EMS: Does HIPAA Permit Body-Worn Cameras?

Today’s society has become completely reliant on cellphones that have the capability to capture and send video footage, not to mention the myriad cameras on buildings, traffic signal posts, vehicles and many people’s doorbells.

Then there are body cameras. Also known as body-worn cameras (BWCs), the wearable devices are audio, video and photographic recording systems. Some of them offer live streaming and global positioning.

BWCs often are affiliated with being utilized as a component of police officer equipment, beginning approximately in 2005. In fact, a May 2022 presidential executive order mandates that all federal law enforcement agencies that regularly conduct patrols or routinely engage with the public in response to emergency calls must utilize BWCs, with initial goals that video will help to deter violence, particularly with the capability to capture the use of excessive force, afford a measure of transparency and become an additional form of documentation.

One area that remains somewhat “camera-free” is the intimate components of the healthcare industry.

Federal and state laws were created for closed circuit television (CCTV) security systems, and other laws throughout the country regard BWCs that relate to law enforcement. The foundation of initial regulations involves three categories: consent, awareness of being recorded and expectation of privacy.

However, these laws have limited scope in conjunction with BWCs in the healthcare environment and haven’t become an issue … yet.

Potential to be misconstrued
The components of the patient assessment in the back of an ambulance entail both the physical and the verbal. Palpation of the patient to identify injury or pain response easily could be misconstrued. The behavior of a prudent paramedic who is simply starting an IV can turn into what appears to be aggressive behavior when a patient’s natural human reaction to pull away from the pain of a needle stick occurs. Documented injuries to paramedics have occurred when the back doors of the ambulance close and after other personnel, firefighters and police officers left the scene.

Violence in the form of a physical altercation becomes the tipping point for many organizations to seek BWCs on paramedics. This simply would become a video version of who is the guilty party. However, both the paramedic and the patient fall under the scrutiny of the eye of the beholder. Also, as with any footage, a debate begins regarding how much of a video is made accessible to the public, what should or can be redacted, and how the material can be manipulated.

Trepidation
The advent of police officers, paramedics and other EMS providers being held liable for actions that lead to the demise of patients who are in their care based on police-worn cameras has heralded the importance of greater oversight as well as issuance of criminal charges and jail time. These consequences, above all, have cultivated trepidation of EMS prehospital providers to buy into the pros of body-camera protection.

The confines of HIPAA that deal with protected health information are used to safeguard health information. However, the use of BWCs in the world of EMS is based on the focus of quality assurance; an ability to evaluate patient safety in the form of treatment; following policies; and the ability to develop protocols. That said, overall, the focus in terms of HIPAA is on how video footage is stored and safeguarded to prevent the exposure of sensitive data. The “law” has identified the need for encryption, passwords, timelines and public access yet hasn’t given consideration to the concept of BWCs in the form of employee conduct.

HIPAA allows healthcare operations and quality assessment to be the cloak of enhancing patient and paramedic safety yet does nothing to ensure the personal protections that fundamentally become another component of the law.