More than half way through our “What the market says you need in your patient portal” series I bring to you one of my favorite topics: healthcare gamification and serious games. Games are great at explaining complex systems. There are fewer places one can find complex systems than in the micro and macro worlds of 
healthcare. In healthcare we’ve seen games of multiple types. Here are some of my favorite examples:
- Games that help modify user behavior: Humana took a pioneer stance in the world of serious games in healthcare with their Horsepower Challenge. Using the craze the followed games like Dance, Dance, Revolution, Humana used “exergaming” in 2009 to challenge 20 members of Congress and 2,000 5th and 6th graders nationwide as they “raced” across the country by taking steps with a pedometer. She also harkened back to a healthcare game I mentioned in a post back in 2011, namely Re-Mission.
- Games that train wellness behaviors: In the game Re-Mission, a nanobot named Roxxi is injected into the human body to fight particular types of cancer at the cellular level. Those playing the game are also asked to monitor the patient’s health and report any symptoms to the fictional Dr. West. Each level of the game informs the player on a variety of treatments and on the importance of staying compliant with medical protocol. HopeLab trial studies, that were published in peer-reviewed journals, revealed that playing Re-Mission led to more consistent treatment adherence, faster rate of increase in cancer knowledge, and faster rate of increase in self-efficacy. Most notably are blood test results, that showed the measured level of chemotherapy drugs in blood to be higher in players versus the control group.
- Clinical learning labs: These are the types of gaming environments where practitioners can train in virtual learning labs on an avatar. A great one is foldit: Solving Puzzles for Science. foldit, funded through a University of Washington grant, is an attempt by game developers to crowdsource scientific research. Within a few paragraphs of texts, the gamer is educated on what proteins and amino acids are and why their shapes, and what those shapes fold into, are important. The goal is to have human “protein folders” work on proteins that do not have a known structure. Scientists can then take folding strategies that human players have come up with while playing the game and automate those strategies to make protein-predicting software that can fight HIV and cancer more effective. Beyond protein prediction, protein design has even more direct implications to disable a virus. Thus far there are not many automated approaches to protein design, so foldit’s human folders are a great source of research.
Gamification is the term we use to describe serious games that go beyond strictly trying to entertain. They have a “higher purpose”, so to speak. Designers use game techniques to get players to do something not game-like at all. The possibilities for embedding serious games into patient portals are seemingly endless, but my favorite is in the realm of personalized prevention. The patient portal is a powerful repositiory of patient data and can also function as an empowerment tool. Similar to the build of the patient portal itself, if you want to develop a serious game that works, you must, better than anyone else, understand the purpose of your game. You must know to whom your game is targeted. You must devote a lot of time to figuring out what motivates your intended audience. That understanding must be crystal clear before you even consider how the game should be designed. Document, in detail, what your experience needs to communicate with the gamer. What kinds of puzzles best match this experience? Then consider what type of game genre matches these puzzles. Lastly, consider what platform would need to be used to help the gamer bring action to play.
Building a game that is based on what motivates your audience is what makes a serious game a game. The market will continue to push this functionality onto the patient portal.
