Virtual reality games may improve stroke recovery

Virtual reality games that challenge balance may speed recovery after a stroke, a new study suggests.

The exercises appear to be a relatively inexpensive way to improve people’s ability to balance and walk following a stroke, Dr. Hillel Finestone, the study’s senior author, told Reuters Health.

  

Finestone directs Stroke Rehabilitation Research at Elisabeth Bruyere Hospital in Ottawa, Ontario, Canada. His small study found that stroke rehabilitation patients who played virtual reality games while on their feet could walk a little farther and maneuver a little faster than patients who sat through the exercises.

“We showed that people do improve,” Finestone said. “We saw improvements in balance. It’s not the be-all, end-all, but we see a good potential.”

For their study, the researchers randomly divided 59 patients who had recently suffered a stroke into two groups.

With the help of therapists, people in both groups participated in a series of 10 to 12 virtual reality gaming sessions lasting 20 minutes each over three weeks.

One group stood to play the games and the other sat. Games included soccer goaltending and snowboarding and were designed so that people standing needed to shift their weight by leaning and reaching to succeed.

The mobility of participants in both groups improved, but the standing participants saw larger gains. Following the therapy, people in the sitting group added 70 feet to the distance they could walk in two minutes, while the standing players added 111 feet, on average, the authors found.

Finestone said that difference could mean a recovering stroke patient being able to walk from his or her living room into the kitchen.

Standing virtual reality participants also shaved more time off a standard test of mobility that requires a participant to get up out of a chair, walk to a line on the floor and then return to the chair.

But Dr. Kara Flavin, from the Stanford School of Medicine in California, told Reuters Health the study didn’t convince her that investing in a virtual reality program would pay off in significant improvements for stroke patients.

“I definitely would want to see more data before I would incorporate it into my practice,” said the physical medicine and rehabilitation specialist, who wasn’t involved in the new research. “If I brought this study to the hospital administration, they wouldn’t be jumping to buy it for me.”

More than 795,000 Americans have a stroke each year, and nearly 130,000 of them die, according to the Centers for Disease Control and Prevention. Stroke is a leading cause of serious long-term disability, and survivors often battle paralysis, speech problems and confusion.

Once just toys for kids and teenagers, videogames have been incorporated into a variety of physical rehabilitation programs. Prior studies found virtual reality exercises improved recovery among people with traumatic brain injury and adolescents with cerebral palsy, the authors of the current study write in Stroke.

A 2011 Canadian review on virtual reality technology hinted that it might help stroke patients recover (see Reuters Health story of May 4, 2011 here: reut.rs/1nDzk5D).

Finestone and his team hypothesized that patients who stood and participated in the intensive virtual reality exercise program would recover movement faster than patients who sat through the exercises.

“We did show some improvement, and it was safe and feasible,” Finestone said. “It’s giving people hope that we can do this.”

Stroke patients might be able to play videogames at home, but they would need to be specially designed to help them recover, he said.

“We’re hoping we can put this into communities,” Finestone said. “We need to organize it and package it properly.”

SOURCE: bit.ly/1fB9TtF Stroke, online April 24, 2014.

CMS: We intend to set ICD-10 date for October 1, 2015

Author Name Jennifer Bresnick

In an email update, CMS has finally broken its silence on the ICD-10 delay with a message that will provide some relief for providers still questioning the future of the new code set: the department intends to release guidance officially mandating October 1, 2015 as the new implementation date.

“On April 1, 2014, the Protecting Access to Medicare Act of 2014 (PAMA) (Pub. L. No. 113-93) was enacted, which said that the Secretary may not adopt ICD-10 prior to October 1, 2015,” the short news update says. “Accordingly, the U.S. Department of Health and Human Services expects to release an interim final rule in the near future that will include a new compliance date that would require the use of ICD-10 beginning October 1, 2015. The rule will also require HIPAA covered entities to continue to use ICD-9-CM through September 30, 2015.”

While many stakeholders suspected that CMS would indeed set the new date for October 1, the confirmation is the first real communication from CMS, whose silence has sparked a whirlwind of speculation and a great deal of frustration.  Providers and professional organizations alike have expressed disappointment and trepidation over the surprise delay, snuck into HR 4302 with no discussion or debate.

In the weeks since Congress enacted the ICD-10 delay, CMS has had to recalibrate its timelines, adjust its guidance, set a new direction, and deal with the undoubtedly significant sting of having the rug pulled out from under them.  Up until the very moment President Obama signed the bill, CMS was pushing hard for industry-wide compliance by 2014.

Perhaps the most interesting feature of the new announcement is the language that will require healthcare entities to continue using ICD-9 all the way up until ICD-10 comes into effect.  Many providers have expressed a wish to voluntarily move to ICD-10 before the mandated date in order to make best use of their resources and reduce the burden on organizations that prepared for 2014 in good faith.  If providers are not allowed to move forward according to the new plans formed during CMS’s silent period, the department may be facing even more discontent than they are at the moment.

The pushback is also expected to be a financial blow to providers who have already allocated resources to the transition, but may give vendors more opportunities to prepare their products and ensure a more successful switch.

“In 2012, CMS estimated the cost to the health care industry of a one year delay to be as much as $6.6 billion, or approximately 30% of the $22 billion that CMS estimated had been invested or budgeted for ICD-10 implementation,” the Coalition for ICD-10 wrote in a letter to CMS earlier in April, urging Administrator Marilyn Tavenner to announce the new compliance date.

“A 30% cost increase due to a one-year delay is consistent with the experience and observations of the coalition members. Continued uncertainty relative to the ICD-10 implementation date will add significant demands on limited resources and will measurably increase the overall cost of completing the transition.”

http://ehrintelligence.com/2014/05/01/cms-we-intend-to-set-icd-10-date-for-october-1-2015/

NCQA: Health IT Can Be Tapped To Support Patient Engagement

Friday, April 25, 2014

Successful integration of patient engagement tools into health IT systems has "the potential to improve inefficient communication methods and change the dynamic of the relationship between the patient and health care system," according to a new report from the National Committee for Quality Assurance, EHR Intelligence reports. 

However, the report noted that there is not yet a complete framework for boosting patient engagement through health IT systems.

Details of Report

In a survey, the report authors identified six common themes of "opportunities and challenges" related to patient engagement through health IT:

• Patient engagement is an untapped opportunity with major potential, especially among marginalized groups;
• Health IT should adopt a user-based model that originates from the needs and preferences of patients;
• There is a dearth of evidence on the effectiveness of such tools;
• Patient-engagement tools should be integrated into overall health care IT systems;
• Patient and consumer trust needs to be fostered; and
• Leadership and collaboration among stakeholders are necessary to realize the full potential.

The report also detailed four activities that will help the industry identify and develop a cohesive strategy for patient engagement through health IT, including:

• Developing joint principles that will facilitate the design, creation and adoption of health IT tools that boost patient care, improve overall population health and lower health care costs;
• Creating and implementing an evaluation framework that focuses on investment and prioritizes consumer choice;
• Facilitating the creation of a unified health data integration strategy focused on patient engagement; and
• Demonstrating innovative ways to use IT tools for patient engagement.

Comments

In the report, the authors wrote that "[h]ealth IT tools for patient engagement are often disconnected from the health care system and in need of full integration across all opportunities for engagement." However, the report added that successful integration of patient engagement in health IT systems has "the potential to improve inefficient communication methods and change the dynamic of the relationship between the patient and health care system."

NCQA President Margaret O'Kane said the "core idea" of the report is that health IT "should be designed around the needs and preferences of patients." She added that "the question of how to link [health IT] and patient engagement is an area where a unified strategy is most needed" (Murphy,EHR Intelligence, 4/23).

http://www.ihealthbeat.org/articles/2014/4/25/ncqa-health-it-can-be-tapped-to-support-patient-engagement

Empirically Driven Consumer Engagement: The Power is in the Simplicity!

Necessity breeds solutions. mHealth Games, is a perfect example of how creative efforts to solve a problem can generate powerful solutions that work. Picture perfect innovation. Cost effective tools developed by and for those on the front lines. Disruption of the greatest kind.

In August of 2013, I was given an opportunity to design and implement an ICD-10 training program for a large managed care organization in Miami. This is not as easy as it may sound. Most coders, including myself, have been doing it for so long that we think in code. The idea of having to retrain our brains as well as our providers was almost an unimaginable task. Knowing this I quickly realized the one variable that would ensure success was the ability to create content that would engage everyone. But how?

This particular organization spanned 4 states and 3 time zones. Efficiency was critical. The ability to monitor and measure the amount of engagement on a daily or hourly basis would provide the intelligence that I needed to modify, adjust and improve the content. I knew what I needed to succeed, but could I execute?

Creative content is what activates consumers to engage over and over. It is what keeps them coming back. I am not an IT person. I have no technical training at all, other than that which was required to graduate. How was I going to pull this off? I could hire a company who specializes in IT or even e-learning, but would that accomplish my goal? No, although experts in their field, they lacked the experiences of a coder, and that was what I knew I could capture my audience with.

So we started experimenting with tools to engage. The first one took over two weeks. I took the top 200 ICD-9 codes and mapped them backwards and forwards to the corresponding ICD-10-CM codes. I added specific conventions to each mapping and added tips for clinical documentation. I thought I had knocked it out of the park. I sent the final project out and waited for feedback. I kept waiting and waiting, until I finally realized that even as great as the tool was, it wasn’t applicable to what we were doing today.

So, I came up with a better idea and requested the top 20 codes from each of their providers. With this new information I was able to create a personalized training program for each provider. Surely, they would be interested in learning about the codes they use on daily basis and how to mitigate any impact to their revenue. But again, I was wrong. This still wasn’t able to truly engage at the level I needed to succeed.

At this point, I was desperate for a better way and turned to Google to research alternative methods. I spent at least 200 hours reading about technology and how it is being used in distance education. What I found was amazing! Really smart people had created amazing tools that would allow me to work with technology. That was a defining moment! A change in paradigm had occurred. I was no longer dependent upon others to close the gap between what I wanted to create and what I was capable of creating.

This is where the fun begins. I had found the tools and now it was time to really start creating engagement. Had I of known the complexity of trying to learn new software, design games and teach ICD-10 -  I may not have taken the challenge. This is actually much harder than it sounds, but the results were well worth the time, talent and energy!

The learning curve was steep and fast. I can not tell you how many times I considered quitting, but then I would look at the results and I knew this had the potential to change everything! Why? Because these games are not just games. They are published using the xAPI or “experience API”. This means that we now are able to learn as much about our learners as they are learning from us!

Consider, the power of one game and the insight of data it could provide. The traditional tracking methods of pass/fail have now been replaced by the ability to visualize when a learner has both interacted with the concepts and mastered them. Thus creating an individual path to success!

These are the tools of the future! They create the foundation for the new learning health care system, but most of all they provide high value at little cost. We already know that games activate consumer engagement, but the time to market and cost of production complicated the process and reduced the return on investment.

Over the last few weeks, I have spent hours upon hours discussing the potential impact on consumer engagement and the potential value of taking mHealth Games to the next level. I have listened to stakeholders from every end of the ecosystem describe their version of how, why, and what this expansion could look like. Opportunities that I never thought possible have been discussed with people who can actually make them happen. But what if we choose to grow organically, where we continue to have to the freedom to create, deliver, modify and improve? After all we have just begun.

The single greatest take-away from this week was how every conversation of “growth” had the same plan, “By partnering with us, we will be able to bring in engineers and you won’t have to design games anymore!” But doesn’t that defeat the entire purpose of this journey?

  

Kameron Gifford

mHealth Games

Video games of to adapt to players' mood

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IANS

San Francisco, April 26 (IANS/EFE) A team of engineers at Stanford University has developed a hand-held controller that allows video games to adapt to a player's level of engagement.

For instance, if a player's heart rate, blood flow, rate of breath and other physiological signals show he or she is bored with an unchallenging game, the controller can gather that information from the individual's hands and increase the level of difficulty.

 

When players are engaged, their heart rate and breathing generally become faster, Gregory Kovacs, a professor of electrical engineering at Stanford and head of the laboratory where the prototype controller was developed in collaboration with Texas Instruments, told EFE.

 

The engineers removed the back panel from an Xbox 360 controller and replaced it with a 3-D printed plastic module equipped with sensors that measure gamers' blood pressure, heart rate, temperature and breathing rate and depth.

 

Users' arms and hands transmit signals that indicate what is happening internally, the professor told EFE.

Created in Kovacs' laboratory under the leadership of doctoral candidate Corey McCall, the controller has sparked the interest of several companies in the video game and entertainment industry.

 

This non-invasive system for measuring autonomic nervous system activity has numerous applications beyond the world of gaming, Kovacs said, noting that it could be used to prevent traffic accidents.

 

Sleepy drivers continue to be a major cause of car crashes, he said, adding that many lives could be saved by using sensors on the steering wheel to monitor motorists' level of alertness.

 

 

 

http://www.ianslive.in/index.php?param=news/Video_games_of_to_adapt_to_players_mood-420408/SCI-TECH%20and%20HEALTH/36

 

 

 

 

How IT is Driving Changes in Community-Based Healthcare

 

By John DeGaspari

How is IT being used to transform healthcare delivery at the community level? At the annual meeting of the New York State Chapter of HIMSS, on April 23 in New York City, which was attended by Healthcare Informatics, Mary Ann Christopher, MSN, R.N., president and CEO of the Visiting Nurse Service of New York (VNSNY), gave an insightful presentation of IT-driven initiatives, which she said are crucial to transforming care delivery in her organization.

Christopher said that VNSNY, as the nation’s largest not-for-profit community-based healthcare system in the nation, occupies a unique place as it meets challenges inherent in healthcare delivery. It is both a payer and a provider organization, giving it “access to upstream dollars that allows it to innovate and deliver care in unique ways,” she told an audience of several hundred. It encompasses 50,000 providers, an inter-professional team of physician, nurses, rehab therapists, social workers, pastoral care, home health aides, and strong staff in IT, who deliver care to 70,000 patients in their communities. Information flow and continuity is critical to ensuring good care, she said.

“We are in a place in healthcare delivery that is cataclysmic, with the passage of the Affordable Care Act (ACA),” with both opportunities and challenges with the 30 million Americans having access to health insurance and care, Christopher said. “There are opportunities to come together as a health system that we didn’t have before.” Delivering care in a silo environment focused on discrete events and episodes is no longer acceptable. “Much of our intervention has been on the tertiary level of care, less on health promotion and disease prevention,” she said.

Christopher sees opportunities embedded in the financial pressures brought on by the ACA. “Value-based purchasing means we need to come together in more intentional ways to bring together the healthcare delivery system in ways that are aligned, both financially and in terms of their quality outcomes of patients and populations,” she said. Under the new healthcare scenario, caregivers need to consider what is happening to patients in the primary physician’s office; acute care, post-acute and sub-acute care settings; home and hospice care, as well as where patients live, she said. The challenge is transforming healthcare in a way that reaches all of those environments.

Consolidation among provider organizations and physician practices—either through acquisitions or virtually—is offering the opportunity to avert patient safety issues, as well as to get the cost structure in place to deal with declining reimbursements, she said. At the same time, policymakers are increasingly cognizant of the healthcare needs of marginalized people. Meeting that imperative means focusing on the needs of the most vulnerable populations, particularly the dual-eligible, who fall outside traditional treatment modalities in terms of quality outcomes, she said.

Technology as an enabler of better care

In Christopher’s view, the only way to achieve those goals is to rely on the greater application of technology. She said that the healthcare industry has a “burning platform” to come together in ways that engage people where they live and put the patient and the community at the center of care. “More and more we see a system where we are called to function inter-professionally, where those who have clinical informatics expertise are as critical as the physicians and nurse in that team of care,” she said.
She said VNSNY has embraced its role as a virtual integrator, putting the information in the hands of the providers and VNSNY staff to make better decisions. She expressed a vision that information technology will enable better care. Among her examples: more treatment in place rather than moving a patient to an ED; less isolation from frailty as patients use web-based apps to engage them and participate in round tables with other patients; less diagnostic uncertainty by using home-based tests, with results that can be transmitted to providers in real time; and texting to provide motivational cueing to patients.

For example, VNSNY is using texting to provide motivational cueing to teenage mothers in its Nurse Family Partnership program. “They are not likely to pick up the phone when the visiting nurse comes, but they will respond to texting and cueing, and that’s a modality that we are using increasingly,” Christopher said.

In another initiative, VNSNY is using predictive analytics in its Outcome and Assessment Information Set (OASIS), a federally mandated tool to assess patients for home care. Using predictive models, it is able to identify, based on characteristics of those patients, what other services they might need beyond a traditional home care, she said. “For instance, we know that based on certain diagnostic characteristics, there are frailty indices. We are able to extrapolate that data and able to predict that that patient will benefit from an intensive rehab program to avert falls,” she said.
The OASIS assessment also predicts patients who would be more appropriately managed within a palliative care environment of hospice rather than traditional home care episode that is focused on acute intervention and then discharge. “This is an important set of analytics to make sure we are providing the appropriate care for the patient at the time they need it,” she said.

Christopher noted that VNSNY Center for Home Care Policy and Research has culled data to determine what other episodes might occur, creating alerts to the staff as they deliver care. “Our research center has culled through tens of thousands of patient records, and determined, for instance, that any medication change with a patient under our care potentially triggers a fall, which always triggers a re-hospitalization,” she said.

Predictive analytics are also used in VNSNY’s health plan to assess patients for receiving managed long-term care services. From that analysis it is able to identify the interventions that should be used to care for and coordinate the care for those patients. “It tells us, based on that risk acuity adjustment and that chronic disease burden, how much face-to-face intervention we need, what kind of telephonic intervention we should be using, should it be telehealth or should it be electronic,” she said. In a health scenario that no longer reimburses for the amount of face-time, it is critical for provider organizations to select the appropriate means to communicate with patients, she said.

Using technology to engage patients

The organization is also using technology to optimize patient and member engagement. Its goal is “to get patient and caregivers more comfortable and more literate with how the disease path physiology is impacted by the behaviors that they demonstrate on its hourly or daily basis,” she said. To do that, it has integrated telehealth significantly across the enterprise. 

For example, it is using biometrics with congestive heart failure (CHF) and diabetic patients who, using an application in the home, measure relevant physical data that is transmitted to a central station in real time. The data are used as cues for the provider to give guidance to the patient. “We have found that by using this with a community hospital, to reduce length of stay by 0.8 days for patients with the highest level of acuity of CHF and also to reduce that 30-day re-hospitalization below the national numbers,” she said.

In a separate application, it has used biometric technology to measure data on 410 diabetic patients, with the result that 80 percent of the patients have achieved better hemoglobin A1C control. Christopher added that VNSNY’s research has shown that those improvements have occurred because telehealth has raised the patients’ awareness of the link between their behavior and health risks, and they have modified their behavior for better outcomes.

Interactive voice response has proven to be another effective technology for its frailest patients. It is using interactive voice with members in its Medicare Advantage Health Plan, 85 percent of which are dual eligible, so are patients with the highest disease burden. The goal is to “Interrupt that cycle of non-medication adherence, one of the biggest factors of first 30-day all-cause readmission in the nation,” she said. These technologies have helped to reduce costs because people can be prompted through technological interventions.

Using a solution (supplied by Remedia LLC, Amherst, Mass.), it runs all of the pharmaceutical medications plans of care for its patients to screen for anything that would be inconsistent with best in class practice, and then drive the changes in that medication plan. It has implemented another solution (supplied by Eliza Corp., Danvers, Mass.) to deliver medication of voice alerts to patients about when they should be refilling their meds; if they have not, the patients’ case managers outreach to them to understand what is happening. 

Through VNSNY’s special needs program for 5,000 patients with AIDS and HIV, We also have a special needs program through we care for about 5,000 people with hiv and aids, VNSNY has started a text-messaging initiative (using a technology from New York-based RipRoad), to send patients reminders of medication refills and follow-up appointments with specialists. “Our goal is to help with the management of the disease and also, to reduce unnecessary reliance with EDs,” Christopher said.

New IT platform for care coordination

VNSNY is migrating to a new IT platform (GuidingCare, supplied by Altruista Health, Reston, Va.) that will bring together on a single screen clinical data that care coordinators use to manage the care, services and benefits around that particular patient, but also the claims data the person will have access to, as well as incoming and outbound customer service incoming calls.
She said the system will provide opportunities for patients to access the system any time on any device. “Our goal being that they will be able to control their own health, they will be able to indicate to the care coordinator, what their goal is for them themselves. They will be able to establish with the care coordinator a dashboard that is specific to them, which monitors their disease progress across industry standards in terms of metrics and benchmarks,” she said. She added that the portals VNSNY is implementing are user friendly and include visual cueing to promote better understanding and enhance health literacy.

At same time, it is moving to a new technology platform on the provider side to reduce the minimum data set at intake. This will help to ensure that that initial assessment will use predictive analytics for risk stratification that will then hardwire what the services within VNSNY should be, she said.
It also plans to centralize and automate the scheduling using evidence based guidelines. “We have estimated that this will take out $40 million in cost out of our system, important given the federal and state reimbursement reductions that have occurred within the provider and plan space over last two or three years,” she said.

Searching for health ‘hot spots’

VNSNY has also implemented a program to look at the characteristics of patients accessing the healthcare delivery system within certain neighborhood geographies. It identified the social determinants of health as they impacted the health of the population, such as immunization status; morbidity statistics in terms of diabetes, cardiovascular disease; and issues of crime, alcohol and substance abuse. Using that model and geo-mapping the community, it has identified “hot spots” that require a unique level of intervention, and deployed community wellness coaches, nurses and social workers, working with community-based coalitions in the area to address those needs.

“This is a program that is being followed by the Centers of Medicare and Medicaid Services, the Institute for Healthcare Improvement and the New York State Department of Health. Early results have shown that we are already impacting the number of folks accessing the emergency departments for ambulatory care and sensitive conditions, for which they are better served by primary care access,” Christopher said.

Source URL: http://www.healthcare-informatics.com/article/how-it-driving-changes-community-based-care

The Next Generation of Healthcare: Games and E-Learning – high value, low cost!

Games drive engagement through consumer activation. We know this! They are a fantastic way to challenge learners and keep them engaged and interacting with the content at hand.

So, how do we improve on something that is already awesome? We embed it in a learning ecosystem that drives improvement through partnerships with all stakeholders. This new learning environment sets the stage for providers, patients and caregivers to connect and communicate - anytime, anywhere, any place and on any device.

As we move towards a healthcare system that reimburses for value instead of volume we will need tools that can capture this next generation of care.  We will need to automate the processes of education and learning much like the electronic claims we send today. All of this data will then need to be interpreted to understand and truly visualize the path to wellness. That feedback will allow us to refine the process and continually work to improve the delivery of care.

But what if we can already do this through fun, engaging, and cost effective e-learning games? I believe we can! With the help of new technology, such as the xAPI, we can now track and measure all those things that were so hard to track before.

These short games below can capture up to 32 data points vs. the traditional check boxes, and take days to get to market instead of months. Imagine the possibilities. 

Click on a game below to launch.  Bird Hunt is a flash game, so you will need a flash browser. The Olympic Mountain Summit game is not. 

Fred was just diagnosed with type 2 diabetes and now he is afraid to enjoy the things he used to. This game combines his love of hunting with diabetes education. 

Johnny Three-Scoops and Earl Strong-Fit will not only be fighting for their individual victories tonight, but the fate of their entire teams may lie in the outcome of this single event. With only 3 events left, and this being the only event in which their respective teams have a real contender, this could decide the gold.

Can you help TEAM HEALTH reach the top first by correctly answering the questions?



For more fun, FREE Games visit our website: www.mhealthgames.com

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.

http://searchhealthit.techtarget.com/opinion/Gamification-in-healthcare-isnt-just-about-playing-games

Digital healthcare is the way forward

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

• by GRANT CUMMING

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 café. 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.

http://www.scotsman.com/news/digital-healthcare-is-the-way-forward-1-3377637

The serious business of gamification

If you’re interested in changing behaviour in your workplace, helping employees or customers to develop new skills, or spurring innovation, you may want to consider the approach known as gamification. If that scares you – given that the word is ugly and sounds as if you would just be encouraging staff to play video games – Brian Burke, a vice-president at technology research firm Gartner Inc., says you should relax.

Gamification is actually not about playing games. Games are about entertainment. Gamification is serious stuff, using game mechanics such as badges and awards to digitally engage and motivate people to achieve their goals.

“It’s not entertainment. It’s motivation,” Mr. Burke said in an interview.

He points to the Boy Scouts, which has long used badges to motivate youngsters, and Weight Watchers, which uses a points system and social encouragement to nudge dieters. Both are examples of gamification from the days before the term was even coined. “It provides them with the encouragement, motivation, and clear path to achieve a goal,” he said.

Mr. Burke stresses that when using gamification, it is vital that the emphasis not be on organizational goals but on motivating people to achieve their own goals. When those personal objectives are aligned with the organizational goals, you can hit the gamification jackpot.

Behavioural change is the most common use for gamification. It comes in handy because new habits must be created to change behaviour, and gamification can excite us to adopt those practices.

In his book Gamify, Mr. Burke notes that Spanish bank BBVA used gamification to encourage customers to use its online services. The BBVA Game, which has 80,000 users, rewards players for completing challenges that educate them about Web banking, encouraging them to use the service. Points are awarded, which can lead to prizes. It has led to a 5-per-cent increase in BBVA’s Web-banking users, who spend 60 per cent more time on the site. Because online banking can be easier than going to a branch, the game is aligned with customers’ needs. But it’s also aligned with BBVA’s needs, because it reduces costs.

Samsung Electronics focused on customers with its social loyalty program, dubbed Samsung Nation. Customers are rewarded with points, levels and badges for watching product videos or commenting on Samsung products. The program has doubled the number of items placed in online shopping carts.

A key to success for behavioural change is to increase complexity over time. The BBVA Game starts by encouraging customers to watch instructional videos and then try simple operations such as checking an account balance. As users become more confident with the help of coaching, they move to more complex tasks such as paying bills.

Gamification can also help people to build their skills. Learning new skills often requires a repetitive process of lectures and practice, which gamification can handle. Or if the skill is best learned in an experiential way – such as being presented with a problem to solve – gamification can provide a vehicle for collaboration with others.

There have long been games that can teach new skills, such as Where in the World is Carmen Sandiego? (a series of video and computer games and TV shows designed to stimulate kids’ interest in geography, cultures and history). But Mr. Burke says those are games first, and skill-builders second. Gamification puts the skill-building first.

U.S. organizations such as Capital BlueCross are using it to educate members on the complexities of health care. The U.S. Department of Health and Human Services applied a gamified solution to educate health-care practitioners on best practices about privacy and security.

A key element of design is to create theory-practice loops. Players are provided with instruction, a challenge, and feedback on their efforts. “Gamification breaks the learning process into small, achievable steps and provides constant feedback and encouragement throughout the process,” Mr. Burke writes in his book.

To spur innovation, gamification can encourage people to submit innovative ideas, evaluate proposals and then collaborate to refine the idea into reality. Quirky, a crowdsourcing product-development company that has more than 6,000 inventors as members and has launched more than 400 new products since 2009, uses gamification in this way.

Mr. Burke says the process can be captivating. During his research he found himself hooked as he submitted a name for an anti-theft rucksack – one of 1,400 possible choices – and watched his suggestion bounce up and down in the Quirky rankings.

While he is an enthusiast, Mr. Burke warns that the biggest challenge facing companies is to understand the limitations as well as the opportunities of gamification. “A lot of organizations are pursuing opportunities that are unlikely to be successful with gamification,” he said. Faced with a problem, they throw some points at it and hope a solution will materialize. But you need to figure out how a point system might work, how to employ collaboration, and whether what you are designing can hold for the long term as well as short term.

But if you get it right, he believes you can harness the power of game design to great benefit for your organization.

Harvey Schachter is a Battersea, Ont.-based writer specializing in management issues. He writes Monday Morning Manager and management book reviews for the print edition of Report on Business and an online work-life column Balance. E-mail Harvey Schachter

http://www.theglobeandmail.com/report-on-business/careers/management/the-serious-business-of-gamification/article18020562/

"The Case of the Bad Blood Sugar" - Help Detective Wells solve this case!

 Mr. Bad Blood Sugar and his gang of carbohydrates have initiated a crime wave of epidemic proportions! 

Detective Wells is hot on their trail, but he needs you to help find the clues that will solve the mystery.

Click the image above to launch the game!

mHealthGames.com

The European Commission has launched its long-awaited mHealth consultation, and hinted that policy action could be forthcoming as early as 2015.

Dillan Yogendra, Managing Editor, HIMSS Europe

Dillan Yogendra is Managing Editor of HIMSS Insights and is based in London. He is able to advise you on HIMSS Europe's wide range of media properties, including HIMSS Insights, HealthTech Wire and the British Journal of Healthcare Computing. Follow Dillan on Twitter @DillanYogendra1

mHealth consultation launched

The European Commission has launched its long-awaited mHealth consultation, and hinted that policy action could be forthcoming as early as 2015.

EUROPE | April 17, 2014

European Commission vice-president Neelie Kroes was unequivocal in her support for the emerging area: “mHealth will reduce costly visits to hospitals, help citizens take charge of their own health and well-being, and move towards prevention rather than cure. It is also a great opportunity for the booming app economy and for entrepreneurs,” she said.

Outlining benefits from better use of mHealth services the Commission said the technology would: put patients in control, enabling them with greater independence and helping to prevent health problems; make healthcare systems more efficient, with huge potential for cost savings; and create opportunities for innovative services, start-ups and the app economy.

The European app economy is already worth €17.5 billion and has generated 1.8 million jobs, thus the economic issue is an important one.

In addition, the Commission says that if the full potential of mHealth is “unlocked” it could save a further €99 billion in healthcare costs across the EU, providing issues like mHealth app safety, usage of data, etc. are addressed.

It is now more than two years since the first mobile health app was registered in the UK as a medical device. Subsequent developments of significance to the Commission include strategies in the USA, where for example the FDA took a tailored approach to mobile health app regulation last year.

The three month consultation will run until July and the Commission hopes to engage with a wide variety of stakeholders, including patient organizations, healthcare professionals, app developers and mobile device manufacturers.

European Commissioner for Health, Tonio Borg said: “mHealth has a great potential to empower citizens to manage their own health and stay healthy longer, to trigger greater quality of care and comfort for patients, and to assist health professionals in their work. As such, exploring mHealth solutions can contribute to modern, efficient and sustainable health systems.”

http://www.healthcareitnews.com/news/mhealth-consultation-launched