Touching patients with technology

July 15, 2010
Safe and secure premises predicate healing

Safety and security in healthcare and hospital settings takes special precedence in this vertical market: it's a critical part of the institution and has to be in place so patients, visitors and employees feel safe and can go about the process of getting healed or healing others.

Safety and security has to be unobtrusive and seamless and integrate to nurses and other personnel to foster a good patience experience and satisfaction rating by the user of the facility.

There's a lot riding on technology in this vertical market. There's an explosion of networked systems and the use of technology to foster communications and mobility yet still comply with HIPPA privacy and medical identity theft issues. Data has to be accessed safely and securely and many times remotely. Wireless is used increasingly to access data, send orders and other information or communicate throughout the premises. IP intercoms are prevalent and more and more systems are riding on the network.

At the far end of the spectrum, biometrics is being used to address the rapidly rising incidence of medical identity theft, and high-resolution video cameras are being used to train medical students.

In addition, a hospital is more than another business entity. It's an extension of the patient's method of healing and also of the staff member's family. Depending on the type of facility, there may be a chance of violence, such as the emergency room where gang disputes or domestic issues spill over from the streets. In in-patient surgical facilities, entrances and exits have to be supervised with access control systems, which increasingly are integrated with video.

The nuances, the landscape

Another challenge is the broad depth of the market. Long-term care and aging facilities are another facet. Here, patient wandering systems are a necessity. Local clinics are also part and parcel with the healthcare market. Depending on their location and whether in a rural or urban setting-these facilities need help from technology as well, such as medicine management solutions.

Security is essential at parking lots and other spaces that are part of the facility, yet somewhat removed from it. These areas may be where criminals, or even disgruntled family members or spouses, wait for nurses or other employees after hours. Here, video surveillance, duress systems and call systems that initiate two-way voice solutions are deployed.

Overall, the goal of the healthcare provider and their facility is to provide a safe environment-one that fosters healing. In order to do this, patients need to feel safe and secure.

"Healthcare and hospitals, particularly nurses, are looking to make their daily lives easier, so they can focus on the patient more and provide quality care," said Ericka Chesnul, vice president of Marketing for Jeron Electronic Systems Inc., Chicago.

"The technology that's available can help them do just that. It's about having communications-and the ability to communicate wherever they are. Or, get help or get equipment without having to leave the patient's side. This all reflects on how the patients see their level of care and also reflects on the hospital," she said. "In addition, nurses and doctors don't want to be burdened with all kinds of different devices, so communications is getting smarter, working together."

Chesnul added that patient 'touches' and the number per day may also relate directly to how these entities get funding, correlating directly to Medicare payments. For systems integrators, she offered this advice: "Offer a complete solution-nurse call systems, paging, location systems, asset and people tracking. They need to have all those solutions on their 'toolboxes.' They are really looking for one stop, one person to call."

The cultures from within

Texas Scottish Rite Hospital For Children (TSRHC) in Dallas is a perfect example of how the healthcare industry is changing and morphing to address the patient and their specific needs in the healing process. TSRHC is governed by a board of trustees who are members of the Scottish Rite of Freemasonry in Texas. It is the only Scottish Rite Hospital in the world and is not affiliated with Shriners Hospitals for Children.

Staff always greets visitors and escorts them on their visit, in order to facilitate closeness between the young patients and ease their fears. Stickers for the children indicate which area of the hospital they are to go, with signs corresponding to these logos. Sports memorabilia and other areas where children and their families can feel at home, play and laugh are integral to the facility.

Tranquil and healing

"TSRHC is designed with the child in mind," said Carlton Stewart III, director of Security. "It's the culture of the hospital. We don't point patients in the right direction; we take them where they need to go," he added.
Scottish Rite has a central control station in-house that monitors close to 150 cameras (analog) and DVRs that record 30 days of storage. "This system does everything I want," Stewart said, "but I know the contractors have been trying to get me to change over to NVRs."

The hospital also uses a system at the front entrance called Raptor, which scans the identification of vendors and others and verifies their identity against the National Sex Offenders Registry. Houston-based Raptor Technologies Inc. pioneered the technology that screens visitors for sex offenders nationally.

Integrator expertise in action

Control Services Inc. of Omaha, Neb. is well-versed in the healthcare market, with about one-third of its business from that vertical. Control Services recently handled two impressive systems, including the systems integration at the Nebraska Medical Center Clarkson Tower Adult Intensive Care Unit. The system in the new patient rooms consists of integrated IP cameras and access control card readers, said Phil Fenton, Security Manager for Control Services.

"The intensive care unit renovation presented a couple of unique challenges that we were able to work through with the help of the local building contractor and our own equipment suppliers," said Fenton. "The dual-side wall medicine disbursement cabinets were unusual in that they required card reader access from both sides of the wall. This required custom sliding-door cabinets to be built and special card readers to be installed."

Control Services also coordinated the installation of 13 high-resolution Axis IP cameras with night vision capabilities and several card access readers throughout the intensive care unit. Each patient room has a motion-sensitive camera with PTZ capabilities that can automatically record up to 24 hours of video using Milestone recording software.

The cameras are networked to monitoring locations on the floor so that all patients can be seen at one glance, and to a backup monitoring station for additional 24 hour recording and observation. Each AXIS camera is equipped with night vision, which was essential to providing secure monitoring when the patient rooms were dark.

The card reader access control devices manage access to the floor and all patient rooms and work areas. In addition, access control card readers are installed on all patient room medicine disbursement wall cabinets and can be opened from either side of the wall. This custom feature creates a secure medicine storage facility for each room and a formal record of the name and time of anyone entering the patient medication cabinets.

"The individual room cameras have significantly improved our ability to monitor patients at anytime of the day or night," said Sandy Crites, Manager of The Nebraska Medical Center Adult Intensive Care Unit. "In an intensive care unit, everything is critical and the new technology we are deploying creates a more efficient medical facility and allows the staff to better manage its time."

Heal and recover

Control Services also recently installed a nursecall system and remote wireless communications network at the Jennie M. Melham Memorial Medical Center in Broken Bow, Neb.

The system was part of a new $12 million facility renovation and expansion program. The new addition contains 23 state-of-the-art private rooms, an expanded nurse's station with individual computer workstations, two labor and delivery suites, examination rooms and a new networked wireless computer and wireless telephone system.

Control Services installed an Austco Nurse Call room system, integrated to the wireless communication network to make it easier for patients to communicate when they need help or assistance. By delivering a message directly to the appropriate nurse carrying a wireless device, the system enables the nurse to respond quickly to a patient need or request. The open system platform of the remote wireless and computer system also allows for easy future expansion and new system upgrades.

The system also creates an audit trail of events and how they were handled, saving nurses hours of paperwork when documenting patient activities. This automation increases caretaker productivity and accuracy, but more importantly, it puts the nurse back at the bedside.

Fenton said the hospital and healthcare vertical market has grown over the last several years. "Not only are hospitals becoming more secure, but now, employees and their visitors and patients are willing to accept a little inconvenience in trade for peace of mind with safety and security," he said. "Hospitals already have the network in place. With something like an infant protection system, we are able to integrate into the intrusion alarm, which then calls up the camera nearest to that alarm. It also allows the hospital to have a record of the event."

Fenton said the 'real estate' for the nurse's station is limited, so wireless mobility is critical. Intercoms over IP are another opportunity in the market, he added. "We start with a needs assessment to see how the user wants to manage their system and once we know that we match technology to the facility," he said.

Addressing analog installations

Randy Fierbaugh, national director of Healthcare Solutions Group for Niscayah Inc., Tampa, Fla. said this vertical has a large installed base of analog systems and lack of funding for upgrades, so it's important for the integrator to bring hybrid solutions to the table.

"It's all over the board right now as far as who's doing what in funding," he said, adding that many of the healthcare providers are waiting to see what the new National Healthcare Plan will mean for them.

"One of the big issues is the move from analog to IP and digital," he continued. "On new installs, 90 percent are IP video, although they do a fair amount of analog and many are using some sort of hybrid DVR technology. But definitely the trend is IP video, more IP access control and also infant protection systems, patient wandering and visitor management systems."

Fierbaugh said the convergence of systems in the vertical market will allow solutions to be monitored from one platform at multiple facilities and that's what the end-users in these facilities are looking for. "They want to be able to provide a centralized management of facilities that were traditionally off-site managed. Because of reduced budgets and manpower, they are moving to this type of centralized approach."

"You can create that with systems over access control and over the network," he continued, "and make managed systems more efficient and effective, such as visitor management, infant abduction so we're monitoring incidents or issues and exceptions which make the systems smarter and do more with less."

Another trend he sees is more facilities accepting third party and remote management and also, 'embedding' personnel from a third party within the facility to handle management of the system.

The healthcare market depends on technology and the solutions a security provider can offer as an integrated solution. Each facility is different, so it takes a sharp ear to listen to their needs and deliver what's best for the facility, the patients and the personnel.

HEALTHCARE AT A GLANCE

The U.S. has one of the largest medical and healthcare industries in the world, followed by Switzerland and Germany, comprised of more than 750,000 physicians and 5,200 hospitals. About 3.8 million in-patient visits and 20 million outpatients visits are logged daily. One in every 11 U.S. residents is employed in the healthcare business.

TECHNOLOGY FUELS HEALTHCARE PRODUCTIVITY

In the next 10 years, the healthcare market will focus on early diagnosis, digitized patient information that can be accessed from numerous locations, and "total solution" selling that contributes to healthcare productivity gains. Early diagnosis and prevention is enabled by emerging diagnostic technologies. For example, positron emission tomography (PET) is used to detect many kinds of cancer with great accuracy. A "paperless" hospital is another emerging trend. Digital patient records enable doctors to access patients' records-wherever the doctor is. In a digitized hospital, healthcare providers do not have to wait days for an x-ray to "come back from the lab" because the x-ray machine is digital and the image is instantly available. - Altera Corp.

TELEHEALTH TIP

Telehealth is the delivery of health-related services and information via telecommunications technologies. Telehealth delivery could be as simple as two health professionals discussing a case over the telephone, or as sophisticated as using videoconferencing between providers at facilities in two countries, or even as complex as robotic technology. Real-time telehealth is a telecommunications link allowing instantaneous interaction. Video-conferencing equipment is one of the most common forms of synchronous telemedicine. - US Department of Veteran Affairs VIDEO TRAINS SURGEONS

In a fully equipped operating theatre at the German Heart Institute in Berlin, trainee surgeons, anesthetists and cardio technicians practice open heart surgery on a sophisticated dummy. A Geutebruck hybrid recorder stores video, audio and theatre equipment data, while streaming it in real-time to the trainer in the control room and to fellow students in a lecture theatre. With a special medical torso (pictured), complete with beating heart and simulated responses to different drug treatments and interventions, theatre teams practice new procedures and learn how to cope with the unexpected without endangering real patients. A GSD-671 high resolution indoor dome camera focuses on the operation site, while a megapixel camera provides pictures of the surrounding activity. Photo courtesy Geutebruck.