gamification in digital healthgamification in digital health

doi: 10.1093/eurjcn/zvac048. Ritterband LM The Model of Gamification Principles for Digital Health Interventions: Evaluation of Validity and Potential Utility J Med Internet Res 2020;22(6):e16506 doi: In applying a medical device approach to gamified apps, patient safety concerns resulting from mechanical malfunction and design flaws must be considered. However, the gamification principles go beyond the MARS by providing specific guidelines for presenting this information and contextualizing it within a users broader goals and understanding. The role of gamification in digital mental health - Fleming - 2023 - World Psychiatry - Wiley Online Library World Psychiatry Perspective Free Access The role of gamification in digital mental health Theresa Fleming, Marlou Poppelaars, Hiran Thabrew First published: 14 January 2023 https://doi.org/10.1002/wps.21041 Sections PDF Tools Share Issue 1 Gamification in healthcare is gaining momentum, with attempts to apply gaming principles to improve patient clinical outcomes. No more missing records or letters lost in the post - I will bring in a While we may believe that weve exercised and eaten well, an unbiased device based on goals translated into points or badges (ex:Apple Health App) tells us otherwise. The Model of Gamification Principles for Digital Health Interventions We partner with global pharma companies and global health insurers to improve patient outcomes, improve treatment adherence, and reduce cost of care. As gamification and software platforms become more accepted, it is possible that the need arises for the new world of the digital practitioner: one who specializes in healthcare apps, accepts referrals from other practitioners, identifies the best programs to meet individual patient needs, and consults to assess whether game applications might improve clinical outcomes. 8. J Behav Med 2019 Feb;42(1):67-83 [, Lipczynska S. Psyberguide: a path through the app jungle. Stud Health Technol Inform. 32519965 In sum, the lack of relationship between the credibility score and the gamification principle ratings suggests that the credibility of an app (which includes efficacy as well as other issues such as software support, input from experts, etc) is largely independent of its level of gamification. However, the literature is at an early stage. For example, push notifications or prompts encourage users to record food intake or encourage movement (ex:Mango Health App, Nike Run Club). Economic Burden of Nonadherence to Standards of Diabetes Care. Assessment 2014 Jun;21(3):272-285 [, Stoyanov SR, Hides L, Kavanagh DJ, Zelenko O, Tjondronegoro D, Mani M. Mobile app rating scale: a new tool for assessing the quality of health mobile apps. In digital health today, it is almost impossible to find a successful app without elements of gamification. Takahashi D. Candy Crush Saga: 2.73 billion downloads in five years and still counting. And we are looking into adding a few additional inflammatory conditions. They want a platform where they can be supported holistically. A weak relationship was found between the gamification principle ratings and the PsyberGuide credibility score. In the end, no ratings were deemed to lack sufficient justification, and all ratings were included in the analysis presented here. Thats just part of the game. Through this monitoring system here in Iceland, both through the phone calls and our platform, we have had really good results in terms of low mortality rates and low ICU admission rates. Von Bargen T, Zientz C, Haux R. Gamification for mHealth: a review of playful mobile healthcare. So if we are going to help people, nudge them into better habits, we have to be able to talk to both sides of the brain. Health professions educators increasingly turn to gamification to optimize students' learning outcomes. A 2-way gaming interface could permit the digital practitioner to monitor the progress of the patient, address any deficiencies that might be noted, and adjust the game accordingly. Within this field, theres broad diversity to the level of gamification. The Top 15 Examples of Gamification in Healthcare - The Medical Futurist J Ment Health 2019 Feb;28(1):104. Metareviews of gamification strategies within behavioral interventions summarize the work in this area [4,5] but often focus on the mechanics employed (eg, badges, leaderboards, etc) and neglect other potentially important factors (ie, the context of the app). Evid Based Ment Health 2019 Feb;22(1):4-9 [, Eysenbach G. The law of attrition. Raters were given 2 weeks to evaluate their apps and were instructed to use each app for at least 15 min every day. Digital health ecosystems have become increasingly relevant since the onset of the COVID-19 pandemic Digital healthcare solutions were perceived as a highly relevant topic by 68 percent of survey respondents. Thaler RH. JMIR Serious Games 2019 Jun 18;7(2):e13051 [, Fari N, Yorke E, Varnes L, Newby K, Potts HW, Smith L, et al. Daniel Eisenberg: How much do you see competitors taking a gamification approach like Sidekick, and to what extent do you view them as a serious threat? Dr. Tryggvi Thorgeirsson: In our experience, pharma have been very clear, over the past few years, that they are selling outcomes, theyre not selling pills, really. Br J Health Psychol 2015 Feb;20(1):130-150. This course will teach you the mechanisms of gamification, why it has such tremendous potential, and how to use it effectively. These principles provide a descriptive framework for measuring both the presence and quality of gamification implementation. [, Robins RW, Hendin HM, Trzesniewski KH. In the long run, only intrinsic motivation has demonstrated a lasting effect. You want programs that tackle these holistically and work together. JMIR Ment Health 2019 Jun 26;6(6):e13717 [, Yen BT, Mulley C, Burke M. Gamification in transport interventions: Another way to improve travel behavioural change. This was done to allow raters some flexibility in interpreting the score between these endpoints and middle points. Given the variety of apps reviewed on PsyberGuide and the variance in scores of credibility and user experience of these apps, it provided a useful point of comparison to evaluate the gamification assessment. But then we saw that investors who are deep in this space actually leaned in. I had a fantastic mentor there, Professor Ichiro Kawachi, and with him, I looked into the field called Behavioral Economics, which combines psychology and economics to really explain the drivers behind our behavioral choices. Costs of First-line Chemoimmunotherapy for Advanced NonSmall Cell Lung Cancer. Stat Med 2006 May 15;25(9):1547-1560. Through expanding evidence in intervention design, the scientific community will have a better understanding of how to gamify for longer lasting impact. (3) Now we need to understand why it works. The app store rating (Apple or Android) for each intervention was obtained. Dr. Tryggvi Thorgeirsson: Yeah, thats right. Digital Health and the Gamification of Life - Google Books Daniel Eisenberg: Well, I think thats a great final note on which to end. www.fda.gov/downloads/MedicalDevices/DigitalHealth/UCM568735.pdf. From increasing prescription adherence to exercise-tracking apps, you can find a gamified version of almost any health practice. The FDA has recognized the proliferation of software programs in healthcare and, to date, has regulated these products as medical devices when their intended use is to treat, diagnose, cure, mitigate, or prevent disease, referring to them as software as a medical device. The 21st Century Cures Act has provided greater clarity on which software is required to be regulated as a medical device by exempting from regulation those programs that are used for maintaining or encouraging a healthy lifestyle and are unrelated to the diagnosis, cure, mitigation, prevention, or treatment of a disease or condition.7 Although many games in healthcare may fall into this exempt category, the ones that adapt to the user experience and have a role in the previously mentioned disease processes would require regulatory review and approval. Audio Daniel Eisenberg: Hello and welcome to McKinsey on Start-ups, I'm your host, Daniel Eisenberg. Email: eli.phillipsjr@cardinalhealth.com.REFERENCES. Transl Behav Med 2018 Sep 8;8(5):793-798. Gamification can be used together with other digital health technologies such as virtual reality (VR) or augmented reality (AR) to make cognitive or physical rehabilitation more fun and engaging, and to take away focus from potential pain. Published 2017. We see an interesting evolution going on in the market, where pharma has been an early adopter. Theoretically, one would imagine some overlap between our gamification model and user experience aspects such as engagement. If packaging that traditional therapeutic with a digital therapeutic can augment the impact of that therapy, theres a huge value in that. Most notably, although the raters were trained with several modes of material, they were undergraduate students and not experts; however, several results from the study help limit this concern. Reimagining Health Care. You mentioned GDPR and HIPAA. Authors Aseel Berglund 1 , Tiny Jaarsma 2 , Erik Berglund 1 , Anna Strmberg 2 3 , Leonie Klompstra 2 Affiliations And our vision is to be a central global partner for that, impacting patients on a global scale, improving health and quality of life, and making better use of resources in the healthcare industry. Although our decision was influenced by a desire to reduce the burden on raters and increase the efficiency with which ratings could be completed, there are many ways to assess gamification that should be explored in future work. Throughout the pandemic, there has obviously been a lot of need to be able to remotely track patients who arent able to come in for their checkups. The large majority of research simply ends after the study period and offers little-to-no insight on efficacy in a year or longer. Gamification principles may therefore facilitate the execution of game mechanics by providing researchers another avenue to explore and measure engaging features that involve the patient. J Appl Psychol 1997 Apr;82(2):247-252. JMIR Mhealth Uhealth 2016 Jun 14;4(2):e74 [, Kim BY, Sharafoddini A, Tran N, Wen EY, Lee J. Thus, we believe that our gamification principles are not in direct conflict with the MARS; rather, they provide a roadmap for ways to increase app quality. As for the format, we didnt meet our investors face to face until the absolutely final stages of the process, when everything was more or less clear. So improving patient outcomes has a huge benefit, of course, just in brand differentiation and competitive standing. Daniel Eisenberg: Finally, when you look ahead for Sidekick, say, three to five years from now, do you have a vision of where you are at that point? [, Hamari J, Koivisto J, Sarsa H. Does Gamification Work? More and more, it is also relevant for direct reimbursements, and thats one of the interesting evolutions happening in the industry. Dr. Tryggvi Thorgeirsson: Id say there were not many things that were easier than I had expected. 6. Authorship Information: Concept and design (EGP, CN, BAF); acquisition of data (EGP, CN, BAF); analysis and interpretation of data (EGP, CN, BAF); drafting of the manuscript (EGP, CN, BAF); critical revision of the manuscript for important intellectual content (EGP, CN, BAF); and administrative, technical, or logistic support (EGP, CN, BAF). This study provides empirical support for the model of the five gamification principles for internet interventions. But one of the things we have been experiencing over the past 12 to 18 months, and even just the last six months, is an acceleration in the marketplace, especially when it comes to payors, who are becoming much more serious at scaling these types of tools. Fleiss kappa is recommended when there are more than two raters. In fact, some 80 percent of our choices are controlled by the emotional, impulsivethe lizard brain, if you will. I think this evolution has been really needed. Thats where technology can hugely help us, allowing us to have those touchpoints multiple times a day, week by week, month by month. BY Richard . An edited transcript of their conversation follows. 2. Mind the Gap: The Potential of Alternative Health Information Exchange, Patient and Clinician Experiences With Telehealth for Patient Follow-up Care, Impact of Primary and Specialty Care Integration via Asynchronous Communication, From the Editorial Board: Rajesh Balkrishnan, PhD, Drivers of Health Information Exchange Use During Postacute Care Transitions, Alternative Payment Models and Hospital Engagement in Health Information Exchange, Organizational Influences on Healthcare System Adoption and Use of Advanced Health Information Technology Capabilities, Understanding the Relationship Between Data Breaches and Hospital Advertising Expenditures. Supporters of gamification believe this methodology could potentially transform patient outcomes. This study extends the existing literature that aims to understand technology-based behavioral interventions by identifying and coding their features [24,30,31]. Smartphone applications to support sleep self-management: review and evaluation. That marks the . Pers Soc Psychol Bull 2001;27(2):151-161. Daniel Eisenberg: Tell us about what Sidekick Health does, and how you came to establish the company. As gamification techniques are intertwined with other intervention components, their validity and incremental impact are relatively unknown. You have to have all of the compliance and regulatory issues handled very thoroughly. I felt we had so much research on questions such as, What are the risk factors? or, Should we do this diet or that diet? But in my view, we had so much less research on, What are the behavioral methods to better help people change their habits and stick to their programs? So I really focused on that question. Dr. Tryggvi Thorgeirsson: Well, I do think consumers are much more knowledgeable and guarded with respect to their data than they have been previously. But pharma are huge organizations, where you have the commercial teams, medical, market access. Lack of digital health literacy hurts people on Medicare - Fortune www.fda.gov/downloads/MedicalDevices/DeviceRegulationandGuidance/GuidanceDocuments/UCM587820.pdf. Digital Health and the Gamification of Life: How Apps Can Promote a You have to make sure that you are pretty clear on whos going to be using it, whos going to be paying for it, how, and what is the competition like? MARS scores for each program included in this study were obtained from the PsyberGuide website. This suggests that gamification could have a positive effect on health . One app (HAPPYNueron) did not have an app store rating. Medicare. The Mobile App Rating Scale (MARS; Stoyanov et al [19]) is a widely used measure of app quality that focuses on aspects of engagement, functionality, aesthetics, and information quality. For each gamification principle, raters were asked whether the principle was present in the app (binary), and, if so, to what degree that principle was present (1-5 scale). In addition, individual studies of gamification of digital health interventions typically present results as general game vs control studies [6,7] or focus more on the qualitative and subjective aspects of gamification . (PDF) Gamification: What It Is and Why It Matters to Digital Health Thats another unique selling point that is quite important to our partners. Let's have a look at 4 reasons why gamification works for healthcare training. We have to do a better job at engaging with male patients, and thats in healthcare in general. Gamification is the application of a game system in a non-game context (1). And in many cases, there are definitely other considerations at the country level. The role of practitioners in the era of gamification has not been well established, but clinical practice guidelines for game selection may be on the horizon. But equally important is we see a positive impact on mental health and quality of life. Dr. Tryggvi Thorgeirsson: There are certain obvious big differences. The alternative could be that they might stay for two additional days at home, and due to dehydration, they could go require ICU admission in a very serious state. So I just see interesting evolution happening on both sides. https://digitalhealtheurope.eu/. We are all to some extent constantly checking phones, so I would think that would actually really help with retention and engagement with your kind of product. Understanding how gamification applies to healthcare is essential. JMIR Mhealth Uhealth 2015 Mar 11;3(1):e27 [, Nielsen J, Molich R. Heuristic Evaluation of User Interfaces. 2022 Jun 16;zvac048. Weve been able to work with some great talent from that company, and others, to inject strong gaming elements into all of our programs. Table 5 lists the app credibility score (ie, PsyberGuide Credibility Score), the MARS score, and the app store ratings for each app. Future work should focus on providing such artifacts and continuing to study their utility. Nothing could be further from the truth. Published November 17, 2017. PsyberGuide credibility ratings are meant to determine the likelihood that a given product will produce the proposed benefits. If we are doing it correctly, and if we convey that to users, then we have earned peoples trust, and thats been our experience. Rigorous regulatory processes are essential for safe applications of such principles to patient care. Ann Tour Res 2019 Sep;78:102753. And all are a part of what pharma calls going beyond the pill.. Gamification: Why health wins - Pharma IQ Can they cause harm? Download PDF: The Gamification of Healthcare: Emergence of the Digital Practitioner?