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60 I ICT TODAY higher than the ambient noise levels of the space. A typi- cal speech level of 60 to 65 dB at the listener's ear is con- sidered comfortable, which means the ambient noise level should stay below 55 dB SPL to maintain intelligibility. However, 55 dB is difficult to achieve in most public envi- ronments. Most speech reinforcement systems operate between 70 and 75 dB, which is still comfortable, but when systems approach 85 to 90 dB, intelligibility does not increase much; listeners will start to complain about the volume. 3 WHY DESIGN A SOUND MASKING SYSTEM? While the main goal of a paging system is to be intelligi- ble, a sound masking system is the complete opposite. The goal of a sound masking system is to specifically make voice unintelligible. Why? Simple, so only the intended listener hears a sensitive conversation and no one else, which is especially important in a hospital or healthcare setting. Sound masking can be traced back to the beginning of time. People did not make camps next to the rivers and waterways but further away from those areas. Why? They needed to hear potential animals approaching or others that they feared would bring harm to themselves or their families. By keeping conversations quiet and private, sound masking also helps to meet Health Insurance Portability and Accountability Act (HIPAA) requirements. This law mandates that individually identifiable patient health information be protected. Although written and com- puter files are obviously to be protected, verbal informa- tion must also be protected. "Covered entities" (i.e., those who must comply with the law) must make reasonable efforts to safeguard patient information from being overheard. The law gives no spe- cific guidance on how this is to be accomplished, but a document released by the Department of Health and Human Services and the Office for Civil Rights provides some clarification. In the Protected Health Information section, the document cites that "The Privacy Rule pro- tects all 'individually identifiable health information' held or transmitted by a covered entity or its business associate, in any form or media, whether electronic, paper or oral." 4 The Office for Civil Rights also states that the law does not require retrofitting spaces, such as soundproof- ing of rooms, in order to comply. 5 However, many hospi- tals and healthcare facilities have already realized that compliance to the Privacy Rule's oral protection is wise and have begun retrofitting their facilities. Experience has suggested that most hospital rooms do not need sound- proofing but can benefit from sound masking. There are various types of speech privacy, which include universal and partial. Universal listeners and talk- ers have privacy from all surrounding persons regardless of degree. Some well-designed closed offices, conference rooms, and secure facilities meet this type of speech pri- vacy. Partial listeners and talkers have privacy from some of the surrounding persons regardless of degree. Open office cubicle areas meet this type of speech privacy. A person may not have privacy from those nearby but does have privacy from those farther away. This is a dis- tance issue and "radius of distraction," which is the area where human speech is intelligible, is used to identify the degrees of privacy relating to the listener. Sound masking helps to reduce this radius. While the main goal of a paging system is to be intelligi ble, a sound masking system is the complete opposite. The goal of a sound masking system is to specifically make voice unintelligible. The finding of researchers has shown that the privacy problem in healthcare facilities is very similar to that experienced in open offices. As a result, sound masking has been used beneficially in a number of loca- tions, such as patient rooms, corridors, and nursing areas of hospitals. Sound masking can be used in senior living facilities and long-term acute care facilities. It is also beneficial in medical suites or patient contact areas of medical insurance providers. Pharmacies can also provide confidential privacy at counter areas with sound masking.