How Gamification is Influencing Healthcare

In the computer game HEMOCRAFT, created by Pfizer, children with hemophilia become immersed in a digital learning experience based on the popular Minecraft game. The goal: to teach them how to manage their symptoms and how to merge their treatment into their routines.

On screen, kids consult the village physician, help their character receive an infusion, manage medication and gather materials to build an “infusion kit.” And, if all goes well, players embark on a quest to slay the Big Bad Villain of Minecraft – the Ender Dragon!

“These new digital innovations can be integrated into everyday routines to help empower people with hemophilia to learn about and track different aspects relevant to their disease so that they can have informed conversations with their healthcare providers,” said Kevin W. Williams, Pfizer Rare Disease Chief Medical Officer, in an interview with Healthcare IT News.

Gamification is the process of adding games or game-like elements to an experience to encourage participation, according to Merriam-Webster. It is quickly becoming part of the business world as well as the customer service world. According to B2B researcher MarketsandMarkets™, the gamification market is projected to reach a value of $11.10 billion by 2020.

As the need for IT and technology-driven innovation grows within the healthcare industry, gamification has become more of a factor. Not only does gamification allow for data collection, it also gives both patients and healthcare providers the chance to benefit from a different kind of learning.

Gamification gives the healthcare industry and providers a new way to appeal to investors, as it offers a low-cost way to deliver healthcare education and patient engagement. Technology with a low ROI gives healthcare administrators a chance to pitch something different to potential investors and stockholders. If it’s executed correctly, gamification may increase knowledge and create better outcomes for both companies and patients.

Gamification provides new ways to track exercise and medication, while also helping patients learn how to manage chronic conditions. Here are just a few examples of gamification in action:

Depression: Gamification Increases Optimism

Many apps employ gamification that can be used to influence and adjust patient behavior. One such app, SuperBetter, allows the user to work on self-improvement through gaming. In a 2015 study conducted by the University of Pennsylvania, researchers found that adults with depression symptoms who played the game for one month reduced their symptoms and also increased their optimism.

“There’s nothing fun about surviving an illness or injury, but you can use the same psychological strengths and ability to focus on opportunities to get stronger, learn and connect with others. Games are an accessible and powerful structure for doing that,” said one of the creators of SuperBetter, Jane McGonigal, in an interview with Children’s Health Today.

Juvenile Diabetes: Reducing ER and Urgent Care Visits

Just like HEMOCRAFT, the game Packy & Marlon helps children with juvenile diabetes learn how to control and manage their condition. The game was shown to reduce urgent care and emergency visits related to diabetes by 77%. It’s a Nintendo game that takes the player through a summer camp where they have to maintain blood glucose levels in their character by taking insulin, eating the right foods and testing their sugar.

Mobile Apps: Improving Medication and Exercise Management

By adhering to medication schedules, patients can earn rewards through an app called Mango Health. The app gives the user alerts to take medicine, and gives points every time they take the medicine. Users can then use their points to earn gift certificates or donate money to charities.

Another app, Pact, offers cash rewards financed by members; those who don’t meet the fitness goals set for them place money into a fund that rewards the members who do meet goals. Fitbits and other step trackers are being used by employers to start competitions among employees for walking goals and rewards.

Changing Physical Therapy Practices

Patients recovering from injury or surgery with physical therapy are using several different types of gamification to make their recoveries more effective and efficient.

One study by the University of Washington examined physical therapy for burn victims, and found that all participants experienced less pain when they used VR to assist in their therapy. Results from the study showed VR may be able to serve as a pain reducer in burn victims and in other painful medical issues as well.

The Medical Interactive Recovery Assistant (MIRA) is another way physical therapy patients can reap the benefits of gamification. It was invented by Cosmin Mihaiu, who wanted to design a system that can help patients recover through playing video games. MIRA tracks number of repetitions, notes speed of movements and sends a report to the person monitoring a patient.

Gamification can help stroke victims as well. In a game based on an Apple TV app called Bandit’s Shark Showdown, stroke patients use a robotic sling to synchronize their arm movements with the character in the game. Neurologist John Krakauer helped in developing the game because as he studied stroke victims, he began to realize that traditional physical therapy might not help reverse the damage, he told The New Yorker in an interview.

“The movement training we are delivering is occurring at such low doses that it has no discernible impact on impairment,” Krakauer said. He and his team are working on a clinical trial to use robotics and the game to show that their idea could be the future for treatment of brain issues.

Refining Surgical Techniques

Surgeons who play video games more than three hours a week are likely to commit 37% fewer errors than those who don’t, according to a study published by the National Institutes of Health. In the study, researchers followed 33 residents and attending physicians and compared their laparoscopic skills and suturing capability and video game scores and experience.

When they compared the top video game players to the others in the study, those participants made 47% fewer errors while performing 39% faster.

“Training curricula that include video games may help thin the technical interface between surgeons and screen-mediated applications, such as laparoscopic surgery,” the researchers wrote. “Video games may be a practical teaching tool to help train surgeons.”

Educating Healthcare Providers

Tightening cybersecurity practices is a concern for healthcare organizations, as the industry is one of the most widely targeted and hacked across the country. One health system in Michigan found a new strategy, which was to train employees with 10-minute gaming modules. Through user feedback, Beaumont Health System found that the training greatly improved employee engagement, according to Healthcare IT News.

In 2011, Veterans Affairs Boston Healthcare System and others conducted a study in which 111 primary care physicians participated in a randomized trial that tested those who played an online game against those who didn’t. The purpose was to test the physicians’ knowledge of hypertension treatment. In post-testing, the game group scored 90% vs. the control group’s 78%, and during the study, researchers found that the game group physicians had an average of 2.3 more patients reaching the blood pressure goal set for them.

“This study is particularly noteworthy because it is the first to demonstrate that an online educational game among medical professionals can improve the health measures of their patients,” the researchers wrote.

Are There Cons to Using Gamification?

Certainly, gamification shouldn’t be the only way physicians work with their patients. Face-to-face interaction is still important, and some patients might not want to use these methods. Games work because success builds chemical messengers like dopamine and serotonin in the brain, and the little victories make people feel good.

But could gamification make some want to replace that vital face-to-face interaction?

The past few years have seen a huge increase in online and social media activity, and studies have shown that younger generations have become more prone to staying home and not going out with friends. According to Pew Research, nine in 10 Americans now have an online presence and 77% own a smartphone, meaning more and more people will be using these health apps and games.

Patients and providers will just need to make sure to strike a healthy balance between personal interaction and the use of technology to ensure that the standard of care remains as high as possible while capitalizing on innovation and creativity. Gamification should be used as a tool, not a replacement of care.



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