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DeeAnna Merz Nagel Nov 24, 2009

Surveillance: Do You Know Where Those Cameras Are?

I saw a feature on the local news about security and surveillance and I was astonished at how common surveillance cameras are. They are everywhere~ in subway stairways, on street corners, in the grocery store, at major theme parks. And actually, I guess I knew that. We all know that, right? But how many of us walk into a hospital or an office building and don't even notice the camera at the entrance? What happens if the building you lease has a surveillance camera at the entrance or in the building? It seems far-fetched but it might be a good idea to ask when you sign that new office lease.

Most security companies that install alarm systems will also install surveillance equipment that can be monitored remotely. And while the reasons for installing such equipment varies, our concern as counselors is maintaining client confidentiality. Now that our privacy is not so private anymore, it serves us to take extra precautionary steps. If you have your office in a large building and the camera is at the entrance, scanning everyone who walks in, yet the camera does not follow the person to a destination, is that okay?
Hospital lobbies track everyone coming in the door- patients, hospital staff, vendors, visitors` and yet this appears to be "okay" under HIPAA compliance. But what if you are just one of a couple of tenants in a building or say, a renovated house and the landlord has decided it might be a good idea to monitor the entrance with a camera for extra protection? If you lease an office you might not even know that a camera has been set up.

What would make surveillance acceptable? If the landlord signs a HIPAA Business Associate Agreement does that suffice? And even if that did protect you legally, who has access to the tapes? The landlord? The security company? What if the large building housing many offices has cameras set up in the entrance but the building is located in a small town? I am thinking it becomes easy to connect the dots and confidentiality might be breached.

It used to be that some counsellors were concerned about placing a sign outside indicating counseling services because some people do not want to be seen pulling into a therapist's office. And then we had to comply with HIPAA if a shared office offered client sign-in. We make sure that client names are not visible to other clients and guests signing in. But we have to worry about cameras? It is a sign of the times!

DeeAnna Merz-Nagel is a clinical counselor, teacher, workshop presenter, sat on the ACA Cyber Technology Taskforce, and is co-founder of the Online Therapy Institute

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