Gaming and Healthcare: Let’s Take It to the Next Level

There are great opportunities to merge the best of game development and medical device innovation to aid in the prevention of health problems and manage chronic disease. There also is huge potential for healthcare gamification to inspire and help those who want to maintain their wellness. The market’s reach encompasses children, the elderly, their families and support networks — the young, the old, the strong, the vulnerable and everyone in between.

When it comes to health-related games and gamification, I ask you to open your minds not to “what is” but to “what if” and “what could be” because there is so much emerging technology in digital health and so much promise for game developers and medical device developers to collaborate.

Healthcare and gaming share some important attributes. The art and science of game development is intricately linked to making a connection with the gamer. As developers, you know how to leverage your skills and creativity to create environments and challenges that appeal to gamers and get them engaged. You excel at tempting the gamer to come back for more. The fruits of your labors inspire players to want to spread the word about the best games among their friends and communities.

In managing our health, we are constantly confronted with the elements that play such an important role in games: different environments, threats, choices, different paths, temptations, decisions, rewards and, of course, consequences. In the world of healthcare, the penalties are real, including unpleasant symptoms, pain, suffering, disease and even death. Thankfully, the real-world rewards also are tremendous, including wellness, energy to enjoy life and longevity. After all, we only get one life in this body.

These observations are not new, and there has been some admirable health-related game development. But this symbiosis between our two industries is worth revisiting as we look ahead to the next generation of technology for both gaming and digital health. The question I ask you today in the hopes of opening the floor for deeper discussion:

Wouldn’t it be cool to get real-time biometric feedback from the person playing your game and to make that feedback a part of the gaming experience?

That would mean moving through the looking glass together into a realm where gamer feedback goes far beyond thumbs and fingers on a controller but literally comes from inside the player.

Defining digital health and healthcare gamification

Before we go there, allow me to share my definitions of digital health and gamification from the perspective of a medical device developer.

Digital health is gaining ground and getting a lot of attention in the medical device and biotechnology communities. It is the use of tools to get physiologic insight into the body. These tools can include a combination of products, including sensors, mobile phones, tablets, smart watches, desktop computers, and, as we’ll explore in this blog, gaming consoles and game systems. The infrastructure supporting digital health solutions typically requires cloud computing, software development and dedicated hardware, such as servers.

As one example of the momentum of digital health technology, at the 2014 International Consumer Electronics Show (CES) this past January, there was a 20 percent increase in space devoted to digital health exhibitors. (CES, 2014) Concurrent with CES 2015, there is expected to be a separate and associated show dedicated to digital health. Among the fascinating demonstrations at CES 2014 was a driving videogame that sensed the gamer’s physical state and, based on whether the “driver” was agitated or relaxed, determined whether the car could go fast on the track or slow down for stabilization. Another game detected brain signals, allowing the gamer to unlock new levels only if he or she was calm. The mind reels at how these early developments could evolve into games targeted to helping people with specific medical conditions.

Alliances have been a huge and essential part of digital health’s evolution. Unlike some other areas of medical device and healthcare systems development, digital health requires cooperation between sometimes strange bedfellows, including traditional medical device manufacturers, mobile device makers, consumer electronics companies and cloud computing firms. The medical device community has great strength in its knowledge of manufacturing efficiencies, FDA regulations and approval processes, the healthcare delivery system, distribution models, biocompatibility and patient safety. But medical device suppliers do not have the breadth of skills to put the pieces of digital health together. Collaboration is the key.

The time is ripe for creative collaboration between game developers, medical device manufacturers and all of the participants in digital health, including doctors, pharmacists, other healthcare providers, patients and their families.

It’s time to rally at the intersection of healthcare and gaming.

When we refer to gaming, we are talking not only about videogames and online apps but also gamification of traditional forms of healthcare communication and interaction. Gamification can have different meanings. For the purposes of this post, I’d like to draw from a description of gamification offered in a recent Wall Street Journal article exploring workplace gamification. The author, Farhad Manjoo, said gamification is a term that “refers to transferring the features that motivate players in videogames — achievement levels, say, or a constantly running score — into nongame settings.” (Manjoo, 2014)

As with workplace gamification systems, healthcare gamification likely will include a variety of elements, including accumulation of points, performance tracking against goals, incentives, competition against peers and bonuses or penalties. As Manjoo emphasizes in his article, gamification has the potential to be fun for some but dreadful for others who are leery of the “growing sensation of being watched, and measured,” in everything they do.

For healthcare gamification to catch on, it will be of utmost importance to communicate to consumers that, unlike in workplace gamification, they hold complete power to opt in or opt out. We also must continue the healthcare industry’s strong track record for protecting consumer privacy. Healthcare information already is more vigilantly guarded — by law, by protocols and by systems — than information in many other areas of our lives. It is critical for digital health and game innovators to confidently carry on that protection of privacy.

Empowering people to get healthy with games

Social connections and social media will play a huge role in healthcare gaming. We see the seeds of this activity in weight loss-related online support networks, tracking tools and friendly competitions. There promises to be an increase in real-time online games that combine social media and imported data from players, such as real-time information about their heart rate, activities, food choices and calories consumed. In this type of social game, physicians, nurses and other healthcare professionals can join in the game, so there is both peer and healthcare provider feedback. It’s a great multi-player scenario.

To draw a parallel to workplace gamification, players in healthcare games also are working to meet goals against stated performance objectives. Instead of striving to hit sales targets, they are working to lose pounds, keep blood pressure in check or remember to take their medications. In some games, results will be measured against patient-input information, relying largely on the honor system. In others, it might be possible to monitor patients, or players, with quantitative measurements at checkups or via data submitted wirelessly, enabled by on-body sensors.

There are advantages to healthcare gamification that is web-based, leveraging the Internet, mobile devices and social media. Yet there also is the potential for big wins in console-style games. Think Wii Fit^® with a medical degree. It’s all about making wellness and fighting disease fun, or at least more interesting than getting a handout from the doctor telling you what to do.

Game developer Ayogo, Inc. is a great example of an entrepreneurial company that is helping people improve their health through the fun of videogames. The company’s YouTube® channel provides thought leadership on healthcare gamification and reiterates a core Ayogo belief: “Playing can be lifesaving.”

There has been considerable work and interest in developing games for people with diabetes. Ayogo is just one business active in this space. The Journal of Diabetes Science and Technology explored the relationship between games and diabetes management in a 2012 article. (Lieberman, 2012)

Body sensing, biometric feeds and gaming: the new frontier

There is a brave new world of innovation in body sensing and real-time remote monitoring of physiologic data. These developments are on the leading edge of digital health and biotechnology. Some of the solutions may seem straight out of a sci-fi thriller, but they are real and used in very practical applications.

The examples here provide a taste of what is happening today in digital health. I ask you as creative game developers to think about the far-reaching potential for what could happen tomorrow with this technology.

Metria Informed Health: Metria is a portfolio of digital health products from Vancive Medical Technologies. The portfolio includes products for lifestyle, health, wellness and, eventually, clinical monitoring applications. The Metria portfolio brings together core technologies around physiological sensing, interpretative algorithms, communication, data management and visualization, all packaged in a way that benefits the quality of life of the user. At the heart of the portfolio is the sensing device itself — a simple, discreet product with a unique form factor that adheres to the body with a skin-friendly adhesive. Depending on the product configuration, the sensor can gather a variety of physiological information, from activity levels to sleep to calorie expenditure. Products under development will capture advanced metrics such as heart rate and respiration rate. Depending on the end use, the collected information can be leveraged for gathering lifestyle insights or for other purposes.

Collaborators in Metria include BodyMedia, Inc. and Proteus Digital Health, Inc., both leaders in their own regard.

BodyMedia: BodyMedia is a developer of wearable body monitors. Capable of capturing physiologic data around-the-clock, BodyMedia’s technology “is used by consumers as well as health and wellness professionals to guide behavioral changes to help control weight and promote an active lifestyle.” (BodyMedia, Inc., 2013) According to the company, its technology has been used in hundreds of clinical research studies related to conditions such as obesity, chronic obstructive pulmonary disease (COPD), diabetes, cystic fibrosis, cancer and sleep problems.

Proteus Digital Health: Proteus specializes in digital medicines and ingestible sensing technology. Using the firm’s Helius service, which Proteus describes as “a healthshare solution,” a patient swallows a tablet containing a sensor which transmits information about activity levels and medication-taking behavior. For example, transmissions from the sensor can confirm whether an individual has taken his or her medication. In some cases, the medication is embedded within the tablet along with the sensor. In other cases, the tablet only contains the sensor and is swallowed at the same time as medication. A patch on the patient’s skin knows when the individual has ingested the sensor-enabled medicine. It captures data about activity and rest patterns and relays the information to a mobile phone. Patients determine who within their support network has access to their information. (Proteus Digital Health, Inc.)

This video demonstrates, for example, how an elderly woman’s daughter automatically receives a text or e-mail confirmation that her mother is moving enough and has taken her medicine. (Proteus Digital Health, Inc.) The daughter does not have to repeatedly call with reminders and can relax knowing her loved one is all right.

Creating a new healthcare paradigm, Proteus says digital medicines “can communicate, via a digital health feedback system, vital information about an individual’s medication-taking behavior and how their body is responding.” (Proteus Digital Health, Inc., 2013)

Other Innovations: There are many other companies making contributions to digital health and making headlines. Preventice offers mobile health applications and patient monitoring systems for continuous care. The firm, which was an early collaborator on Metria, has expertise in remote monitoring protocols, algorithms, data management and electronic medical record integration. Entrepreneur and inventor Mir Imran of InCube Labs, LLC has devised a “robotic pill” which could replace injectable drugs by navigating its way to the small intestines and latching on to deliver drugs. (Hay, 2014) Apple Inc. also is getting in on the action. The company recently published a patent related to “a health-monitoring device built into a pair of headphones or earbuds.” (Mashable, 2014)

Engagement is everything

This is the digital health technology of today. Tomorrow, perhaps an individual will swallow an ingestible sensor that transmits data about movement or medications to a videogame that responds by unlocking new worlds and experiences? Or, maybe the sensor will transmit vital signs to the game and, if there is a problem, a “hero” comes to the rescue in the form of a real-time video conference, chat or live consultation with a healthcare professional?

Conceivably, a mobile health monitoring solution could be used in a game with rewards for behavior. Imagine the players as an elderly individual, her adult child and her doctor. Maybe the game challenges the central player’s mind to stay active and challenged while the supporting players cheer her on and offer tips and guidance? Or shake up this model and make the central player a young adult with special needs and the supporting players his therapist, parents and peers. As with Minecraft and other popular games, gamers might live around the block or half-way around the world.

The potential is fascinating, the possibilities endless. It’s all about engagement.

As you as game developers know so well, if the player is engaged with the game, he or she is going to have fun. And if the game is a health and wellness-oriented game, the gamer is going to derive a lot of benefits from that engagement. To keep gamers coming back for more, the information and feedback players receive or earn from the game must be accurate, reliable and useful to them.

The worlds are colliding between traditional gaming, social media, body sensing, mobility solutions and cloud computing. Game developers have a chance to start catching this wave of healthcare gamification while the waters are still unchartered and there is plenty of room for creative license, new ideas and fresh partnerships.

Deepak Prakash is Global Director of Marketing for Digital Health at Vancive Medical Technologies, a business unit of Avery Dennison Corporation. Based in Chicago, he has more than 16 years of experience in the healthcare industry. He holds an MBA from Northwestern’s Kellogg School of Management. Prakash also earned a master’s degree in chemical engineering at The University of Akron, and a bachelor of technology (B.Tech.) degree, also in chemical engineering, from the National Institute of Technology, Warangal. He can be contacted at [email protected]">[email protected], (773) 294-3784 or online via LinkedIn.

COPYRIGHT © 2014 Avery Dennison Corporation

Vancive Medical Technologies, Vancive, Metria Informed Health and Metria are Trademarks of Avery Dennison Corporation.

All other product or company names that are mentioned in this publication are trade names, trademarks or registered trademarks of their respective owners.

References

BodyMedia, Inc. (2013, May 29). Body Monitors Help Drive Healthy Behavior Change: ACSM Sessions. Indianapolis, IN, United States.

Hay, T. (2014, February 17). Can 'Robotic' Pills Replace Injections? The Wall Street Journal.

International Consumer Electronics Show (CES). (2014, January 10). Take a look at some innovations coming out of the Digital Health and Fitness categories at the 2014 CES. Retrieved from http://youtu.be/6VH7FircilQ

Lieberman, D. A. (2012, July). Video Games for Diabetes Self-Management: Examples and Design Strategies. Journal of Diabetes Science and Technology, 6(4), 802-806.

Manjoo, F. (2014, January 12). High Definition: The 'Gamification' of the Office Approaches. The Wall Street Journal.

Mashable. (2014, February 19). Apple Patents Activity Tracker in Headphones. Retrieved February 19, 2014, from Mashable: http://mashable.com/2014/02/19/apple-activity-tracker-headphones/?utm_cid=mash-com-li-main-link

Proteus Digital Health, Inc. (2013, May 1). Proteus Digital Health Completes $62.5 Million Financing. Retrieved November 7, 2013, from Proteus Digital Health: http://www.proteus.com/proteus-digital-health-completes-62-5-million-financing/

Proteus Digital Health, Inc. (n.d.). Powered By You Video. Retrieved February 21, 2014, from Proteus Digital Health: http://www.proteus.com/