An interactive communications system comprising: a plurality of in-room video communication systems, each in-room video communication system including a video monitor, a video camera, a microphone, and an audio speaker associated with a patient; a video selection unit which connects video entertainment or video communications with each of the in-room systems in order to enable other persons, such as medical professionals, friends, relatives and associates, to contact a patient via the video communication system associated with this patient; characterized in that the system further comprises a hierarchical access control unit which controls based on a defined access hierarchy an individual degree of permission of each of the other persons to contact the patient via the video communication system, wherein the access hierarchy contains a plurality of roles, wherein each of the other persons is assigned one of said roles in the access hierarchy, and wherein said roles define the individual degree of permission of each of the other persons to contact the patient via the video communication system, wherein the hierarchical access control unit includes: (i) a data entry terminal through which the access hierarchy is entered or modified, (ii) a hierarchy rules engine which converts the entered access hierarchy into a corresponding set of rules, (iii) a hierarchy rules database which stores the set of rules, and (iv) a server which selects among competing video communications based on the set of rules, wherein the set of rules define that a video communication between the patient and a person to whom a role with a first degree of permission is assigned within the access hierarchy takes precedence over a video communication between the patient and a person to whom a role with a second degree of permission is assigned which is lower than the first degree of permission, and that the permission to contact the patient via the video communication system is limited to the person to whom the role with the first degree of permission is assigned if vital signs of the patient measured by a physiological monitor exceed a predefined threshold. a plurality of in-room video communication systems, each in-room video communication system including a video monitor, a video camera, a microphone, and an audio speaker associated with a patient; a video selection unit which connects video entertainment or video communications with each of the in-room systems in order to enable other persons, such as medical professionals, friends, relatives and associates, to contact a patient via the video communication system associated with this patient; characterized in that the system further comprises a hierarchical access control unit which controls based on a defined access hierarchy an individual degree of permission of each of the other persons to contact the patient via the video communication system, wherein the access hierarchy contains a plurality of roles, wherein each of the other persons is assigned one of said roles in the access hierarchy, and wherein said roles define the individual degree of permission of each of the other persons to contact the patient via the video communication system, wherein the hierarchical access control unit includes: (i) a data entry terminal through which the access hierarchy is entered or modified, (ii) a hierarchy rules engine which converts the entered access hierarchy into a corresponding set of rules, (iii) a hierarchy rules database which stores the set of rules, and (iv) a server which selects among competing video communications based on the set of rules, wherein the set of rules define that a video communication between the patient and a person to whom a role with a first degree of permission is assigned within the access hierarchy takes precedence over a video communication between the patient and a person to whom a role with a second degree of permission is assigned which is lower than the first degree of permission, and that the permission to contact the patient via the video communication system is limited to the person to whom the role with the first degree of permission is assigned if vital signs of the patient measured by a physiological monitor exceed a predefined threshold.