Complying With HIPAA and JCAHO Requirements Specific security concerns are controlled access to specialized areas, supply rooms and medical carts, especially to control the access to medications, drugs, syringes, and needles. By Rod Oden While adhering to the usual group of local, state...
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Medical carts are also a focus as they often contain drugs, syringes, and needles. In Figure 4, another Comp-X electronic lock has been retrofitted allowing a nurse to access the “meds” drawer by entering a pin number. The cart could have been configured (see Figure 5) with a different model lock that features a proximity reader that would allow the drawer to be accessed by proximity badges.
No longer are the days where a decision is made as to whether it is a good time to rekey. JCAHO requires locks to be rekeyed when a person or persons having access to a designated controlled area leave. JCAHO routinely inspects areas and this is a common infraction that can lead to the revocation of certification.
HIPAA requires monitoring of who has access and when in regards to patient information.
Both JCAHO and HIPAA requirements have created a demand for locks that can be easily rekeyed while tracking all access.
The migration to electronic locks
It is critical that healthcare facilities that accept Medicare and Medicaid payments maintain JCAHO certification. These facilities cannot afford failed inspections due to a door that was not self-latching, or locks that were not rekeyed in a timely manner.
Ideally, a proximity card would be made to access all controlled areas (door locks, cabinets and drawers, padlocks, etc.), but the cost and confinement to installation space make that impossible.
Electronic locks that can be easily retrofitted in all types of controlled areas and the electronic keys that monitor access are the means to satisfy the requirements.
Initially these locks (and keys) are expensive but the cost to upgrade is quickly offset as the cost to rekey is dramatically lowered.
An additional motivation to upgrade to electronic locks is to obtain complete accountability regarding access to controlled areas.
Figure 6 is an example of the data available from the use of Videx electronic keys.
Several companies offer electronic keys and lock cylinders that retrofit door locks. Videx is unique as they offer lock cylinders and cores that can fit into just about every type of locking device. They also offer their own custom configurations.
Figure 07 shows a medicine cabinet protected at the bottom with a Videx electronic lock. The existing cam lock was removed and replaced with the electronic version in Figure 8. This is a good example of how easily electronic access can be facilitated.
An added advantage using these types of retrofits is that the electronic locks can be easily recovered when the cabinet is no longer controlled.
Controlled areas within the healthcare facility may be secured with padlocks. Converting these areas is normally problematic as it requires reconfiguring the padlock and hasp mechanism with some kind of electronic bolt apparatus.
Videx offers both electronic lock cylinders that can retrofit into commercial padlocks and their own brand of commercial padlock (see Figure 10).
To address many of the issues relating to padlocks: weather-proofing and environmental exposure, multiple sizes in shackles, and differences in the hasp arrangement, Videx has reinvented the padlock. All components are made from stainless steel and instead of a shackle,. there is a flexible cable.
This padlock (see Figure 11) is ideal for JCAHO/HIPAA applications.
It is common in institutional environments when padlocks (that can be opened with regular keys) are issued that they mysteriously “disappear.” This phenomenon is due to the fact that the padlock with keys can be used elsewhere outside of the facility.
Electronic equivalents can only be opened by electronic keys. The operability of electronic keys can change from day-to-day. Therefore expensive electronic padlocks are less likely to disappear because they are rendered useless without keys.
For those applications where an electric lock, deadbolt, latch, or strike is called for, Videx has a port that works with electronic keys and a controller that works with the port to trigger an authorize “request to exit” or “request to access.”
Availability of electric locking mechanisms
Many applications in the healthcare facility require custom electric locking or latching mechanisms.
A typical example might be a secured paper container used to collect discarded patient information. The drop slot might be controlled by an electric lock and it might be in constant use. A standard-duty cabinet, cam, or drawer lock would not work because of the constant use.
Having grown up in the family locksmith business, I can remember a time when the only business restriction we had was from the local police department. Our shop had no parking area, so customers and...