health games at work: introductory notes from the greater philadelphia business coalition on health

December 11, 2012

in context communication,health games,hotseat health app,wellness

i moderated a fantastic panel on health games today at the greater philadelphia business coalition on health. my panelists were keas, shapeup and towerswatson. while i left it to them to showcase specific solutions, i did frame the morning’s discussion with a sense of why games, what’s the potential, and where’s the hype.

these are the notes from my introduction. you’ll forgive them for being in standard case.
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In the past year, and much to my surprise, I’ve become a game developer.

My game, Hotseat, uses smartphones to get us up out of our seats throughout the day to reduce the health risks associated with prolonged sitting, or “sitting disease”—which include obesity, of course, but also kidney disease, heart disease, cancer and even earlier mortality. Hotseat lets users choose activities they wish to do and then books a rotating schedule of 2-minute breaks into their day, based on their calendar availability. Hotseat also allows users to engage in competitive and collaborative challenges.

Having created a game, I can tell you it’s no small undertaking to design something that adheres to the principles that make a game a game and that delivers the desired engagement, learning and emotional satisfaction that games do.

So, let’s start by defining what a game is. What you see here is a sketch of a talk by Jane McGonigal. Jane, as some of you may know, is the author of “Reality is Broken: Why Games Make Us Better and How They Can Change the World.” Jane is also the creator of many games, with the one relevant to workplace wellness being SuperBetter. Jane originally made SuperBetter for herself after suffering a concussion that led to a difficult recovery. She created the game because, in her words, “a good game is a unique way of structuring experience and provoking positive emotion. It is an extremely powerful tool for inspiring participation and motivating hard work.”

It’s this “powerful tool for inspiring participation and motivating hard work” that’s motivated her to extend SuperBetter to the general public and to employers, and it’s what has made games so constructive in the health world overall. As Jane and others have noted, games help us develop skills, achieve mastery and social status, guide us to and reward us for desired behaviors, and simply let us have fun doing things that can be difficult or challenging for us.

For all of these reasons, games are attractive to employers, and gaining traction with them. In the 2012 Technology + Employee Wellness survey I administered with ShapeUp, we found that 56% of employers currently use competitions and challenges and another 40% plan to.

The 2012 TW/NBGH Employer Survey on Purchasing Value in Health Care also found that competitions were firmly in use as a way to engage employees, and that more employers were planning on adding games in 2013. They found that competitions were up nearly 40% compared with last year and are expected to rise another 33% in ’13. This same study looked at companies that maintained cost increases at or below their median for the past four years. One of the core areas that made a difference was the use of technology, and in this space they found that consistent performers (12%) are more likely to offer online games, either individual or multiplayer participation, than low performers (5%).

Challenges are only one type of health game, though they are the most popular in the workplace wellness space and largely what we’ll focus on today. There are also “serious” health games. There are games to help soldiers recover from PTSD and endure pain, games that help individuals recover from traumatic brain injury, those that provide a single shooter experience to teens battling cancer, or devices to help kids get more activity. Even mobile-based games—with zombies, no less!—to get all of us up and moving, and so on.

Who’s making these games? As you can see from our panelists, they come from a varied background. Some are start-ups that reach you directly or through partnerships, like Keas and Pfizer or Aetna’s partnership with a general health game called MindBloom. There are companies, like Richard Branson’s Virgin HealthMiles, where a player comes into the space, drawn by the passion and desire to fix a major health challenge. Some are coming to you from venerable consulting firms, like Adam’s benefits education game we’ll see momentarily. We’ve also seen insurers jump in, with Humana being an early frontrunner. Humana’s created games for kids to seniors, serving the community with tools like you see pictured here: HumanaFit. Other insurers are curating a portfolio of games, apps, products and services as the industry marches toward 2014 and a more consumer-based market. More insurers, game developers and others are contributing to this rapidly growing space, and we’re likely to see more interest in this field and a winnowing of it as we learn what works.

Before I wrap and we dive into the demos, we need to recognize some of the limitations or barriers with health games.

In the NBGH report employers cite “lack of evidence about which practices work best” as a large part of their problem.

Let’s admit that there’s still some skepticism about games at work. In large part this is about misperceptions. The very word “game” makes some employers apprehensive, linking games with unproductive time or time wasted. And there’s a misunderstanding about who plays games. Social games are not the exclusive domain of the young male. Two-thirds the population of the US plays games, with mobile and digital gaming seeing dizzying increases. 84% of tablet owners play games . And the average social gamer is actually a 43-year-old woman.

That doesn’t mean all health games are equal, or that we’ve reached a point where we have enough evidence about what works in health games and that it’s being broadly applied.

Two weeks ago Gartner released a report predicting that 80% of current gamified applications will fail by 2014. And that could be because, as I quote Brian Burke, research vice president at Gartner:

“Poor game design is one of the key failings of many gamified applications today…focus is on the obvious game mechanics, such as points, badges and leader boards, rather than the more subtle and more important game design elements, such as balancing competition and collaboration…”

While we switch over to see some of today’s health games, I’ll leave you with these thoughts:
It’s incumbent upon us to be mindful of whether we’re offering employees games to change health behavior or merely gamifiying our current approach.

Our understanding of how health games can serve us will only grow, especially as more companies create them and more serious investment—like The Robert Wood Johnson Foundation’s $8 million investment in health games through their Health Games Research Initiative—takes place.

Of course, to find out how games work for us, we need to see them in action. So I encourage all of you to be open to testing and collaborating with companies such as today’s panelists and research organizations.

Thank you.

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