Could gamification be a secret to cutting costs?

From the mHealthNews archive
By Ephraim Schwartz

Jeffrey Burns, MD, of Boston Children’s Hospital, was inspired by watching his 15-year-old son gaming with players outside the country.

Wondering why he couldn’t share knowledge with colleagues working in other parts of the world, he embarked on an initiative to build a community-centric learning lab and platform with a social wrapper around simulations and training modules. The result: OpenPediatrics, a demonstration of gamification for distant training.

Using OpenPediatrics, which Boston Children's developed in conjunction with IBM, surgeons can now participate in a shared virtual surgery, and if the particular patient has a unique set of needs the simulation changes and becomes part of the community forum. From there, the data is indexed at a very granular level for fast retrieval.

Rather than training by performing virtual surgery on a virtual patient prior to a surgical procedure, a surgeon can ultimately upload real patient data into a simulator and create real scenarios based on a particular patient’s EHR.

Increasingly, the use of computer gaming technology and design, coupled with mobile and long-distance applications, is helping to reduce costs by streamlining processes, training professionals and motivating patient participation.

[See also: A Candy Crush for stroke patients?]

A report on skill training games by the Kaufman Foundation points out that when well-executed, a serious game can improve knowledge retention by 108 percent over traditional methods. 

Gamificaiton and mobile technologies are also being used to expedite research efforts. One such program is FoldIT, from the University of Washington’s Center for Game Science in collaboration with the Department of Biochemistry.

The DARPA-funded project aims to teach an Artificial Intelligence (AI) engine to recognize protein structures to design drugs that combat diseases like AIDS. The point of making it a game was that players did not need to have any background in biochemistry - rather, the puzzle allowed them to design unique ways to fold a protein within certain given limitations. In just two weeks, the far-flung community helped design a new way to fold a protein for a forthcoming drug, an effort that otherwise would have taken years.

Perhaps the biggest promise for cost reduction is in motivating patients to become more engaged in their own well being and thus reducing emergency room visits and critical care situations. Here statistics bear out the point that mobility and gaming together may have the biggest impact of all on healthcare costs.

It is estimated that 67 percent of all the heads of households play computer games multiple times per week. And these aren’t just 16-year-olds. The average age of a gamer today is 34, and 43 percent are women.

Up until now the best motivational tool to increase the level of adherence in adolescents and young adults diagnosed with a variety of cancers has been one-on-one intervention. But that manner of care is costly.

What if providers could achieve similar adherence results with a patient-regulated tool monitored by a distant care team?

The Re-Mission game from HopeLab, played on tablets, laptops or smartphones, is one such tool. Users deploy a robot, Roxxi, who makes sure that the virtual patient is adhering to the proper care behavior. The game allows patients to destroy cancer cells and manage side effects associated with cancer therapies such as bacterial infections, nausea and constipation by using an arsenal of tools like chemotherapy, antibiotics and stool softeners.

[See also: Mobile healthcare gets the feel of haptics and robotics.]

Following three months of trials, the Re-Mission game significantly improved adherence among  patients undergoing treatment.

Not everyone is convinced that gamification is the way to go, according to Cora Sharma, a senior analyst with Chilmark Research.

“It’s really hard, incredibly hard, to measure the ROI,” she said.

Which helps explain why healthcare payers are focused on adoption numbers. And even if an application garners a high level of adoption, some payers see a potential downside to relying on patient participation. Concerned that people may tire of entering their own data, payers are not convinced that gamification is the answer.

According to Sharma, some payers are experimenting with what might be called “passive” participation. In these cases, programs monitor behavior without patient input in such a manner that a payer can send an alert to the healthcare team if the data indicates a problem.

Gamification is an important avenue of investigation as long as the healthcare community remembers that creating games is not a trivial pursuit.

No healthcare organization should expect that it can easily transform a healthcare app into a game. Indeed, healthcare game designers must be as scrupulous in their designs as game makers generally are when developing a product - it can't be too easy or too difficult, it has to be intuitive, and it doesn't require the player to read a manual - all the while having the stickiness to make players want to come back again.

Ephraim Schwartz is a freelance writer based in Burlington, Vt. He is a recognized mobile expert and columnist, having spent 15 years as Editor-at-Large for InfoWorld, half of them covering the mobile space. Prior to that he was Editor-in-Chief of Laptop Magazine.

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