Gamification is the use of games or, more precisely, the mechanisms of engagement, entertainment and relaxation present in them for other purposes, such as to change behavior, educate or even treat some diseases. What role can it play in healthcare?
In the beginning, the child chooses his favorite character from Disney films, Marvel comics or Star Wars. The character becomes his everyday companion while brushing his teeth. For every 2 minutes of brushing, the child receives digital stickers, while for regularity and systematicity also stars and special plaques. This is how the Disney Magic Timer app motivates children to brush their teeth. By stimulating the “reward center” in the brain, it changes a disliked activity into entertainment. Gamification uses elements of play to provide education in healthcare, teach, change routine tasks into pleasure, motivate one to engage in physical exercises and treat mild mental disorders (behavioral cognitive therapy). In this way, games help use the strength of our minds to modify our lives.
For many years, games were seen only as a source of entertainment, as a time waster, harmful especially to children, competing with time spent outdoors with their peers. However, a properly designed game can bring benefits. There is increasing evidence confirming this statement, from research conducted in various centers around the world. In one of these studies, a game helping diabetic children led to a 77% drop in emergency visits. It has also been observed that children playing Super Mario Bros games feel less stressed before surgical procedures. The experts claim that the popular Angry Birds game, which absorbs the player’s attention, may alleviate anxiety states. The efficiency of gamification has also been verified by the Accenture consulting agency. In a pilot program with 5,000 participants, it was proved that 70% of the people who participated in a rivalry related to making 10,000 steps everyday continued the healthy habit after the program finished. On the market, there are ever greater numbers of applications available to motivate people to do sports, eat healthy food, lose weight and pursue healthier habits. Everything on the basis of rivalry with friends, in the form of light entertainment.
“Games may form a good motivation-reinforcing factor, especially for chronically ill people” – comments Bonnie Henry, who directs GameMetrix Solutions. We must remember that these people have to fight with their disease every day and it is extremely difficult to maintain their engagement after some time passes following a visit to a doctor or when the disease is not accompanied by troublesome symptoms, as in the case of diabetes. It is estimated that in cardiology the adherence may be even lower than 50%, meaning that over a half of the patients do not observe the doctor’s recommendations. Secondly, as much as 70% of all healthcare-related costs result directly from human behavior, especially inadequate lifestyles and the lack of adherence to the set therapeutic path.
Gamification is all around us, even if we don’t realize it. We like rivalry, we like to compare ourselves with others and aspire to membership of certain groups or certain status. However, it was only thanks to the development of mobile technologies that the concept could be developed and used in a more directed way – to control chosen aspects of life. A good example is the use of apps that build communities of people doing a particular sports discipline. The app users may share photographs or publish their achievements and running routes. Posting the morning jogging route on Facebook with the use of the popular Endomondo app is also an element of gamification. The trend has additionally been supported by the development of wearable technologies. Health trackers – like Jawbone, Fitbit, Garmin, Misfit, Microsoft Band or Apple Watch – measuring distance travelled, vital signs and burnt calories, enabling everyday life to be made a real part of the game for health and better condition. A game in which everyone can be the hero and the winner.
According to the Markets&Markets report, the gamification industry will grow to 5.5 billion dollars by 2018 (in 2013 it was USD 421 million), with a yearly increase of 67%. Among the stimulating factors, one can list wider research into the efficiency and medical results of gamification and the change of generations (people brought up after the digital revolution, fluent users of computers and tablets). After the boom in mobile technologies, which entailed wider discussion about the use of games in healthcare, the world is on the verge of making another quantum leap, that of into virtual reality (VR). It is enough to put on special 3D goggles – like Oculus Rift or Samsung Gear VR – to enter into a completely different reality, a different place. The psychiatrists from the University of Louisville use VR technology in “exposure therapy” for patients with various types of phobias, such as claustrophobia. Similar methods could be used for some other mild mental illnesses, such as depression or autism. Interesting conclusions were made by the experts of the University of Washington: patients undergoing minor but painful procedures without anesthesia, such as wound dressing, were allowed to play SnowWorld during the procedure. The strong influence on the patients’ senses was effective in diverting their attention from the pain. Can gamification find more applications in medicine? There is increasing evidence that it can. In CyberPsychology and Behavior we read about the first positive results of the rehabilitation of some brain diseases and injuries. The disabled will be able enter places otherwise inaccessible to them in the real world, and telemedicine will take on a new meaning.
The Akili game enables the detection of the first symptoms of Alzheimer’s disease. The PlayCare application, while engaging children in interesting tasks, analyses the occurrence of the first, sometimes hidden, symptoms of autism. Reflexion Health is a video game for senior patients – a virtual trainer and physical therapy specialist in one. There are ever more applications for games in healthcare. No matter if the goal is education, creating good, healthy habits, helping with mental disorders, or healthcare and prevention, then hidden behind the elements of the game and light entertainment is an opportunity to bring out the most important elements of health management: knowledge, engagement and motivation in the patient. However, there are also some disadvantages: the games may be addictive and the educational factor may often be dominated by the entertainment layer. The long-term consequences of remaining within virtual reality are unknown. According to some psychologists, intensive experiences may be as strong as other stimulants and make the virtual world, not limited by the laws of physics (without gravity, geographical and temporal barriers, giving us absolute power), simply win over the real one, tempting us with its freedom and creativity.