Preloaded creative director Phil Stuart on how games can be used in the health industry
One of the fastest growing areas of game industry is the development of games for more than just entertainment.
Harnessing the power of games for alternative purposes for education, training, communication or social change is something we're very passionate about, and one sector which we believe will benefit most from games’ reach and transformational qualities is Health.
This post attempts categorises the opportunities, and showcase some of the best games leading this charge.
Public awareness and outreach
One of the most visible parts of the health sector is focussed on outreach and education. The success of any public awareness campaign is measured in reach and engagement, and the pervasiveness of games and their flexibility makes them the perfect tool to target large numbers of people and tackle a wide range of subjects.
A great example of this reach is Plague Inc., a strategy game that challenges the player to kill off the world’s population. Whilst not designed as a health awareness project, the modelling of the factors and spread of disease are realistic enough for it to be praised by the Centre for Disease Control and Prevention for its strong educational integrity.
As the 15th highest grossing iPhone game of 2012 in the US the game has educated over ten million people about how disease spreads globally. A huge success for the health sector, even if it wasn’t the intention of the designer.
Beyond the potential reach of games lies their power to create deeply immersive experiences. That Dragon, Cancer (You can view a video here) is a highly emotive game that lets the player experience what it’s like to have a son with terminal cancer.
The website describes it as “an adventure game that acts as a living painting; a poem; an interactive retelling of Ryan and Amy Green’s experience raising their son Joel, a 4yearold currently fighting his third year of terminal cancer. Players relive memories, share heartache, and discover the overwhelming hope that can be found in the face of death".
A very emotive experience which is well suited to the affordances of the first-person perspective.
Actual Sunlight and Depression Quest both attempt to show the player what it’s like to suffer from depression. Two games that transport the player to a time and place and deliver an experience which creates empathy and strong resonance. The holy grail for any communication initiative.
Games as the cure
Could just playing a game actually have a neurological or physiological effect which would be useful in the treatment of medical conditions? Emerging research is saying it can.
In the British Medical Journal the act of playing games has been reported as a very useful tool in distracting or reducing chronic pain in children suffering from cancer.
Recently released UCL research also shows that playing realtime strategy games (in this instance StarCraft) improves the player’s neuroplasticity. These improvements are a consequential benefit of playing an ‘entertainment’ game, but smart companies like My Cognition are blending game design with cognitive learning models to improve the efficacy of the hypothesis with the ambition to turn a game into both treatment and diagnosis.
One of the major factors when treating long-term or serious illnesses is managing the psychological impact of the diagnosis. This is never truer than when the patient is a young child. ReMission 2 is a collection of online games designed to help young people fight cancer.
This version was informed by research on the original ReMission game that demonstrated how specially designed games can drive positive behaviour change to improve biological health and illuminated how gameplay impacts brain function to motivate healthy behaviour. The games are simple, but the research is hugely exciting.
Whilst Re-Misson’s games are cathartic and affirming, for many patients, not knowing what is about to happen is as worrying as knowing why it is. Surgery Squad allows players to play through their surgery before hand, under the premise the more you know, the less you fear. Not for the squeamish.
Games for surgeons
Surgery has always provided a rich source of inspiration for games. Trauma Center, Amateur surgeon and most recently the QWOP-inspired Surgeon Simulator have made surgery games mainstream. But games have something to give back to this specialist field too.
Games have long been used for skill and scenario training, largely down to their fail-safe quality. Touch Surgery was created by four surgeons who felt the teaching of surgery could take cues from touch-gaming. It’s light on gameplay but the jeopardy is most definitely there.
Whilst it’s perhaps obvious, it has also been reported in a recent study that surgeons who played video games regularly had better dexterity, thus helping them perform their job better. Game technology is also finding its way into the operating theatres, with surgeons reportedly using the Kinect to interact with computers without having to scrub up again.
Prevention, diagnosis and rehabilitation
The mainstream press has always latched on to the sedentary behaviour implicit with deeply immersive games and the RSI potential of the highly repetitive interactions demanded of them. However the ‘sensory controllers’ of the big three consoles has quashed this stigma and resulted in an influx of games which challenge dexterity, coordination and general levels of fitness.
Nintendo’s Wii Fit, Microsoft Xbox’s Kinect Fitness (Your Shape evolved) and Sony Playstation’s Move Fitness allow the player to bring virtual personal trainers into their own home. Each control system has its merits, but all three have the transformative potential that can come from the game’s ability to engage and motivate participation.
The Kickstarted Zombies RUN! is a mobile game which adds gameplay and story to a traditional running app. A great cross-over product, that will get those that wouldn’t necessarily run, running. The follow up, The Walk is likely to be even more successful as it targets a bigger audience, walkers.
GeckoCap records a child’s use of an inhaler using a simple augmented cap. Game-like mechanics reward the child for participating, whilst the collected data is presented in way that allows parents to monitor and manage the disease. It’s a simple and effective virtuous circle which allows for the effective management of the condition.
Whilst Nintendo’s 2009 vision of the pulse-driven gameplay has faded, the opportunity to read your vital statistics ingame is palpably close. Xbox is leading this charge with its next-gen Kinect.
The camera controller is so accurate that it can see the heartbeat of the player, pinpoint not just joints but also joint rotations, track muscle tension based on body models and can also interpret the amount of force being applied to both your body and the floor. The tech demo shows this in action. The potential for games to diagnose and rehabilitate a range of structural and postural conditions is huge.
Failing trials is a potential cause of this, so removing external factors which can cause this failure is a major endeavour for all the companies involved. Interestingly, a major cause is the result of trial-patient drop out.
Mitigating this through incentivisation is of course prohibited by law, so games provide a very exciting opportunity to sustain engagement over extended periods of time, whilst providing some genuine fun for the participant, during what can be a long and arduous process.
Preloaded has just finished a largescale game, created for (only!) 700 trial participants, to be played in ten different countries and designed to sustain their interest for two years. This type of brief creates unique opportunities in terms of the way you use social game features for ultra small playing communities and how you maintain interest over many months.
A game genre led almost entirely by science and health professionals is human-based computation games, or crowdsourced gaming. Put simply, it uses the power of a gaming community to help advance progress in a specific field.
The games themselves are often linked to very specialist fields such as protein folding algorithms (Foldit), decoding the code to genetic diseases (Phylo) or finding the connectomes of the retina (Eyewire).
Most notable in terms of gameplay is EteRNA, a puzzle game in which players help to solve real life RNA molecule folding problems. Starting out with simple yet addictive puzzles, the player is trained up until they have the skills to contribute to regularly changing RNA problems posed by the scientists behind the game. Top voted solutions are synthesised in a lab and ultimately improve RNA folding research at a much faster rate than traditional computer models.
The genre uses the broad appeal of games and the human brain to advance science in a deeply symbiotic (and very futuristic!) relationship.
The ubiquity of games underlines the value society now places on them. Games have the ability to capture attention, to tackle challenging subjects, to target niche audiences and create deeply memorable experiences like no other medium.
Opportunities for games in the the health sector are clearly farreaching. Advances in technology, the pervasiveness of devices and the new ways of interacting with games is driving innovation and opening the door to many new creative opportunities.
Increased commercial focus and investment is also placing greater emphasis on hard research, slowly legitimising games as a serious tool capable of solving serious problems.
Whilst games aren’t a silver bullet, they are a powerful disruptive force that will define new ways of engaging with patients and offer new possibilities for managing, understanding and treating a range of conditions. Not least, the patient will hopefully have a more familiar, enjoyable and personal experience!
If you work in the health sector and are interested in creating games with purpose, drop us a line at email@example.com.