Patient Visitor Management-Physical Identity Challenges in the Healthcare Industry

Dr. Eric Cole, founder, and CEO of Secure Anchor Consulting, Cleat Bordeaux, director of Healthcare Business Development at HID Global, and Mike Ramstad, System Senior Director of Security from Essentia Health, explore the physical identity challenges in the healthcare industry. 

They address current challenges like COVID’s impact on motivation, visitor management, and healthcare security. 

Transcript

Speaker 1 (00:05):

Powering trusted identities of the world's people, places, and things every day. Millions of people in more than 100 countries use our products and services to securely access physical and digital Places over 2 billion things that need to be identified, verified and tracked are connected through HID Global Technology

Speaker 2 (00:28):

Enterprise Management 360, your main source for tech news analysis, podcast, and videos for the enterprise.

Speaker 3 (00:38):

Hello and welcome to this EM 360 podcast. My name is Dr. Eric Cole and I will be your host for today's podcast. I am the founder and CEO of Secure Anchor Consulting, a company that has focused on building out effective security roadmaps that actually worked to protect an organization. In today's episode, I'm joined by Cleat Bordeaux, director of Healthcare Business Development at HID Global, and Mike Ramstad, system, senior director of Security from Essentia Health. And we're here to talk about physical identity challenges in the healthcare industry. So let's go ahead and kick things off with Mike. Can you tell us a little bit about yourself, your background, and what Essentia Health does?

Speaker 4 (01:28):

Sure. Yeah. Thanks Eric. My background has been kind of a varied background over, over the years. I haven't been in healthcare my whole career, but I've been doing this almost 30 years. I started my career in the public sector in law enforcement. The last almost 20 years I've been in the private sector. I've worked in a multitude of different industries, globally, nationally, locally. So different experiences from that aspect. As I stated in, in a multitude of different styles of industry. The last eight years I've been working in healthcare as stated. Currently I'm with Essentia Health, which is a health system spread across three states. So we are in Minnesota, Wisconsin, and North Dakota. We have about 13 hospitals around, you know, somewhere in the a hundred range of clinics spread across. And our kind of platform is we're more of a critical as access hospitals located more in rural locations outside of our primary locations where our bigger facilities located in Duluth, brayer Lakes, Minnesota, and Fargo, North Dakota. So that's a little bit about us and a little bit about my background

Speaker 3 (02:41):

And cleat. Can you tell us a little bit about yourself and what you do at HID Global?

Speaker 5 (02:46):

Hey, good morning Eric. Good morning. Mike Cleat, Bordeaux. I am with HID Global. I have been here for about coming up on seven years. Wow. I am Director of Healthcare Business Development. I've been doing that for about four years. And Eric, I have found that to be probably the most rewarding sector of a 20 plus year physical security career going back to the late nineties. So that's where I'm at and that's, this is probably where I will finish out. I enjoy it that much. And,

Speaker 3 (03:19):

And you mentioned that you really enjoy the space and, and love working in the physical security. Can you sort of, from your perspective, cuz I know you work with a lot of different clients, not just Essentia Health, what do you view as the biggest challenges in the healthcare industry when it comes to physical security today?

Speaker 5 (03:39):

So the, the fact that it is healthcare and that's what makes it also interesting to work in this space, Eric, it's always something different. And so that, that's a great question because that's a challenge. There's a challenge right now, and my challenge right now is probably different than this same time last year. So, you know, for the purposes of today, big challenges are compliance, compliance is becoming a challenge. COVID has kind of fallen to the wayside. So now it's more in line with compliance. The a, the just American, well actually the global economy is also becoming a healthcare security challenge. Interestingly enough, inflation recession inability to find FTEs. Like these are challenges that my clients and my potential clients are facing and I'm trying to help them navigate. So they become my challenges as well. So like I said, that's one of the things I enjoy about this, this space is it's always something different. If we had this call two years ago, obviously managing covid and number of visitors, that would've been clearly number one. But things have shifted now. Workplace violence inflation overrunning on the budget so they can't get the proper technology. So those are some of the, the, the more current challenges that I'm personally facing. Now,

Speaker 3 (04:55):

Clete, you mentioned the pandemic. Is that still having a big impact on you today or has that sort of been problem solved and you moving on to the next challenge?

Speaker 5 (05:04):

From the conversations that I have, it is pretty much fallen the wayside. Which presents another challenge actually <laugh>, that does present another challenge because there were great strides being made in, in so many areas of healthcare security. And without covid, the, the motivation to make those changes seems to not be there for senior leadership. And so you couple that, so, so changes that security directors like Mike have wanted to make for years, they don't necessarily have the ammunition to make it as much anymore because Covid is not as high on the radar for most people. So an answer to your question, it has kind of fallen to the wayside, but that's not necessarily a good thing for some of us in healthcare security.

Speaker 3 (05:49):

So, so Mike cleat mentioned how sort of the pandemic going to the waysides creating challenges. Can you talk a little bit about that in a Essentia health? Is that sort of what you're seeing where it's making things more difficult? Or how are you transitioning from post pandemic into sort of what we call this new normal?

Speaker 4 (06:07):

Yeah, I think there's definitely some challenges related from the transition back. I think some of that is, you know taking a look at what impacted some of the things we do during Covid, which I think was positive for many healthcare organizations, was realizing you know, as they had to screen individuals coming into their environment to meet compliance from that standpoint, many discovered like we didn't have control over our facilities, so getting control, closing entry points that maybe would've been a normally open or having a more open feel and closing it down a little bit more. There were a lot of positive things that came from that. I, I think the challenge comes is as we relax on things and coming out of the pandemic, so for example, you know, here at our organization you no longer have to wear that mask in the hospital.

Speaker 4 (06:59):

And I think some people view as, you know, maybe not having to do that anymore as also meaning we should be wide open. And I, for example, somebody reached out to me and asked if we were gonna open up more entry points now that the pandemic officially was over. And you know, my response back was, no we weren't, because as an organization what we discovered was, you know, controlling our environment was much easier without having all these access points and from a security perspective, we were gonna default on the safety of everybody in our facility over what maybe our past perception would've been of, you know, convenience overrides everything. So we're seeing some of those things and some of those challenges because as things outside of healthcare open back up after coming out of the pandemic and relaxing maybe certain things we certainly wanna make sure we're still maintaining the best safe environment we can.

Speaker 4 (07:53):

And one of our biggest challenges and I, and click kind of hit on it, and it's not just healthcare security, but it, it, you know, many businesses across the country just in regards to staffing you know, strong physical security program has, has layers. And, and part of that component is the physical person to help do some things. And I see that as being a bigger, bigger and more struggle for us as an organization when it comes to security. And that's part of, you know, what we're seeing as we transition out of this pandemic. And, you know, we've lost a lot of people in the workforce for various reasons and it's, it's a struggle for us to get good qualified folks to fill some of these roles.

Speaker 3 (08:35):

Now, switching from challenges in sort of looking at the next six to 12 months, what would you say are your top two or three biggest priorities when it comes to physical security in, in terms of Essentia health? Like what are the big areas you're really focusing on and want to tackle over the next six to 12 months?

Speaker 4 (08:55):

Yeah, Eric, I think our three primary things that we're looking at and we're tackling one is around the process of going into maintaining control of our environment and rolling out more formalized visitor management process for our facilities. So that's one thing we're currently working on. The second thing is, as we all know, and you can turn on the tv every day and you see things going on in the country as, as violence continues to increase and concerns over those types of incidents from happening and occurring we are focused on how do we maintain the safest environment. One is identifying, like I said, mentioned with visitor management who's in our facilities, but then two is weapon screening. So that's another priority of ours and how do we go about doing that in a right the right way?

Speaker 4 (09:44):

So, and then the last thing you know, it's really a primary focus for us is because of staffing those kinds of things is really how do we transition some of our mindset and build that strong physical security program and leverage technology more to make us less reliant on having to have as many people to do some things that where we could maybe leverage technology for. We're always gonna have to have the people part of it. But how do we become more efficient and effective from that standpoint if leveraging the technology to help offset some of that of what we're seeing with those struggles in regards to personnel.

Speaker 3 (10:22):

Now just following up with that, with technology always comes sort of the budget issue and getting the money to spend on that. Are you seeing that as a big challenge where when you're asking for money or resources, say for weapon screening or things like that, are the executives pretty open or are they still pushing back on budget and resources and wanting you to do more with less?

Speaker 4 (10:46):

Well I think I'm pretty fortunate here at e Essentia is, you know, there is support, of course we do have financial restraint just like everybody else. And CLE kind of mentioned with the economy, the government pulling back and certain reimbursements those kinds of things. So it certainly is a challenge, but it's about prioritizing as an organization what's important. You know, we are on this journey right now of improving and making sure that we are doing everything we can to create the safest environment for our employees, our visitors, our patients from that perspective. So it's always gonna be a challenge cuz there's always competing priorities and there's only so many dollars. So my job is really to, you know, evaluate what are the requests that we have and, you know, create that kind of strategic plan that says this is a phased in approach cuz we can't do everything at once, but what's that biggest bang for our buck, if you will, of what we can put in and, you know, demonstrating to the organization that positive return based on those dollars spent and what what that means to the organization.

Speaker 4 (11:49):

And so I've always been very fortunate in the fact of, you know, having those conversations and taking a, you know, a approach based on information and accurate information has really helped kind of drive that. So I wouldn't say that my experience here is everybody's experience in healthcare cuz there's certainly no talking to peers. It's a challenge. And it's, and it's gonna continue to be a challenge, but it's, it's how do we present that and how do we work in that into the overall organization, organization's you know, strategic plan and, and how, how are we playing a part in that?

Speaker 5 (12:24):

Eric, I just wanted to add to what Mike is saying. You know, he's speaking on his experience at e Essentia and I'll just just tell you guys from talking to others, he's, he's spot on. He's spot on. He laid it out. So I just wanted to give that industry perspective because you know, Mike, speaking from his experience at e Essentia and he may have in some cases even more support than others, but that is generally the sentiment and answer to your question from elsewhere, Eric, it is absolutely a challenge for the very reasons I'm like Elmont.

Speaker 3 (12:55):

Now Cle what, what do you see as effective ways where if organizations are getting these increased demands on physical security, physical protection, but the board is pushing back, what have you found as ways to either help them prioritize or help better show the return on investment to get the resources they need to implement the effective security measures?

Speaker 5 (13:18):

Funny enough, what I learned to be most effective in that area and, and in some ways how to even coach others and to, to be successful in that venture, I actually learned from working with Mike. And long story short, Eric and, and Mike touched on it, there are so many competing priorities when it comes to healthcare. It's, it's about patient care, it's about hospital budgeting, et cetera, latest advancements medically. And so you can't rely upon, or I encourage healthcare security professionals not to rely upon just saying, Hey, here's a cool camera, can we get this? That, that doesn't work. That doesn't work. And so when you say what's the best way to, you know, help your organization realize, realizes security priorities data, and that's what I learned a lot from Mike. And that's what I preach to others. You need to capture data, you need to capture data of the current state, projected states, maybe small pilot programs like, and again, these are all things that I learned from him in the past that, that were successful for him at one organization. And he, I assume he took some of that same stuff up to his new organization. That's what I would encourage for security professionals data via, it can be via consulting, it can be via your own pet projects that you've run on on a very limited basis after hours, but step before your leadership with data, not just random requests and a brochure from your security partner about the latest camera, the latest weapons detection, et cetera. Make sure you got some data with you.

Speaker 3 (14:51):

Now, cle, cle building on that, i I I agree with you. You're spot on. You can't look at anything in a vacuum. You sort of have to step back and look at a big picture. So a lot of what we're really talking about has to deal with visitor management and we, we talked about weapon screening and things like that and it's easy to sort of put that under a microscope and only look at it by itself. But can you sort of talk to us how visit management is really part of a multi-pronged approach and really a much bigger solution for the organization?

Speaker 5 (15:21):

Absolutely. it really begins with visitor management. It really begins with knowing who's in your facility and that, that starts from Eric's in an accident and I transported him there to the emergency room. I'm on your property, I am sitting in your facility, you have no idea who I am and what I'm about. So visitor management really is, is really that, that's the perimeter, that's your perimeter there. And and coupled with that, when we talk about multi-pronged, coupled with that, there's cameras who's walking in the door, who's in my door, why are they here? And then in winter goes on and on from there, cameras around the facility, then it can start to get into weapons detection. You, you'd be very surprised, Eric, to hear maybe not actually <laugh>, but you'd be very surprised to understand, especially in some of these rural areas, just how easily somebody comes through the door with all types of weapons just as part of their everyday life.

Speaker 5 (16:18):

Machetes, I hear about weapons and open carry states and those aren't necessarily things that you want to be in a healthcare environment. So now we start to get into weapons detection, we start to get into audio detection. These people that are within your facility. And that could be patients or visitors. Are they known bad actors? Are they on national lists where we should be concerned with them? Are we aware of them having violent tendencies due to their condition? Like there is, there's so many things to be concerned about. I I highly respect those in Mike's position because I'm, I'm, I'm sure I'm just touching the tip of the iceberg and thinking about all the various angles that he needs to be concerned with. But I, I take pride in making sure to preach the gospel for one of the very first ones. And that is who's in your facility? You know, he can do so many, he or she can do so many things once they're there. Obviously there's patient generated violence, there's visitor generated incidents, there's theft of tens of thousands of dollars, individual medical devices. There's, there's all these things. Where does that start? That starts with understanding who is coming in our facility. So that, that's my little piece of contribution, but there are a lot of angles to consider that I'm sure might, can, can chime in on. Yeah,

Speaker 4 (17:37):

Absolutely. I mean, I, I would just, you know, kind of piggyback off what CLE is saying is that, you know, we look at a strong physical security program, right? I mean there's, there's four main components to, to that you, you have our ultimate goal to deter something from happening, right? So that's kind of that first, first level in our second level that we, we want to, you know, ensure is happening is that detection. So that's really where the technology comes in to play, right? And then it's that delaying, you know, something from happening to give us the ability to respond, hopefully, you know, eliminate, you know, something from happening or at least minimize the outcome. And I think when we talk about visitor management, it really is that second layer, right? I mean our first layer is that perimeter security that we have in place, but when we're open for business, you know, or we're it, it is our general hours of operation that kind of first layer is open so that then we have that visitor management.

Speaker 4 (18:32):

And I think what we learned at the previous healthcare organization I was at and just other industries I was in, just in general, cuz that visitor management's been around for a long time, but in healthcare is controlling our environment and somebody coming in. It's not just the fact that we know who they are, it's that they know we know who they are. And that's a big deterrent. And you know, the project that we did at my last organization over a two year span, once we had things fully in place, I mean we reduced visitor violence by 80% and a lot of it really came down to that touchpoint. And that touchpoint is that visitor management, you're coming in, we're having the conversation. Why, you know, my big push and my conversations I have are, you know, we need to control the environment. Well how do we do that?

Speaker 4 (19:14):

We do it within the lobby. And having a strong visitor management program really means that it shouldn't be many organizations put in what they call visitor management, but it's, it's self compliant. Meaning like if I come in and you don't have anything that prevents me from walking by the desk and you're busy checking somebody else in, I can just walk on by. And so somehow some way that, that checkpoint has to be mandatory, right? And things that we've used or I've used in the past, you know, optical barriers that, so you can't get past that point. You can't just bypass us. And you have to come get that credential that then grants you that access and by simply, you know, controlling it, we're preventing things from why are we allowing, you know, people to walk into our facility and walk up to a floor.

Speaker 4 (19:59):

And then now if they want to cause a problem, the problem begins there. So for example, someone walks in our lobby and we have visitor management, they come in, they're extremely intoxicated. They're already irritated and agitated. Why would we introduce that into the environment and now put that onto the care staff to have to manage it and or allowed to get to a situation which now where security has to be called and I'll deal with the situation. So those are some of the, you know, things over time we've learned within these environments. But it's, it's not as easy as it sounds all the time cuz it is a very delicate balance because of what we do and taking care of people. So you have to have that balance and how we do all those things that creates our environment to be welcoming and inviting, but also you know, safe and secure. And

Speaker 3 (20:44):

Mike, as we just start to wrap up c cuz you sort of touched on it, but I'd like to go a little deeper. H how do you manage that balance between proper physical security but also customer service? Like you said, you, you're in the business that if somebody is injured or needs emergency care, you need to get them back very quickly, but on the other hand, the quicker you get them back, the biggest the threat. So how, how do you balance the priority of serving the customer yet still keeping the facility safe?

Speaker 4 (21:12):

Yeah, that's a good question Eric. I think you know, certainly somebody seeking and needing help is the first priority and you know, over time it's what is, what are those workflows that you have in place? So if that is something that happens, how do we have that follow up? How do we, you know, go back, get the priority met, meaning that that medical attention, but then how do we have the additional follow up, right? So previous institution that came from, you know, our ed, we did weapon screening but if there were those cases or somebody came in via the, the ambulance bay and not the main entrance or they came in via a wheelchair, they couldn't walk. Your traditional walkthrough isn't gonna be successful for you and you, you do want to get them that care immediately.

Speaker 4 (21:58):

But how you balance is, is then you have to have, what's that follow up process? We don't just forget about it or say, oh well that person we don't check and, and we had follow up procedures, whether that was then going back after the, you know, things were stabilized and checking any, you know, type of packages or purses, backpacks that might've come in at that time and or just doing a cursory check in regards to, you know, using a wand or those types of things. We still ensured the process was filed. It might have been not immediate, but you know, again, in those situations, certainly urgent situations, those things are gonna happen. And we just all have to understand that. But I think it's also that balance comes in with you have to be a team player and insecurity, it's not us against everybody else.

Speaker 4 (22:40):

We have to be working together and when we're building these workflows and these processes, we have to include our, our partners in security cuz security can't do it alone. I mean we talk about that all the time and you know, so if that is the case and that does happen, what can they be doing? You know, at that point that knowing that, hey, this came in, this is an urgent thing, knowing it didn't go through that initial plan screening process. What parts can can that the other rest of the staff that's dealing with the, the urgent matter do and be aware of and pay attention to. And that's really in, in my opinion how any security program's gonna be successful because we can put anything in and we can have all this great stuff, but if our employees aren't engaged in a part of the process, you know, there's everything can be circumvented, right? So I think that's, that's the biggest

Speaker 3 (23:29):

Key. And Mike, I think as we wrap up, you summed it up great where security is a team sport. You can't just put it on one person or one division. Everyone in the organization eats to play a part. So I just want to thank C Cleed and Mike for all your great insight on today's topic. And thank you to everyone who listened to our conversation. If you would like more information on what we've discussed today, make sure you head over to HID global.com and essentia health.org. We'll be back next week with another episode in our podcast series. Until then, make sure you subscribe to this podcast on all major platforms. Follow the conversation on our socials at EM 360 Tech on Twitter and LinkedIn. And for more great daily content, head over to EM 360 tech.com.