There is increasing interest in the concept of body-worn cameras (BWCs) for EMS providers. A previous article explored the reasons for implementing an EMS BWC program and the legal and policy issues an agency should consider. This part discusses practical and logistical issues that must be addressed.
BWC Selection Factors
There are a number of commercially available BWCs an agency could consider using. No single BWC is right for every department or every use case.
Before making a purchase decision, an agency would be wise to speak with nearby law enforcement agencies to find out what make and model of BWCs they are using, how the agencies like them, and procurement/operating costs and other considerations. In addition, field personnel and supervisors should field-test several makes and models of BWCs. A formal program should be established to evaluate various types. Each model tested should be evaluated using common criteria. To ensure apples-to-apples comparisons, all criteria should be clearly defined, and employee testers should be trained thoroughly on the use of each BWC being tested.
Factors to consider in making a selection include ease of operation, mounting options, cost, durability, battery life, video quality, and video storage options.
Ease of operation—How difficult is the camera to activate and deactivate? Can it be activated or deactivated accidentally? How easy is it to upload and store videos at the end of a shift? How will videos be “tagged” (i.e., labeled for storage so they can be readily searched and located after uploading), and how easy is it to tag videos? How much training is required to enable field personnel to use the BWC?
Mounting options—Some chest-worn BWCs use a magnetic mount, while others use a clip. While magnetic mounts are convenient, the camera can be knocked off if bumped or brushed with sufficient force. This could happen while restraining, carrying (e.g., in a stair chair), or transferring a patient. Depending on the design, a chest-mounted clip may be a viable alternative, but clips can break, and some may not offer any easier placement than a magnetic mount.
One drawback of a chest-mounted BWC is that the camera records what is happening in front of the user’s chest, not where the user is looking. BWCs mounted on eyewear offer the best view of what the wearer is actually seeing during the recording; however, such units are generally wired to a belt-mounted battery/recording mechanism, which some users find ungainly. Additionally, some users may not like to wear eyewear all the time, and cameras can make the eyewear feel lopsided.
Other alternatives include collar- or epaulet-mounted BWCs. Both have similar drawbacks to eyewear-mounted BWCs, and neither option shows where the user was looking.
Cost—A study by the Department of Justice’s Office of Community Oriented Policing Services indicates BWC acquisition costs can range from $120 to $2,000 per unit.1 However, the true cost of a BWC includes much more than the initial price of the camera itself. Additional costs include maintenance, charging/uploading systems, video storage, replacements/spares, legal or administrative fees for complying with Freedom of Information Act (FOIA) requests or subpoenas, and (depending on the size of the agency and number of cameras purchased) a system administrator. Moreover, agencies will need to decide whether cameras can be shared because special procedures will need to be put in place to allow this, even though doing so may cut down on procurement costs.
Durability—BWCs are used in some unforgiving circumstances. Therefore, EMS agencies are well-advised to consider the relative durability of the BWCs they consider for purchase. Durability factors include life cycle, construction, ingress protection (IP) rating, and warranty.
Life cycle—Consulting with area law enforcement may provide an EMS agency some idea of the relative life cycles of different units. While a longer life is generally preferable, as with other types of technology, features and capabilities of BWC units are constantly evolving, meaning a long life cycle may lock an agency into a BWC that becomes outdated or even obsolete.
Construction—Agencies should also consider the construction of the BWCs. Questions to answer include whether the BWC is purpose-built or simply an app on a smartphone, materials used in manufacturing the BWC, and what kinds of testing have been performed (e.g., drop testing, submersion testing, real-life field testing).
IP rating—The ingress protection (IP) rating is a universally accepted measure that defines how well the BWC prevents dust and moisture from entering. The greater the number, the better the protection. Although no minimum standards or recommendations exist in the United States for BWC IP ratings, the United Kingdom Home Office suggests a minimum rating of IP54 (i.e., protection against dust penetration and water splashes), although the report indicates that “most devices are at least IP65 (i.e., dust-tight and waterproof up to 1 meter depth).”2
Warranty—Purchasers should compare the warranties of each BWC being considered to ensure the best possible protection.
Battery life/recharging—Most BWCs are equipped with rechargeable batteries designed to last for an eight-hour shift (or longer) with normal use. Of course, actual battery life will vary based on agency recording practices. For example, a low-volume EMS agency might require BWCs be turned on only after a call is dispatched, whereas in a high-volume EMS system, it may be easier to require that BWCs be turned on at the beginning of a shift and left on for the duration. Agencies should carefully weigh shift length versus estimated battery life to minimize the need for crews to recharge batteries midway through shifts.
BWCs are recharged through either a cable or a rack. The recharging system usually doubles as the means to upload videos for storage (unless this can be accomplished via Bluetooth or Wi-Fi). Racks tend to provide a faster charge and video upload, but they necessitate leaving the BWC in the rack for a while. Cables offer the convenience of recharging in a vehicle, at the station, or at home (which might be very convenient for EMS systems in which providers respond from home); however, cables are generally slower for both recharging and uploading videos. If a cable is used, agencies should consider whether the cable uses a standard USB or proprietary connector.
Video quality—As with other video recording systems, BWC recording capabilities range in quality from standard definition (SD) to high definition (HD), but a few are capable of ultrahigh-definition (UHD) recordings. The essential tradeoff is that higher-quality recordings (HD and UHD) consume commensurately more storage space (and hence cost).
When thinking about video quality, agencies should also consider whether a unit has a “night mode” (i.e., is capable of recording in low-light conditions) and what its lux rating (i.e., the minimum amount of light needed to produce an acceptable image) is. Most BWCs in common use have a lux rating of 1 (i.e., they can record in conditions comparable to dusk) or lower, and some have a lux rating of 0 (meaning they can produce an image in complete darkness).
Video formats—A final point of consideration is whether recordings are stored in a proprietary format that requires special viewing software. Such formats provide additional security precisely because most people would not be able to view a video were one to be accidentally released; however, if videos are stored in a proprietary format, an agency must be able either to convert the video to a commonly accessible format or provide a special viewer if the video is to be released to comply with a Freedom of Information Act request or subpoena.
BWCs offer promise for EMS agencies to improve care through better quality assurance and documentation. They can also provide solid evidence of the circumstances and quality of care as well as patient, provider, and bystander behaviors. BWCs are not all the same, so it is essential that EMS agencies make their procurement selection based on careful assessment of the various points of consideration presented in this article. Agencies need to weigh the pros and cons against the costs of the BWCs themselves as well as continuing costs for storage, administration, and maintenance.
1. Miller L, Toliver J, Police Executive Research Forum. Implementing a Body-Worn Camera Program: Recommendations and Lessons Learned. Washington, D.C.: Office of Community Oriented Policing Services, 2014.
2. Nortcliffe T. Technical Guidance for Body Worn Video Devices. Home Office, Centre for Applied Science and Technology, 2016.
Erik S. Gaull, NRP, CEM, CPP, leads the emergency management consulting practice at Cadmus Group, LLC and is a firefighter/paramedic III with the Cabin John Park (Md.) Volunteer Fire Department. He is also a member of the EMS World editorial advisory board.