Healthcare Inspection - Alleged Inappropriate Surveillance James A. Haley Veterans’ Hospital Tampa, Florida

At the request of several members of Congress, OIG initiated a review that a hidden camera was placed in a brain-damaged patient’s room without next-of-kin consent. In June 2012 the patient’s family became aware of a video surveillance camera (VSC) in a smoke-detector-like cover that had been placed in the patient’s room. The patient’s family was aware when the VSC was activated three days after installation. We concluded that the use of the camera for patient safety concerns was reasonable. We conducted a survey of VSC usage in VHA healthcare facilities. VHA requires VSCs in Mental Health Residential Rehabilitation Treatment Program facilities, pharmacy vaults and controlled substances storage areas, childcare facilities, and canteens. VSCs are standard in high traffic areas such as parking lots, building entrances, waiting rooms, stairwells, and research areas. VSCs were reported in clinical areas such as: Mental Health Units, Emergency Departments, Intensive Care Units, and Geriatrics/Extended Care Units. Half of the respondents had posted signs that VSCs were in use. No facility reported current use of a hidden camera. Seven facilities employed hidden VSCs in the past for law enforcement and/or suspected criminal activity. Ten medical centers reported current use of VSCs with audio capability in police interview rooms; sleep laboratories; mental health seclusion rooms and in the common area of the VA Manila, PI Outpatient Clinic, located on U.S. Embassy property. We recommended that the Under Secretary for Health ensures that VHA policy addresses the clinical uses of covert and overt video surveillance cameras in a clinical setting, including public notification, informed consent, approval, and responsibility for use of these devices, as well as detail procedures for staff to follow in obtaining video recordings for teaching, patient care and treatment, patient safety, healthcare operations, general security, and law enforcement purposes. Restrictions on the use of personal electronic devices within a VA facility to photograph and video should also be considered. The Under Secretary for Health concurred with our recommendation and provided an acceptable action plan.