Electronic Health Reporter

Guest post by Gil Lalo, director of enterprise architecture, C/D/H.

Microsoft’s Xbox 360 ranks among the best-selling game consoles in the world , and its latest iteration, Xbox One, comes with a much faster processor, tight integration with Skype, voice recognition capabilities and an amazing motion sensitive camera attachment called the Kinect.

Aside from gaming, the device has shown remarkable promise in healthcare as creativity meets practicality and talented people from various clinical disciplines develop applications that exploit some native Xbox platform features. Here are some recent examples:

Long-distance Stroke Rehabilitation

Software company Jintronix uses the Microsoft Kinect software development kit (SDK) to capture movement from the body’s 48 skeletal points on a 3-D camera. With Kinect’s capture technology, Jintronix and Microsoft’s Stroke Recovery system created cost-effective programs for clinicians and patients. Therapists can use them at the office to see more patients at a time, and patients get cheaper, efficient therapy sessions in the convenience of their own homes.

Microsoft’s Stroke Recovery with Kinect has three main programs: one evaluates manual dexterity and coordination with a timed game in which patients pick up blocks and place them in a box; another challenges them to achieve a target body position; the third is an outer-space game that assesses reflexes. All three provide immediate scores and reinforcement.

Maintaining a Sterile Environment in the Operating Room

The Sunnybrook Health Sciences Centre in Canada is one hospital already using Kinect in its operating rooms to reduce hygiene and infection issues. The contactless control of Kinect is enabling doctors and surgeons to view patient notes, scans and x-ray images without touching surfaces, such as a computer mouse or keyboard, which could be infected with bacteria. This has reduced time spent on standard operations and procedures as doctors can wash and disinfect their hands less frequently.

Early Onset Illness Detection and Fall Prevention for Home-bound Seniors

Motion-sensing technology found in devices like Microsoft’s Xbox 360 are effective at detecting early onset illness and fall risk in seniors, according to research from the University of Missouri.

In one study, researchers used Microsoft Kinect to monitor patient behavior and routine changes at TigerPlace, an independent living community located in Columbia, Mo.

In a second study, a fall detection system used Doppler radar to recognize changes in walking, bending and other body movements that may signal a heightened risk for falls.

More Precise Surgeries

Often, vascular surgeons can avoid performing open-heart surgery by placing stents to open clogged arteries or support aortas to treat an aneurysm. Medical imaging greatly enables the precision needed for proper stent placement. Surgeons at St. Thomas Hospital in the UK took this a step further by using the Kinect for Windows sensor in conjunction with a large monitor. Kinect allows them to change the image view of a patient’s chest area, look at a new image, or zoom in on details—all without touching a screen, a keyboard or a mouse.

Advanced Procedures to Rural Areas

By adding a camera to one console at each end, it is possible to turn two Xboxes into a relatively inexpensive video conferencing system. After physicians at the University of Washington Medical School – the only medical school in a five state area of the U.S. – used the system to show students in Boise how to install a breathing tube, they have expanded to using this solution for a variety of other training sessions.

Personal Trainers

With Skype, Kinect and detailed motion detection, a personal trainer can provide guidance anywhere in the world and use the augmented information from Kinect to alert a client, for example, that his ankles are not 90-degrees with his foot in a lunge. Then the trainer can put a red dot on the client’s foot, a laser pointer of sorts, to communicate proper form.

Face Change

With advanced software, Kinect is able to detect changes in facial expression and differences in eye coloration, and skin or tongue position. It can also detect inflammation on the lymph nodes of the neck, or even a millimeter of change in the distance between the left corner of a lip and left eye.

True METS

By measuring the detailed movements of your body and heart rate, it will be possible to figure out new and interesting ways to compute metabolic equivalents (METS) and deliver true value for that physical activity. Imagine the possibilities for correlating the data of 100,000 people who did yoga – their heart rate changes, breaths per minute, and motion.

The value of this data is difficult to calculate, and the fact that we can gather it to use it for understanding body response is immeasurable. It makes one wonder, “What other process can we improve, or what knowledge can we gain, or how can we save more lives through the gamification of healthcare?”

These examples of using Xbox technology in healthcare are happening now, and the pace of development is increasing as the benefits and applications become known.  So far, no application exists for de-identifying Personally Identifiable Information (PII) and gathering an analysis of large data sets in the cloud for health information with internet connectivity of Xbox, but it is not a stretch to imagine this happening in the very near future.

Of course, with the Xbox being a great platform for gaming – its intended use – one can play Halo or Grand Theft Auto while pondering the possibilities of what applications will be uncovered next.

Gil Lalo, current director of enterprise architecture with tech consulting firm C/D/H (www.cdh.com), has served as interim CIO for multiple hospital organizations, and most recently worked at Microsoft in Washington, DC, as a program manager for the Federal Civilian Healthcare Consulting Practice, and built a new consulting practice within Microsoft specifically focused on the healthcare vertical market. C/D/H has served clients across Michigan for more than 20 years with offices in Detroit and Grand Rapids. C/D/H consults in collaboration, infrastructure, unified communications, mobility, and project management. C/D/H is a Microsoft-certified Gold Partner, a VMware Professional Partner, and has earned top certification with Citrix.