The Xbox Kinect in Healthcare

I saw a blog post on here a couple weeks ago about Microsoft and their Kinect gaming console.  The main idea of the article was that whether or not gaming consoles are sustainable as gaming on smart phones continues to increase rapidly.  I thought to myself that the Kinect has so much more potential than the “typical” gaming console where all you can do is play video games on a television screen while sitting on your couch.  So I thought I’d do a little bit of research and see what was out there, and I came across this article:


Healthcare has progressed pretty rapidly since our grandparents and even our parents were kids.  From the polio vaccine to face transplants, more can be done than ever thought possible before.  So how about bringing a video game console into the operating room or into a group therapy session?  Sound far-fetched?  Maybe it does, but it’s happening in Canada.  At Sunnybrook Health Sciences Centre in Canada, surgeons and other medical staff use the Xbox Kinect to browse patients’ files, test results, pictures, etc without ever having to touch a single foreign object.

When surgeons, doctors and nurses have to stop the medical procedure and touch a foreign object, the risk of contamination and infection increases.  By using the Xbox Kinect game console, the doctor can use his or her hand to flip through the pages of the patient’s electronic medical file.  This also saves valuable time for both the patient and the doctor.  This way the doctor does not have re-scrub his or her hands and arms before he or she can get back to the patient’s procedure.  That may be precious time that the patient does not have and cannot afford to lose.  It may free up the doctor’s time so that he or she can perform more procedures in a day and help save more lives.

Furthermore, Craig Mundie, Microsoft’s Chief Research and Strategy Officer, announced that the Xbox Kinect can be used to help patients remotely with therapy sessions, both physical therapy and group therapy-type settings.  In fact, the Kinect’s sensors are so refined that the doctors can actually see facial expressions demonstrated by the patients!  An additional bonus is that the remote nature of the group therapy sessions allows people the anonymity to open up and be honest without feeling embarrassed or self-conscious.


So does this mean that we will never have to take another day off work to go the doctor’s office?  I doubt it, at least for now anyway.  One thing to keep in mind is that the Kinect is an add-on to the Xbox 360, which will cost you $200 to $4001.  The Kinect is an additional $150.  And then there are add-ons such as the wireless adaptor, hard drive and annual memberships.  This may not seem like a very large investment for a doctor’s office or a hospital, but when you consider that each household would have to purchase these items, the cost savings of taking the day off of work and the transportation costs saved may not justify the investment of the materials purchase.

Another thing to consider is that technology is always improving.  So while the Xbox Kinect may be today’s “new developments in IT”, it could very well be surpassed by another company’s newer, better invention or even Microsoft’s (the maker of Xbox) latest and greatest model.

In summary, on an individual-basis for appointments such as therapy, the Xbox Kinect may not be a viable alternative to the “old fashioned” doctor’s office visit.  That said, if it helps decrease the risk of infection and contamination in a surgical setting, the Xbox Kinect is a low-cost investment for operating rooms everywhere.  It could also save doctors and patients valuable time, which is priceless in comparison.

So to respond to my original thought about the Kinect having a lot more potential than other gaming consoles, I believe the answer is yes, the Kinect is more than just for video games.  Some gaming consoles may become obsolete as smart phone gaming continues to increase in popularity, but I don’t think that the Kinect is one of them.  What do you think?



The High Cost of Medical Bills

A recent article in Time magazine, Bitter Pill: Why Medical Bills Are Killing Us, the article yet again focused on the outrageous bills that uninsured or underinsured patients are stuck with following medical services received. The article enraged the general public by comparing the cost of simplistic, over-the-counter items that can be found at your local drug store for a fraction of the cost of what is charged by most hospitals. Furthermore, the author continued to focus on the disparity in healthcare pricing across the country, using common procedures with up to ten of thousands of dollars variance depending on geographic location.

What is always interesting about these types of articles is that information is always one-sided; insinuating that hospitals ‘do not care about the patient’ or simply ‘out to make a profit at the expense of the innocent’.  Having worked a significant portion of my career in healthcare, this couldn’t be further from the truth. The article failed to mention the process of financial assistance offered by all non-profit healthcare facilities that have discounted rates for patients up to 600% of the federal poverty guidelines (see grid below). What this translates to is that discounts are offered for annual incomes up to $141,300 for a family of four (not exactly ‘poverty’).  In addition, most facilities also have catastrophic coverage of a maximum of 25% of a household annual income can be applied to medical expenses.



Persons    in family/household

Poverty    guideline

For families/households with more   than 8 persons, add $4,020 for each additional person.
1 $11,490
2 15,510
3 19,530
4 23,550
5 27,570
6 31,590
7 35,610
8 39,630


As mentioned above, the article also relates the retail cost of an item at a local drug store to the amount charged by a facility, such as the classic example of a generic acetominophen charged at $4-5 per pill where a bottle of 60+ pills can be obtained for $8 over-the-counter. Again, the one-sided image of healthcare ‘costs’ does not take into consideration the direct labor costs associated with the registration personnel that checked-in the patient to the pharmaceutical tech and nurse that administered the drug.  And shall we not forget the indirect labor costs associate with the environmental service staff, administrative directors, financial analysts, billers, coders and collectors all associated with converting the revenue from an ambiguous ‘charge’ to actual ‘cash’. These costs can count for upwards of 60% of the charge billed to the patient. In a future world of health insurance exchanges, this will only become more complicated for the patient but healthcare facilities are proactively responding by the creation of new roles of patient navigators in emergency departments and other ancillary locations to assure patients are directed along the correct path, both clinically and financially.

As we all have probably experienced less insurance coverage with higher premiums and out-of-pocket costs, what are your thoughts on this subject?,9171,2136864,00.html


Is that an ISOlated case of the flu?

Quality management standards seem rare to come across when you look at the health system in Iowa. Specifically their hospitals. Iowa Lutheran is the first hospital in Iowa to achieve their ISO certification.

ISO 9000 standards are well known to American manufacturers as they have used ISO for quality assurance in their products. ISO gives suppliers a peace of mind that what they are receiving, follow international standards in their quality management. That means that a company’s upper management has set up a processes for all steps of their respective system. Six procedures are required by ISO; control of documents, control of quality records, internal audit, nonconforming control, corrective action, preventive action. The organization’s mission is to set standards for goods and services, ensuring efficient processes.

Iowa Lutheran Hospital

Iowa Lutheran Hospital

When you look at healthcare and hospitals, quality care is necessary and could be the difference between life and death. Should it be troubling that this is the first hospital in Iowa that follows ISO standards? Not necessarily. Prior to seeking ISO 9000-certification hospitals were granted certification through the Joint Commission on Accreditation of Hospitals (JCAHO). The largest and oldest accrediting organization for healthcare, they set standards for the quality and safety of health care provided to patients.

What could be the implications of switching from a healthcare specific accreditation organization to an international standard organization? Is ISO 9000 a better quality tool overall for healthcare?

According to the article, “Iowa Lutheran has implemented a quality management system that includes review of acute medical, surgical, critical care , rehabilitative, obstetrical, emergency care, laboratory and radiology services.” It is obvious to see that the hospital is striving for excellence in healthcare and providing the patients with the best services, as any hospital should. It seems to me that any hospital would have the best possible standards set in place for all their different systems. Not only does ISO set up certain guidelines, but it also allows for collaboration between members for best practices, and this is an international group. Iowa Lutheran specifically attained 9001:2008 ISO certification. It takes a process-oriented approach. The requirement ensures ‘what’ an  company must do to meet customer needs and expectations. ‘How’ this is done is left up to the company, or in this case, the hospital. Hospitals are a lucrative business in the way they charge for a doctor to visit a patient, to take and x-ray, virtually everything they do. Insurance companies, healthcare systems and providers, and pharmaceutical companies. There are so many systems, guidelines, and protocols to follow. The four sections that make up ISO 9001:2008 would really benefit a hospital and how it is run. The sections include management responsibility, resource management, product and/or service realization, and measurement, analysis and improvement.

The other metropolitan hospital in Des Moines refuses to change to ISO 9000 standards.   How else can ISO 9000 benefit hospitals?