The First EMS provider in the United States to roll out Axon’s Flex 2 cameras

In January of 2019, Cypress Creek EMS became the first EMS provider in the United States to roll out Axon’s Flex 2 cameras and digital data management solution. The goal was to improve clinical practice and the safety of the staff.

What is driving EMS to use Point of View Cameras?  Recent police-related events over the years have proven the use of the technology as an effective accountability tool.  The technology has improved and the cost has come down.  Calls for increased accountability in public safety has crossed over into prehospital emergency medicine.

Cameras assist leadership in identifying issues before they become big problems.

• Violations of protocols or the standard of care
• Unprofessional behavior
• Unlawful or unethical conduct
• Process or system issues
• Safety concerns

The use of cameras change how people behave.  Rialto Police published a study showing an 88% reduction in citizen complaints following the deployment of Axon cameras.

You can read the Rialto police body-worn camera study here

The camera can improve your attitude and hold you accountable for what you say and how you say it when it is being recorded.  It makes a tangible difference on both sides of the camera.

Video can also minimize risk and cost to an agency in matters involving citizen complaints, personnel matters, and lawsuits.  Being able to identify areas for improvement, acknowledging a mistake, and taking corrective action goes a long way with the community we serve.

CCEMS deployed cameras either worn on safety glasses or shoulder epaulets with its EMS Supervisors in January and in June deployed cameras with every in-charge paramedic and field training officer. Cameras are now rolling on every call and in some cases; multiple cameras are at the same scene. The Axon system recognizes that and syncs them for multi camera viewing later.

Three main areas of concern

There are three main areas of concern that CCEMS addressed when developing its program.

HIPAA

(Health Insurance Portability and Accountability Act of 1996) is United States legislation that provides data privacy and security provisions for safeguarding medical information. EMS providers can collect and use PHI (Protected Health Information) via electronic and video technology for treatment and quality improvement practices.  CCEMS safeguards all PHI collected in these forms, video recordings are treated the same as patient care records.  The Axon system provides for redundant backup, secure encryption, inventory management of all devices, and the proper NIST 800-88 compliant removal of all recordings from the device on upload, and audit trails for every recording.  The original recording cannot be altered.  CCEMS provides regular training, policies that incorporate video recording, and business associate agreements.  The Axon system does not use media cards and if a camera was to be lost or stolen, the recordings cannot be removed using conventional methods, it requires the proprietary software to download.

Privacy, Consent, and the Right-to-Know

Texas is a “One party consent” state meaning, only one party has to know about the recording. Medics are required to record all emergency responses through the transfer of patient care and responsibility.  Evidence shows that one of the most important aspects of patient care is the transfer from one provider to another.  The Joint Commission has identified ineffective handoff communication as a contributing factor in 80% of serious medical error.  CCEMS is not a government entity and therefore, PHI is not subject to the Public Information Act.  The recording is not part of the official patient record.

Data Storage, Access, and Retention

The data is not stored on media cards or local hardware at CCEMS. All data is stored on Axon cloud servers that are triple redundant, triple continent.  The recordings are accessed through evidence management system using secure, encrypted, dual authentication from restricted IP addresses (only those belonging to CCEMS).  The medics can review the video to aid them in patient care documentation.  The CCEMS Clinical staff can review the view for Quality Improvement (QI).  The Evidence.com system provides a redaction tool to remove all PHI (Video and Audio) from a copy of the recording.  A redacted version can now be used in education and training.  The redaction, download, and sharing feature is restricted by user profile.  Only the program administrator and specific members of the Clinical Department have this access.

All video is retained for a minimum time period consistent with the Texas law unless specifically involved in a legal proceeding, criminal case, sentinel event for QI purposes, evidence of a crime, or is subject to a citizen complaint.

Point of View (POV) vs. Body Worn Camera (BWC), it makes a difference.

A POV camera attached to the medic’s safety glasses captures what the medic sees.  Often the medic will turn their head to look at a person, a medical monitoring device, etc. and if the camera was worn affixed to the body, this important video would be missed.  Critical medical interventions like intubations can be captured if the camera is in line with the medic’s eyes.  Until now, having this visual confirmation of tube placement readily available to show the physician has not been possible.

A full 24-hour shift can be recorded on the tiny cameras, which upload to the secure cloud when placed in the charging unit.

Axon is a leader in law enforcement cameras and digital evidence storage and is now branching out into EMS and FIRE. The company was started by the same folks who invented the Taser. So, whenever you see police body camera footage take note of how many times you see the Axon name.  Law enforcement has tested the security of the video recordings and it has been upheld in the judicial system to be secure.

In EMS, Axon allows Emergency Room Doctors to see the recording of what we saw in the field and in the future could provide a real time view from the field. It allows for clinical evaluation, which can help speed up promotions and certifications for our employees. It can also be integrated into our educational programs by illustrating best practices. It can also help CCEMS and its personnel avoid false legal claims. Is it also a handy reference when medics write their reports? In addition, because of the security built into Axon’s cloud storage system, it meets all the requirements of HIPAA. We believe that at least two of our heart attack patients were saved because our supervisors were able to show the emergency room doctors exactly what they saw in the field. In one case a fairly new device, the Lucas CPR device, was used to great effect on a patient. When the device was on he was conscious and when it was off he was out cold. We were able to show that even though he hadn’t had his own heart beat in more than an hour, the Lucas device provided excellent blood flow. The patient recovered with no heart or brain deficits because we were able to use the video to persuade the ER to activate the heart cath team in the middle of the night. CCEMS was one of four EMS systems in the country to deploy Lucas devices after it gained FDA approval and it took awhile to show how effective they are. Axon camera footage provided the proof.

Cypress Creek EMS had actually tried out a previous version of the Axon camera. Cypress Creek EMS conducted a trial  in 2014 and found that the cameras proved to be an invaluable teaching tool that improved clinical practice and sped up advanced certifications.

Axon Founder Rick Smith says, “Our goal is to provide the best technology solutions for all members of the public safety industry so they can get to the truth faster. By offering all first responders the opportunity to capture and share critical video and other data on one network, they are able to seamlessly work together to improve health and safety in their communities.”

Axon Flex 2 cameras enable point-of-view video with unlimited HD and a 120-degree field of view. To learn more visit: www.axon.com/flex-2.

About Axon

Axon is a network of devices, apps and people that helps public safety personnel become smarter and safer. With a mission of protecting life, our technologies give customers the confidence, focus and time they need to keep their communities safe. Our products impact every aspect of a public safety officer’s day-to-day experience.

We work hard for those who put themselves in harm’s way for all of us. To date, there are more than 325,200 software seats booked on the Axon network around the world and more than 210,000 lives and countless dollars have been saved with the Axon network of devices, apps, and people.  Learn more at www.axon.com or by calling (800) 978-2737.