Gaming to engage the healthcare consumer

Most of us know what to expect from a visit to the doctor. When we’re sick or hurt, we’re prescribed traditional treatments like medication, medical procedures, or physical therapy. Imagine leaving your next appointment, though, not with a prescription for any of those treatments — but with a game. From treating post-traumatic stress disorder (PTSD) to helping healthcare professionals communicate difficult diagnoses to catalyzing life-saving behavior changes, gamification is changing the healthcare landscape on many fronts.

Gamification is the application of game elements and digital game design techniques to everyday problems, including business dilemmas and social challenges. Games tap into our natural desires and motivators for competition, achievement, and status. Using tools such as points, achievement badges, or mastery levels, games are a dynamic way to interact with customers.

The concept isn’t new. For years, the airline industry, the U.S. military, and the medical field have used simulation and virtual operations to train pilots, combat personnel, and surgeons. Even some higher education institutions have integrated gaming techniques into their MBA programs, allowing future business leaders to test scenarios and adjust accordingly in the safe haven of the classroom. Recently, the healthcare industry has started to follow suit with an array of health-related apps designed to help consumers get fit, eat better, and achieve health and wellness objectives.

Despite what the name might suggest, developing games with clear instructional objectives and measurable learning outcomes requires work—not just play. Success in this space requires a team of multidisciplinary, multifaceted experts, including advisors in healthcare, instructional design, research, assessment, and game design. The team must also have a proven methodology for applying scientific concepts to a fun and engaging game style.

Market Drivers Behind Gamification in Healthcare

What is driving healthcare organizations to jump on the gaming bandwagon? One answer lies in legislation; namely, the Affordable Care Act (ACA), which mandates a reduction — estimated at more than $2.5 trillion annually — in the U.S. annual spend on healthcare.* To meet this objective and remain competitive, healthcare players are leveraging game theory in their consumer engagement strategies for a few key reasons:

• Outcomes-Based Medicine. The ACA has mandated a shift from the current fee-for-service reimbursement model to “value over volume” in which healthcare organizations are reimbursed for healthy outcomes in the populations of customers they serve. Under the new rules, healthcare payers are incentivized to encourage individuals to act on information to improve their health status. Because chronic conditions represent 75 percent of all health care spending, they need solutions that focus on preventive wellness approaches rather than simple treatment of symptoms. Gaming techniques in customized apps—like those for smoking cessation or weight management—have proven to be a very effective and cost-efficient means of bringing about individual change.
• Consumer-Based Business Model. The healthcare market is shifting to a business-to-consumer (B2C) model, a change that brings many challenges for healthcare payers. To effectively compete for end consumers’ business, healthcare organizations must offer consumers interactive, easy-to-use tools that motivate them to commit and stick to a healthy track. An interactive game is a great way to encourage healthy habits.
• Growth of Generation Y. Gen Yers (millennials) are between the ages of 18–27, representing the largest population cohort the U.S. has ever seen. “Eighty-six million strong, the millennial population is 7% larger than the baby-boom generation, which came of age in the 1970s and 1980s. And, the millennial population could keep growing to 88.5 million people by 2020…” They account for 38 percent of America’s uninsured, and they are the healthiest, least costly group to insure—making them a highly coveted market for healthcare marketplace insurers. Why does this matter? Because they grew up with gaming and are accustomed to interacting with businesses through custom apps and game-based interfaces. To reach this audience, it is imperative that health insurers meet them on their terms through interactive and engaging interfaces that incorporate gaming elements.

Smart Games in Healthcare

Although simulations and gaming methods have been used in aviation and the military for some time, they are relatively new to the commercial healthcare space. So where do innovative healthcare companies use gaming?

Apps for smartphones and tablets. Health-related apps are quickly taking hold at rapid-fire speed. These apps are designed to monitor every facet of an individual’s health profile—from nutrition, to activity, to sleep, and more. Some key areas that current apps address include:

• Nutrition, weight management, and obesity. Because obesity is such a concern in the United States, apps that manage nutrition and weight are quickly becoming important tools in improving health-related behaviors. Obesity, as with other chronic conditions, is ideal for game-based applications that can track health metrics in an engaging manner, and provide challenges and rewards. HealthMonth™ is one such game, focused on making small improvements to your health one month at a time. HealthMonth™ works within the FitBit® family of applications; it combines the science of nutrition with behavior change social gaming tools.
• Disease prevention, self-management, and adherence. In this chaotic time, many people find that adhering to schedules is difficult. This is especially problematic if a slip in schedule affects your health, as is the case for chronic diseases, like diabetes, that require constant testing or monitoring. To help prevent these slippages, Bayer’s Didget™ connects to Nintendo® gaming systems and employs a fun, reward strategy for children to ensure they stay on track with their treatment.
• Cognitive, mental, emotional, and behavioral health. As the saying goes, healthy mind, healthy body. It’s not all about physical health. There are many cognitive and emotional areas that can also be helped by gaming. For example, BellyBio by RelaxLine is a biofeedback device and app that helps relieve anxiety through deep breathing exercises and ocean sounds.

Professional Development. Games and simulations are increasingly used to train healthcare professionals in methods for diagnosis, medical procedures, and patient monitoring. For example, a story-driven narrative about HIV prevention allows the user to review and learn materials. It uses a story-telling approach to learning and includes motion comics, 2D and 3D animations, and engaging visualizations. These techniques, albeit limited in interactivity, provide a rich, interwoven world of characters, storylines, plots, and lessons, and go a long way toward improving understanding and retention.

Data Analytics and Machine Learning. In so much of our world, patient and healthcare data records are available to better inform, educate, and benefit the population. With new technologies and algorithms--such as machine learning, advanced computation and statistics--we can compile and analyze information, and accelerate innovation as never before. Machine learning is mature enough to start accurately predicting medical events, including whether a patient will be hospitalized, for how long, and if health is deteriorating despite treatment for conditions such as urinary tract infections, pneumonia, or heart failure.

Simulations using Augmented Reality (AR) and Virtual Reality (VR). VR-based medical simulations are becoming a mainstay as we teach our next generation students. VR is in use across the medical learning community to include surgical procedures, emergency medical care, collaborative hospital incident command scenarios, and psychological issues such as PTSD, pain management, and insomnia.

In contrast to VR, the AR world is the “live” real world, augmented with one or more computer-generated inputs that affect the user’s senses through sound, video, graphics, or avatars. In the newest technology, the user may actually interact with the AR world, and affect changes to the augmented entities via real-time input. One area this technology has proven helpful is in surgery. A patient ‘s body is superimposed with a 3D visualization of his or her organs. Students who are watching the surgery learn to see what the experienced surgeon sees—by leveraging the 3D overlay—thus enhancing the educational experience.

Telehealth. Employing electronic information and telecommunications technologies to support long-distance clinical healthcare, education, and health administration has been especially useful in reaching underserved groups, such as rural populations. Using videoconferencing, the internet, streaming media, and other technologies, Telehealth is another burgeoning area of care that could use gaming as a channel for promoting and encouraging healthy outcomes.

The Future of Gaming in Healthcare

Gamification to affect healthy outcomes already exists, but healthcare organizations have just begun to scratch the surface. They must stay abreast of technological advances to ensure that they’re relevant to their customer base. Some recent and future developments include:

• Micro-Learning and Gaming. Data collected from a variety of sources can be used to provide just-in-time training at the point of need. Instead of large training systems or cumbersome curriculum, gamified learning can be tailored and served up for each learner.
• Transmedia and Storytelling. The future of learning is fundamentally a story that weaves in characters, storytelling, genres, and a variety of delivery platforms. Imagine learning about the dangers of unsafe sex through a story-driven narrative that requires you to make the right decisions to keep characters healthy.
• Gesture and Sensor Recognition. A number of tech companies are developing gesture sensor recognition systems for in-car use. For instance, Harman is “looking to develop a dictionary of gestures which can be used to replace buttons and knobs currently used inside most car cabins with an array of infra-red sensors.”  Japanese sensor technology company, Alps Electric, is taking this sensor technology one step further, “creating a cross between an arcade game and an appointment with a healthcare specialist.” The Alps car combines face recognition sensors and an array of other sensors that monitor the driver’s vital signs so that the car knows when to continue with the journey and when to call a doctor.

In the rapidly changing healthcare landscape, organizations aiming to stay competitive need to shift focus. The name of the game is customer engagement—knowing what healthcare consumers want, how they think, what motivates their behavior, and how best to communicate with them in a meaningful way.

Technological advances will continue to drive and evolve gamification and how it’s used in healthcare. From apps to leaderboards to simulations, gaming is one certain channel that wise insurance companies will employ to reach, gain, and retain customers—and achieve healthier populations.