Healthcare Gamification: Avoiding Chocolate Covered Broccoli

Last week, at IBM Connect, I met an individual with the coolest title in all Profession Land: Global Lead for Serious Games.

Her name is Phaedra Boinodiris, and after sitting in on her Birds of a Feather chat, along with a post chat dinner filled with good eats and new friends, I wanted to open up the conversation a bit for all to grow and learn from the gaming knowledge stored in this firecracker of a talent.

I’ll start you off with some stats Phaedra shared:

• Average age of a gamer: 34
• Games designed for women: 43% of PC games and 33% in general
• Households that play video games multiple times per week: 67%

Today your average gamer is not just some young guy locked in his mother’s basement. Your average gamers include employees, analysts, mothers, and business professionals named Phaedra and Melody. As Phaedra pointed out, the first game advertising, for Atari, was aimed at the whole family. Then there was a massive shift that aimed advertising exclusively towards boys. However, once Nintendo Wii came out you started to see advertisements for the whole family again.

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Healthcare at Play

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 great ones:

1. Games that help modify user behavior: Phaedra pointed out Humana’s 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. In 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.
2. 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.

This is all gamification, right?

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 in healthcare, as shown above, are truly limitless. However, this has brought us an industry that is absolutely flooded with games. However, as Phaedra points out, they are crippled by one false assumption created within the foundation of many of these games. That is:

A gamified experience includes scores, leaderboards, and badge systems.

Let’s be clear. Games can include scores, leaderboards, and badge systems. However, not everything that includes scores, leaderboards, and badge systems can be called a game (at least not an effective one). Instead, they are often just Chocolate Covered Broccoli. A user will try it out, realize this is not what they ordered, and spit it back out again.

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. Otherwise, all you have is Chocolate Colored Broccoli.

If you are interested in gaming, a source you can check out is Phaedra’s new book “Serious Games for Business: Using Gamification to Fully Engage Consumers, Employees and Partners”, which includes contributions by another great mind I met at IBM Connect, namely Peter Fingar.