This article originally appeared as the cover story in the April 2023 issue of Security Business magazine. When sharing, don’t forget to mention Security Business magazine on LinkedIn and @SecBusinessMag on Twitter.
COVID obviously changed the operations of hospitals forever, and most healthcare systems in the United States struggle with staffing shortages, burnout, workplace violence…the list goes on. At the same time, the market is adapting to a new normal that many industries have – doing more with less.
Interestingly, this is creating a market rife with opportunity for systems integrators.
“Healthcare in general – whether it is acute care, long-term care, palliative care – all of them are on a similar path, and it is changing,” explains Mike Bradley, President and CEO of ECD Systems, a systems integrator headquartered in Tempe, Ariz. “COVID changed the entire healthcare environment, but despite all the struggles of the recent past, healthcare is going to be one of those growth industries you can't ignore for at least the next decade. In fact, there are some integrators in the industry who have decided they don't care about anything else.”
As an aging society, healthcare needs in the U.S. are multiplying at a frantic rate. The U.S. Census Bureau reports 16.8% of the population was 65 or older in 2021, and that number is predicted to grow to 21% by 2030. Thus, Bradley says, “there will be a tremendous amount of money” that will continue to need to be invested into the healthcare infrastructure.
That said, those integrators wishing to focus on the healthcare market are taking a decidedly different route to success than they did in the pre-COVID days. The basic security needs of hospitals have not disappeared; however, integrators targeting this healthcare gold rush are so centered on data and its software-based dissemination for healthcare pros that the word “security” is never, ever uttered.
Moving into the Clinical World
They are not gone completely, but the days of security integrators hanging hallway cameras and fitting access control readers on doors is not where this opportunity lies. Instead, savvy integrators are targeting a whole new healthcare arena – the clinical one.
“A security integrator that sells traditional security cameras already has a relationship with the hospital, so I will tell them, this is a whole new revenue stream and application for your company,” says Chris Lennon, Healthcare Business Development Manager for video surveillance manufacturer Hanwha Vision. “They are always going to sell security, but there’s a huge opportunity in selling to the clinical side of the house. At the end of the day, these systems are making hospitals
money – creating nursing efficiency, enhancing patient care, reducing patient falls and plenty of other revenue saving benefits vs. security, which is really not making the hospital the same saved revenue. That’s why there is such a difference between security budgets and clinical budgets.”
For many integrators, shifting to the clinical side means making a sizeable business transformation. The goal is not a secure facility; instead, it is to take the vast amount of data that traditional security technology can provide and convert it for practical use to create a safer and better patient experience; but perhaps more importantly, a more efficient experience for hospital staff.
“Anyone who can come in and show a plan that solves some of the staffing issues and proves ROI, any piece of that, is probably going to get an audience,” Bradley says. “You may not get a sale, but you will at least get an audience, which builds a relationship. It is also a conversation that very few integrators will have with them.”
Creating the Data
The “big data” revolution sweeping many industries is paramount to success in healthcare, but where does all the data come from? In a word, sensors.
Especially since COVID, patients are much more accepting of sensors that can track their movements. Video surveillance plays a huge role here, but real-time locating systems (RTLS) leveraging low-energy Bluetooth or even ultra-wideband (UWB), coupled with badges and readers, also play a pivotal role.
“We are using low-energy Bluetooth and sensors – you walk into a room, and the badge is automatically tracked,” Bradley says. “All these sensors are tied to software, and the same software systems that are tracking patient charting can also record this tracking (for better patient care).”
On the clinical side, video surveillance’s role is increasing dramatically. Cameras are being installed inside patient rooms in just about all hospitals. Telehealth services leveraging this equipment is used to create a more efficient physician and nursing staff.
“I have worked with a lot of integrators on these projects, and it is new to them because clinical is a very different type of environment – they are in patient rooms, behavioral rooms, medsurge, triage, the ICU, etc., and putting cameras up in these areas vs. putting cameras up in the lobby hallways is a very different type of installation,” Lennon says. “There are a lot of hospital compliance issues and installation guidelines. For example, most installations in a patient room require a dust tent when penetrating ceilings (to mount a camera or speaker), so it doesn’t contaminate the area.”
Tying it into Patient Care
The key to creating all this patient and caregiver data is leveraging it for efficiency for both. “Tracking is one piece, but patient information is the key,” Bradley says. “Patient charting software is already out there in every hospital. We are gathering all this data, what do we do with it? As integrators, we can come with these solutions to say, ‘we've got all this information, and this software that we will deploy will take that information and distill it down to a usable format.’”
For a quickly growing majority of hospitals, that charting and Electronic Health Record (EHR) software comes from Epic Systems Corporation©. “Epic is used in a large majority of the hospitals in the U.S. and globally (to document all aspects of patient healthcare management),” Lennon says. “Basically, it is the software glue that keeps a hospital running. Every nurse, every doctor, every tech – everyone – is using Epic as part of their job every day.”
Epic Systems software now features an embedded, clinical video telesitter management system built by clinicians for clinicians. “If you put a traditional security VMS in front of an observation tech and tell them they have to monitor and virtually interact with 40 patients throughout the day, it can be overly complicated for the average clinician or observation tech,” Lennon explains. “Epic Systems built its video telesitter environment as a clinical tool with specific features to help monitor and supervise patients for all types of scenarios that may lead to a fall or incident.”
Lennon says the integrator sells everything to the hospital – cameras, speakers, mobile carts, camera licenses, on-prem camera servers, AI licenses, etc. Labor-wise, they connect everything like a normal video system and terminate everything to a switch in a typical IDF closet, per the hospital’s instructions. “That is where we come in and virtually deploy the cameras and speakers onto the Epic clinical video management system,” Lennon says.
Adds Bradley: “Everything – whether it is access control, a camera, a nurse call system, or RTLS for tracking – is about getting the information into the hands of the caregivers. We are using ‘informatics,’ which is a new word in healthcare. There is a whole new generation of people being hired and trained and getting degrees in informatics, which is to take all this information – the big data – and make it useful to the hospital. We're selling to those people, and it clicks with them instantly.”
Tangible ROI
Moving the sales conversation away from the security department and into the executive suites means two things for integrators: It means having conversations with new stakeholders, and it means you need to be armed with a measurable return on investment (ROI).
“The great things about selling on the clinical side of hospital is that they have access to different types of larger budgets, and things move very quickly,” Lennon says. “I tell integrators that this is a whole new way of doing business. You will be talking to and dealing with different stakeholders and a whole new infrastructure, because security and clinical video surveillance will usually never meet; in fact, security is generally on a whole different network.
“Clinical and security usually don't interact,” Lennon adds. “For clinical patient monitoring, you are going to be dealing with clinical IT, clinical IT project managers, patient safety directors, clinical integration managers, the patient fall group, the chief nursing officer, CTO, or CIO. A chief nursing officer is the be-all end-all when it comes to approving clinical video, because in the end, it deals with nursing efficiency and enhancing patient care. When that person gives a thumbs up, purchase orders are expedited vs. waiting an extended amount of time for a PO from the security department that is a fraction of the size.”
Beyond maximizing limited staff, one of the key areas of ROI for these systems from the healthcare perspective is fall prevention.
“Every healthcare facility has fall risk; in fact, it is one of its single most expensive and preventable expenses,” Bradley says. “Most hospitals would say that a fall event translates to a minimum of a $10,000 to $25,000 cost on average. Let's say we can knock that down by 50%. The savings alone pay for everything, and even adds back to the bottom line.”
Fall prevention is one of the areas where Artificial Intelligence and machine learning come into play. In the past, a pressure sensor in a bed might have been tied to a nurse call system, but if the pressure sensor is triggered, it is probably too late to really mitigate the fall risk, Bradley explains. A camera mounted in the room can use AI for predictive analysis that the patient is moving around in such a way that they are likely to get out of bed.
“We use AI technology to predict things that are going to happen, freeing up the staff to only react to the things that are critical. Whether it is long-term care or nursing homes or acute care, it is the same need,” Bradley says. “If integrators can use technology that they are already familiar with, tie it into AI, and integrate it with the software that manages the patient, then we have taken something we already understand, and we've made it preventative instead of reactive.”
“The computer vision predictive fall analytics is the secret sauce, and every hospital is interested in automated alerts for potential bed exits and other patient behavior,” Lennon adds. “They will always have a nurse in front of a monitor, but they want that five- to 10-second heads-up that a patient is trying to get up or is having another critical issue. Saving just one patient from falling could equate to a $35,000 savings, while also creating more efficiency on the nursing side and enhancing patient care, so it is a win-win for the cost of putting up a $1,000 camera and a $500 speaker.”
Some security integrators may be reluctant to go to the clinical side of the house and talk to the hospital administrator or chief nursing officer; however, leading with the tremendous potential cost savings for fall monitoring alone can create an easy win. “Cameras and speakers that are used in patient rooms could seem expensive to some, but to the hospital it is a small cost compared to decreasing the patient fall rate,” Lennon says.
Unprecedented RMR
With the ROI issue solved for healthcare providers and the budget to easily make these technology upgrades happen, the benefits to the security systems integrator become crystal clear.
“This kind of technology is a significant investment, but it also carries a tremendous amount of RMR,” Bradley says. “This is not a bid-and-chase world. We know how to present these concepts; we understand the problems of the customers; and we can get an audience to start presenting solutions. Everybody is used to IT products coming with a high level of monthly costs. Licensing is only a part of it – there’s subscriptions, maintenance, and everything else that goes along with updates. We want to be in that world, not in the equipment world.”
Lennon says Hanwha Vision charges a license per camera for the Epic video sitter application, and the integrator resells that Hanwha license to a hospital. “With a typical deployment of 1,000 to 3,000 cameras and licenses, the integrator will create a close relationship with the hospital for license renewals and upsell opportunities for future add-ons,” Lennon says.
Bradley warns that integrators will need to carry a significant amount of cyber insurance, as hospitals are required to be very vigilant about their vendors.
Thanks to this new focus for his company, Bradley no longer considers his company a security integrator; instead, he says he prefers the term ‘technology integrator.’
“Equipment will always be there, but we no longer want to emphasize the equipment,” he says. “We want to emphasize the software and the outcomes that the software can provide to the end-user. Our company has that mentality – we are always interested in that next generation of things that can solve problems for our customers.”
Paul Rothman is Editor-in-Chief of Security Business magazine, a printed partner publication of SecurityInfoWatch.com. Access the current issue, archives and subscribe at www.securitybusinessmag.com.
