Hidden Cameras in Hospitals: HIPAA Violation or Life Saving Tool?

Hidden Cameras in Hospitals: HIPAA Violation or Life Saving Tool?

Exploring the use of covert cameras in healthcare campuses

IS IT EVER ACCEPTABLE FOR A HEALTHCARE FACILITY TO INSTALL AND MONITOR CONVERT CAMERAS WITHIN A PATIENT’S ROOM? IN RARE CIRCUMSTANCES, HEALTHCARE POLICE AND SECURITY DEPARTMENTS AROUND THE UNITED STATES ARE INSTALLING COVERT VIDEO SURVEILLANCE SYSTEMS TO SAVE THE LIVES OF CHILDREN.

VICTIMS

In 2015, Lacey Spears, mother of Garnett Spears and former nursing student, was sentenced to 20 years to life in a Westchester County, N.Y., courtroom; with the judge stated that Munchausen syndrome by proxy (MSBP) had caused Lacey to crave the attention that being the mother of an ill child afforded her.

On January 23rd, 2014 Garnett, then only 5 years old, was taken off of life support one day after being declared brain-dead by physicians. As her son was lying in his hospital bed in immense pain and slowly dying, Spears took to her blog and social media channels, posting frequent updates for the sole purpose of gaining attention to herself.

In January 2017 a jury in Tulsa, Oklahoma jury sentenced another mother, Victoria Lee to eight years in prison with credit for time served from her arrest in 2013.

Court documents reveal that Lee had lied about her daughter’s medical symptoms to gain personal attention. These fabrications resulted in Lee’s daughter having unnecessary medical procedures performed; resulting in, but not limited to, a spinal tap, EKGs, six MRIs, physical therapy, and bladder studies.

MUNCHAUSEN SYNDROME BY PROXY DEFINED

MSBP is a mental disorder in which a parent, typically the mother, fabricates an illness or induces a premeditated injury to her child. Often times the mother will come across as extremely loving and very concerned for her child. This expression outward concern often makes the diagnosis of MSBP very difficult, without concrete evidence.

Examples of induced injuries are feeding the child laxatives to induce diarrhea, smothering with pillows and other objects, poisoning, and causing rashes using household cleaners or heavy abrasives. Examples of fabricated illness include lying about symptoms and often leads to the perpetrator being the only one to be able to temporarily cure her child. Fortunately, MSBP is extremely rare, with only two victims out of every 100,000 children; although mental health professionals believe the statistics of victims to be slightly higher due to undiagnosed cases.

MSBP STATISTICS

- 98% of all MSBP perpetrators are women

- The mortality rate of MSBP is 9%

- Most victims are under the age of six

- 90% of parents with Munchausen’s have a great deal of medical knowledge

- 25% of MSBP involve two or more siblings

- Most cases start at infancy (before the age of 2)

SECURITY’S ROLE IN THE PROTECTION PLAN FOR MSBP

Leading security expert in MSBP, Bonnie Michelman, CHPA CPP, suggests implementing a multi-disciplinary child protection team that would become immediately involved as soon as MSBP is suspected by staff. She states the team should include hospital security management, a mental health practitioner, the primary care nurse, and an epidemiologist for the purpose of potentially finding a cause for a disease. Police and security personnel would be at the forefront of the team, with early involvement to assist with the investigation, the collection of evidence, assisting in case development for the prosecution, and possible arrest.

The use of security surveillance cameras in hospitals is already common place considering there are camera deployments in parking garages, hospital entrance points, public hallways, cafeterias, gift shops, waiting rooms, and elevator lobbies. Video surveillance deployments in patient areas have proven to be controversial among some healthcare groups. Unions and patient privacy advocates have led to limited camera deployments for patient monitoring in some cases.

While the use of video surveillance in patient areas has proven to be controversial at several hospitals, many Risk, Security, and Ethics committees are implementing the use of covert video surveillance cameras for patient safety.

Covert video applications have been able to be put into place on the bases that patients receive a written privacy policy stating that their Personal Health Information (PHI) may be shared for medical purposes as well as “to report neglect or abuse to the appropriate state authorities.” While convert video installments have been deployed to identify wrong doing these same covert systems have been instrumental in establishing innocence for those parents and caregivers mistakenly suspected of Munchausen.

In a 2000 study published by the American Association of Pediatrics and conducted by Children’s Healthcare of Atlanta at Scottish Rite, the use of covert video surveillance in suspected MSBP cases was instrumental in the diagnosis of 56% of the cases. The study concludes that “All tertiary care children’s hospitals should develop facilities to perform covert video surveillance in suspected cases.”

Security departments have a wide array of covert video options including high-resolution pin hole cameras with various mounting options. These off-the-shelf pin hole cameras can then be custom built into the natural environment using surrounding objects and equipment. Other options include covert camera clocks, pens, electrical receptacle plates, tissue boxes, and even covert video biomedical waste bins. Security departments will then choose a systems architecture to identify how video will be transferred and recorded. Some covert cameras have on edge recording within the camera using micro USB cards, while others integrate with external recording devices. Security departments can then choose a wired or wireless approach to retrieving live or recorded video.

While MSBP is relatively rare, the abuse of elderly and disabled patients is at an all-time high with an expected 2.1 million abuse cases in 2016; of which covert cameras could also help identify and prosecute. These are all things to consider when asking the question, is it ever acceptable for healthcare facility to install and mother covert cameras within patient’s room?

This article originally appeared in the September 2017 issue of CSLS.