up to 3,000 facial database matches (1:N) within one second. More advanced solutions also feature Group Matching functionality capable of executing up to 30,000 matches within one second. Live face detection It is most important that the facial recognition readers you evaluate are capable of analysing faces in real time to maintain fluid entry/egress even during high volumes of employee traffic. Hardware-dependent live face detection systems employing technologies such as facial thermogram recognition and facial vein recognition require expensive hardware components, provide less accurate matches and slower authentication performance, which is counterintuitive for mainstream access control and workforce management applications. Dual authentication for added security Although the use of an advanced facial recognition reader provides the convenience, health benefits and cost-savings of touchless identification and authentication, there are many applications where more than one credential may be necessary to ensure the highest levels of security. Advanced facial recognition readers with multimodal, multifactor credentialing capabilities provide this added security benefit. For example, facial recognition readers that support multiple RFID proximity devices supporting 125 kHz and 13.56 MHz provide varying degrees of protection and greater implementation versatility. Videophone or intercom capabilities Facial recognition readers with multifunctionality can solve several challenges with one solution Facial recognition readers with multifunctionality can solve several challenges with one solution. A perfect example includes devices with SIP (session initiation protocol) videophone capabilities which effectively eliminate the need and associated expense of  installing separate intercom devices while adding another layer of security to one’s facility. The COVID-19 pandemic, and hopefully soon to follow post-pandemic world, have surely accelerated the need for highly accurate, cost-efficient, and reliable facial recognition technologies to help get people back to work safely. Selecting the right facial recognition solution for your specific access control and/or workforce management is now more important than ever before, making a little extra due diligence during the evaluation process a smart decision.