Tuesday, April 22, 2014

Gamification in healthcare isn't just about playing games

There are a number of pilot projects, technology startups and other developers who are playing around with gamification in healthcare. It's not yet clear whether this approach -- mixing self-monitoring and entertainment -- is yielding the type of traction and adoption that will ultimately lead to sustainable patient behavior modifications and improved health outcomes. Still, I suspect there will be significant growth in this area over the next several years as more patients adopt a consumer mentality about their health and wellness.
For example, people using the Pact mobile app by GymPact risk losing money if they don't follow through on their commitment to exercise. The app requires them to set a personal goal to eat right and exercise several times each week. The users also designate a financial amount that they are willing to lose if they don't follow through on their promise. Those who faithfully exercise earn money that gets paid by those who don't keep their "pact," creating an ecosystem where some users are paying others.
We have only seen the beginning of how gamification principles will help patients improve their health.
The Pact app and its approach to improving health has some parallels to online gambling. Some people simply enjoy the entertainment aspect of online gambling, while others may have an addiction or are highly motivated by the desire to earn money. Similarly, there are people who are compelled to exercise and lose weight, while others are casually exercising to maintain an average level of fitness.
The concepts and principles of gamification are all around us, whether we recognize them or not. Many people are naturally competitive and like to compare themselves to others. That is why companies like to host walking competitions and measure their employees' performance and progress by giving them wearable activity trackers like Fitbits. This desire to compete is also why television shows like The Biggest Loser are so popular. So, even if you are not the type of person to spend countless hours on playful games like Angry Birds or FarmVille, we are all wired in a way to enjoy and to be motivated by the core principles behind gamification.
Accenture reported there are seven key elements behind gamification: status, milestones, competition, rankings, social connectedness, immersion reality and personalization. As consumers become more engaged with their own health, they will take greater responsibility for managing their own condition. People who have diabetes will feel the need to learn more about their condition, their medications, and how they can improve their self-management.
Those who are healthy can stay that way by becoming more knowledgeable about disease prevention, age-appropriate screenings, and maintaining active lifestyles. As people gain more knowledge and insight about their conditions, they will want to set goals, measure their progress against those goals, reach milestones, and compare their performance against certain benchmarks. If patients take these steps to be actively engaged in staying healthy, they will apply gamification principles whether they realize it or not.
We can't forget about those who enjoy smartphone games and spend many hours tapping on screens to play mind-numbing (but thoroughly entertaining) games. For these individuals, adding a gaming element to disease self-management could reduce their apprehension toward the medications and treatments associated with the condition. There are also examples of this targeted at children. Muppets Band-Aids incorporated a quick response code on the Band-Aids so a parent can scan the code with their smartphone to show an entertaining video to a toddler who just scraped his knee. When Kermit the Frog starts singing about feeling blue, will the child forget about his scraped knee? There is a more serious example of the Pain Squad iPhone app that is designed to help children dealing with cancer track their symptoms so their clinical care team can do a better job to manage their pain.
Simulation games such as PatientPartner are aimed at helping patients improve their medication adherence. By walking through a virtual role-playing game, patients can learn about the various clinical outcomes that may result if they fail to adequately manage their health conditions. Monster Manor is a game that engages young children with diabetes to be better at taking their insulin and to have fun while they are doing it.
We have only seen the beginning of how gamification principles will help patients improve their health. As healthcare providers, payers and innovators find successful ways to engage patients by applying gamification strategies to both children and adult patients, we will see a shift in population health that is driven by more engaged and motivated individuals. Gamification will motivate some patients to receive ongoing feedback, reminders and status updates about their progress in caring for their own health.
About the author:Joseph Kim is a physician technologist who has a passion for leveraging health IT to improve public health. Dr. Kim is the founder of NonClinicalJobs.com and is an active social media specialist. Let us know what you think about the story; email editor@searchhealthit.com or contact @SearchHealthIT on Twitter.

Digital healthcare is the way forward

The focus of modern healthcare is around lifestyle issues such as obesity and diabetes. Picture: PA

Published on the 16 April 2014

Patients can be taught self-care, says Grant Cumming

A new building named the Alexander Graham Bell Centre, located on the campus of Moray College UHI in Elgin, will be officially opened in June to further the pioneering work already being done in the area on digital healthcare or e-health. Detailed attention has been paid to the internal architecture because the centre’s purpose is to bring together – and create a flow of ideas between – people working in digital healthcare in the public and private sectors as well as medics, social workers and academics.

Drawing on the “social physics” ideas of Massachusetts Institute of Technology, professor Alex Pentland, among others, the centre will be a hub for developing new and innovative ways of providing healthcare using information and communication technology (ICT).

Social physics outlines how human behaviour is driven by the exchange of ideas and learning from each other. It also identifies how large amounts of very specific data available on the internet through different types of computer technology can be used to help this process.

For example, one in four people in Moray consults the internet prior to visiting their GP, giving doctors an insight into the value of highlighting credible sources of information to patients which might allow them to look after themselves.

We can no longer afford to deliver healthcare under the existing model. Our system was built to deal with infection and while we will always have infection, the focus of modern healthcare is around lifestyle issues such as obesity and diabetes.

The traditional model is reactive when we need to be concentrating much more on preventative and personalised medicine – we need new ideas on how we engage with a person and their wellbeing throughout their life and that is what the centre is there to generate.

In part, the challenge is subtly to alter the behaviour of patients. As well as Alex Pentland’s, the work of behavioural economists Richard Thaler and Cass Sunstein on nudging people to take action and that of psychologist Daniel Kahneman, whose global bestseller Thinking Fast and Slow contrasts fast, instinctive and emotional thinking with slower, more logical thinking in human decision-making, has been influential.

We can teach people to look after themselves. We need an element of nudging – persuading people to take action, for example by highlighting the dangers of smoking. We also need budging – making people take action, for example the ban on smoking in public spaces. We can use information and new technology, perhaps even gaming, to create, for instance, a fun way to exercise to get a message over to some groups.
The internet is now a social web where we can order goods and interact with people, where information within documents can be linked and disparate databases mined for more information.

We must look at how we can connect and collaborate and use that technology to improve the delivery of healthcare, and where better to develop that format than here in Moray?

Moray has already won global recognition for its excellence in the field of digital health, hosting a World Health Organisation conference on the subject in 2012. And two of the four projects in the UK to have received substantial funding under the DALLAS (Delivering Assisted Living Lifestyle at Scale) scheme are in Moray.

They are:

n Year Zero, an online application which enables people to manage their health information and includes an online family tree, a digital version of the red book that is given to all parents to record their child’s health and Rally Round, a social networking and planning tool to connect family, friends, carers and health and care professionals.

n Living It Up, which uses connected TVs to give people access to health and community information within their own homes. Moray is the test bed area for the project.

It is hoped that the Alexander Graham Bell Centre will further enhance the area’s reputation for digital healthcare.The centre has conference facilities, eight classrooms, custom-built corridor learning pods for students, a community hub and cafĂ©. It also has a mock hospital ward, a resuscitation training room, research facilities and space for new enterprises.

The whole place will be a melting pot for ideas, a safe space in which we hope we will be able to redesign how we deliver healthcare.

• The £6.5 million Alexander Graham Bell Centre has been funded by Highlands and Islands Enterprise, Moray College UHI, NHS Grampian and the European Regional Development Fund. 

Professor Grant Cumming, Consultant Obstetrician and Gynaecologist, Dr Gray’s Hospital, Elgin is one of the medical professionals behind the creation of the centre.