Simply put, gamification is the integration of game principles and mechanics into a non-game experience in order to engage people to reach goals. In other words, the goal of gamification is not to make things fun. The goal is to create motivation, to incentivize, to engage people so that they are more likely to reach the set goal. So making things fun is not the end game (no pun intended) but a means to that end. Most commonly, the game elements used in gamification include levels, altruism, leaderboards, badges, points and some form of competition.

A simple and widely used gamification technique is quizzes or trivias. We encounter them time and again in magazines, and we more often than not take those quizzes, which makes us read about a subject we would otherwise have ignored. Another such example is the nomination of the employee of the month in many organisations, in which the competition and reward aspects of gamification are being used. A more tech savvy implementation of gamification is Oral-B’s Bluetooth toothbrush.

In healthcare, gamification is used in various ways for a wide variety of purposes. Although it has been so for quite some time, recent developments in technology have spurred renewed interest for gamification in the healthcare world. Amongst the first to implement gamification in healthcare, insurance companies devised games to attract new, and retain existing customers. Gamification can be used to improve health at the individual level, as is the claim of the Jawbone UP and other such wearable devices, or can be implemented in such a way as to have a more global, large scale impact e.g. by optimizing work procedures in the healthcare workplace.

Gamification of healthcare is seeing rapid development in the three following areas : training healthcare practitioners, educating patients and treatment/therapy for patients.

Training and education have been successfully using gamification principles for some time. It raises the motivation and involvement level of participants attending the training session, as well as increases the retention of learned skills or knowledge, as exemplified by this study. By using electronic gaming and virtual reality techniques, an adaptive, flexible and risk-free environment can be created, hence providing a more receptive environment, to help healthcare professionals practice the theory learned.

Patient adherence to treatment is arguably the most difficult hurdle to overcome, both for patient and physician. This is especially true of long term treatment and even more so for the management of chronic illnesses, which in fact require permanent changes in patient behavior more than a finite treatment. In such cases, gamification is used to help educate the patient about his or her condition. And an educated patient is a more involved, hence a more persistent patient. As reported by Accenture: “Gaming applications and applications that use the principles of gaming encourage patients to engage with their health, whether for preventative or treatment-linked reasons, because they trade on well established principles of behavioral science.”

In many cases, gamification techniques lend themselves to being the treatment itself. The level of pain burn victims experience during wound care ranges from severe to excruciating. SnowWorld uses immersive virtual reality (VR) to help burn victims cope with pain. By drawing the patient into an artificial world, the mind is tricked in feeling less pain while the patient’s wound are being treated. Immersive VR is also used to help patient suffering from phobia. By immersing the patient in a controlled virtual environment, the patient can safely confront his or her phobia and over repeated session, overcome it.

As promising as gamification can be, many pitfalls are lurking. Designing a gamified application is not designing a game. The role of the application is to help the patient reach a goal, be it modify a certain behavior or something else. It is not to distract the patient from his or her illness.

Other challenges application designers have to address are the same as with regular game design : the natural desire to win could cause users to cheat, e.g. by exploiting loop holes in the application.

Information overload is also a problem that smartphone app designers are facing : despite the many apps available (over a billion apps on itunes and android), mobile users use on average only 3 apps. So the app designer has to capture and retain the attention of users.

There are challenges more specific to healthcare gamification. An ill-designed gamified application may cause the user to take decisions not in line with the goal to attain e.g. because the application is trivializing the condition of the patient (be it the reality or the perception of the patient), or as mentioned earlier, the desire to win shifts the focus away from the pursued goal. And because the goal in question is the health of a human being, the consequences can be serious.

Intelligent, efficient and successful gamification then, requires close collaboration between a wide range of professions (behavioral psychologists, physicians, engineers, etc.) to collectively develop engaging healthcare programs.

Trying to sum it up, gamification applied to healthcare is one of many ways to engage all stakeholders, leading to better patient outcome. Gamification techniques also help save costs, e.g.by using virtual reality. And achieving better patient outcome at a lower cost is a win-win situation. You can read further about this exciting topic at Training Industry, Time to Care and SearchHealthIT.

As always, comments, questions, feedback are welcome.

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