Solutions in the healthcare vertical represent some of the most complex integrations created and take-up of technology means healthcare applications demand increasingly complex security and automation applications.
Hospitals are vast, with thousands of doors and tens of thousands of alarm inputs, posing serious challenges for security integration teams. Whether you’re working on a new site or undertaking an upgrade, each site has its challenges. According to Danny Berkovic of Fredon Security healthcare undoubtedly demands increasingly complex security solutions.
“Integrated systems should provide a more seamless experience in an environment where security must always take lesser priority behind the provision of life-saving services – the systems must keep staff and patients safe without getting in the way,” he explains. “Simple interfaces that provide complex functionality are achieved via integrations and these can sometimes be very complex behind the scenes. Further, healthcare is an environment that is always budget constrained – because any money spent on security is not being spend on patient care. It is critical that the systems that secure a health care environment work reliably 24×7, not only for the patients but also for the staff.”
The complexity of such solutions seems to argue that a large base hospital demands a bespoke solution but according to Berkovic, that’s not always the case.
“It is possible to undertake a healthcare application such as a large base hospital with some of the advanced access control systems that are available off-the-shelf,” he says. “This includes some of the more advanced access control systems that provide high-level integrations to VMS and other systems such as nurse-call. In these environments it’s important to have vendor-supported integrations, as too much customisation can lead to future support issues when upgrading sub-systems. A good solution, if the budget allows, is a PSIM. This is particularly well suited to a retrofit environment where sub-systems may be ageing out at different intervals.
“Our experience in hospital environments suggests that when building integrated systems access control comes first but video surveillance comes a close second. This is because, historically, a good access control system prevents an incident while surveillance allows the security team to review an incident retrospectively. The rapid evolution of affordable and reliable video analytics will quickly change this equation.”
How complicated are these applications? How long are the lead times, how demanding is the work, from installation through to writing application-specific code?
“Bespoke application development is not necessarily complicated to write,” explains Berkovic. “The entire process can be complicated if done properly – and far more complicated if not. A full requirements-gathering process must be followed including the development of comprehensive use-cases and test scenarios to ensure that the functionality developed is what the end users expect. Also, designing with maintenance and upgrades in mind is essential but does not necessary prevent future complexities if, for examples, API’s are deprecated.”
Which is hardest, brownfield or greenfield healthcare applications?
“Both are difficult, but I would suggest that modernising a brownfield site is more difficult,” says Berkovic. “A lot of analysis needs to be done to understand existing systems and budget constraints usually don’t allow for a ‘forklift’ upgrade. Hence, a brownfield upgrade is usually a series of projects to replace subsystems while maintaining the 24×7 operations of the environment.”
Are such applications as much about managing interest groups as integrating systems?
“Integrating systems” is a broad term for making 2 systems work together,” Berkovic says. “Understanding the details of how they should work together to achieve the goals of the interest groups is the real work. It can be made even more difficult if there are competing priorities from interest groups.
“And when it comes to commercial partnerships, it is important for any supplier to a hospital environment to understand that the lives of patients and staff are at stake. Any suppliers who are not willing to partner – sometimes with their competitors – are working in the wrong environment.”
A key question for integrators is the sub systems a typical healthcare integration would bring together.
“Typical sub system integrations could include access control, video surveillance, intercoms, nursecall, RTLS (real time locations services) for equipment and patients, and patient entertainment,” Berkovic says. “Additionally, different environments add specific sub-systems, such as psychiatric care and geriatric care, etc.”
“Increasingly analytics are part of this. Analytics that help video surveillance systems transition from being a reactive service to a proactive service are essential. The specifics on which analytics help most depends on the particular environment – healthcare is not uniform, and environments vary greatly from emergency wards and acute psychiatric units to dementia care.”
Management systems are also vital to a healthcare integration.
“It’s more difficult to define a coherent management system than it is to create one,” Berkovic explains. “The technical elements are challenging but defining the functionality and planning a full lifecycle is the real complexity. Remember that the quality end users most value in a healthcare security and automation solution is reliability.”
What advice would Berkovic give to integration companies looking to expand into healthcare when it comes to the pitfalls and the challenges?
“Bring a team who genuinely care about the environment they are working in,” he says. “Be prepared for callouts at all hours and then maintain systems so you don’t receive such calls. Patient and staff wellbeing is more important than apportioning blame when issues arise. Finally, develop a true partnership with your client.”
According to Wai King Wong of Axis Communications, there is a direct relationship between technology evolution and providing improved patient care in healthcare applications.
“Medical institutions that adopt new technologies are well-positioned to provide better care and more valuable service to patients and their families, Wong explains. “More than that, new technologies may help diminish loss, identify potential risk and improve operational efficiencies.
“A comprehensive risk assessment that considers the specific needs of hospitals is fundamental for a successful installation. The installer must consider product availability or obsolescence, the availability of after-sales support from the manufacturer, ongoing maintenance and disruption to hospital processes during the installation.”
Something for integrators and installers to consider is whether hospital solutions are typically built around access and intrusion, or video surveillance. According to Wong, the latest integrated solutions blur the lines, with CCTV increasingly important.
“Network based technologies are driving new trends and making hospital management smarter,” he explains. “Video surveillance cameras, which used to be only part of the hospital CCTV system, are becoming communication and data capturing devices on the network. This can enhance patient satisfaction, patient care and, above all, enable automatic, efficient and safe processes. Seeing cameras as sensors opens new possibilities. We believe that the hospitals of the future will utilise video surveillance cameras to continuously assess risks, generate automatic alerts, streamline processes, and analyse large volumes of data.
“It’s always easier on a greenfield site because the installer is not working around existing structures, instead the installation begins when the cabling is going in,” says Wong. “It means less drilling into concrete walls and trenching. But modernizing an analogue CCTV system does not have to mean scrapping the investment in legacy cameras. All analogue systems can be digitalized with the simple addition of a video encoder, a small box that converts the analogue signal into digital, without significant impact on hospital operations.”
According to Wong, managing interest groups and integrating systems are an important part of healthcare security solutions.
“The integration of multiple systems creates a powerful solution, but the involvement of user groups and end users is critical to ensure that the solution is fit for purpose,” he says. “At the same time, commercial partnerships can change the whole landscape of a project. If the partnership is led by a builder or electrical contractor, the project can become price driven, whereas if you deal with hospital management the focus is more on the outcome and the patient journey.”
Wong says the nature of the sub-systems a typical healthcare solution brings together depends on the size of the site.
“A typical hospital security system would include building management systems, real time locating systems and duress, as well as fire and security,” he explains. “More and more we see the nurse call system as the central messaging and control platform, which then integrates telephones and paging, electronic medical records, admissions as well as fire and security.”
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