Intimidated or overwhelmed by researching video recording and observation systems for your behavioral health clinic? The good news is most systems have just four key components: cameras, audio equipment, a server, and video capture software. In this article, we’ll simplify and focus on considerations for cameras, audio equipment and software that help support patient care, followed by providing you a comprehensive checklist to support your evaluation process.
Cameras
Cameras capture patient and clinician non-verbal communication for live observation and/or recorded video playback post session. For example, facial expressions, hand gestures and body language, like fidgeting. Clinicians use video to improve their behavior and clinical skills. Similarly, patients may use video to observe their own non-verbal communication to help identify and understand their responses more quickly and shorten treatment time.
Depending on the size of your clinic rooms, multiple cameras may be used to capture both patient and clinician perspectives. For example, one camera mounted on a wall facing the patient’s chair, and a camera mounted on the opposite wall facing the clinician’s chair. Your video management software should support livestreaming and recording of multiple cameras side by side for a comprehensive perspective of the session. Benefits of streaming and recording in multiview may include more accurate diagnosis and treatment, and increasing your observation hours without running room to room because you can observe sessions in multiple locations via the software.
If you’re concerned cameras may be obtrusive or distract patients, there are covert camera models, such as a camera in a gang wall plate or thermostat. If video capture, rather than the aesthetics of the camera, is a concern then a privacy switch with an indicator light to show if a video stream is active or not, may help put patients at ease.
In addition to the privacy switch, other physical accessories, such as a recording indicator light, or start/stop button help keep your clinic workflow and patient experience seamless. For instance, if you don’t have access to a computer or laptop in your clinic room, a start/stop button may be the least disruptive option to initiate recording. A recording indicator light inside a room allows a patient to see an active recording is or is not taking place, and outside a room, the indicator light announces to anyone passing by that a recording is taking place.
Audio
High-quality audio is critical for live observation and video playback to assess verbal communication and there are several items to consider.
Like cameras, there are different models of microphones, so you can choose the best model for your environment. For example, if you work with patients at risk of hurting themselves or others, look for a microphone that is flush with the wall or ceiling, so that it cannot be used to harm.
Another item is the size of the room and where activity takes place within the room. For instance, a large group therapy room may require more than one microphone to pick up audio from all participants about the room. Whereas one microphone is sufficient in a small clinic room with a dedicated area for patient seating.
What type of background noise is there in your clinic rooms? A good rule of thumb is if you can hear it, the microphone can “hear” it. Is there an HVAC vent in the ceiling? Or a white noise machine in the room or hallway? If you’ve experienced a phone call with someone on their cell phone who is trying to talk in high wind, you can imagine a similar effect when air conditioning blows across a microphone. Microphone placement to mitigate picking up unwanted noise can help, and there are also audio modules that suppress sustained background noise, so human voices are clearly captured by the microphone.
If you have a lot of inconsistent noise, like honking horns, or loud voices in other rooms or a hallway with lots of foot traffic, a Digital Signal Processor (DSP) may be necessary. A DSP is the brains of an advanced audio solution. Not only does it support noise reduction it also manages audio levels. For example, if a patient yells the DSP ensures the volume only goes so high before it reaches the camera, so that you’re still able to capture clear audio and avoid audio distortion.
A DSP is also necessary to provide echo cancellation and avoid audio feedback if you have rooms in your clinic that require a supervisor or clinician to provide coaching or feedback via an overhead speaker. Without a DSP, the experience is like a web meeting where someone does not mute the speaker on their computer, and it sounds like they have an echo because you hear them speaking into their microphone and then hear them again out of their computer speakers at the same time. A DSP prevents this type of audio feedback and ensures a session undisturbed by audio issues.
Video Capture Software
For patients who wish to view their video recording after the session, it’s beneficial to have a method of sharing their video with them, without risk of viewing any other patient’s information. Look for a software that allows a secure sharing link that can only be viewed on your network and restricts access to a single video file, or for a software that supports the export of a video file to a non-proprietary file format that the patient can play on their own device using a standard video player.
In addition to a download capability, a video upload capability may be beneficial. For example, a 2019 American Psychiatric Association article highlights home-based videos for early identification of behaviors that align with the diagnoses of autism to improve accurate diagnosis. So if a patient or family member provides a video recording to their clinician, the clinician can upload it into their secure video management system for review and assessment.
Behavioral health care requires teamwork and video capture supports collaboration among a care team, which may improve patient outcomes. For instance, if you offer inpatient mental health services, your care team may consist of psychiatrists, psychologists, nurses, social workers, program facilitators, and variety of therapists. Live stream to multiple team members or record a patient session and securely share the recording with team members to reduce the amount of time it takes to diagnose and care for your patient. To meet information security compliance requirements, such as HIPAA, look for a video management software that allows you to share video securely within the system without needing to export video files to a less secure environment.
We created an evaluation checklist for you to use that includes additional questions and considerations to ask vendors as you research options for video recording and observation in behavioral health:
