PAX East: Thoughts on Gamification for Healthcare

Published in Healthcare Informatics.

By Dr. Dave Levin

I’m not a gamer myself but I have spawned a few. Recently my oldest son invited me to go with him to PAX East, one of the largest gaming conventions in the world. Thus, I came to find myself standing in line on a bitterly cold Saturday morning in Boston with tens of thousands of others waiting to enter the Boston Convention and Expo Center.

The Exposition Floor at PAX East 2017

The Exposition Floor at PAX East 2017

Having recently come from HIMSS17 I was struck by both the contrasts and the similarities which are summarized (somewhat tongue-in-cheek) in the table below:

HIMSS PAX table.png

That last dimension, “Relevant to Healthcare” might surprise you. After all, what can those of us in health care learn from a group that can fill a ballroom for a presentation titled, “Clucks and Clicks: Archeology & Ethics of Chickens in Games” (which was terrific by the way)? It turns out we might learn quite a lot.

The world of games spans a wide range of forms and formats. At PAX you can see everything from cutting edge video-games running on water-cooled high-end PCs to board games and card games. Content ranged from fantasy and sci-fi to “shoot ‘em ups” to bible-based themes.

                      Gaming ranges from high-end hardware to low tech board games.

There is something very powerful going on here. Something that draws many thousands who are willing to stand in the cold and then spend hour upon hour gaming. Something that generates an incredible range of forms and content. How many times have you seen someone intently working a puzzle, crossword puzzle or Sudoku? Maybe that someone was you. Perhaps we are as much “Homo ludius” as Homo sapien.

Gamification, the idea of harnessing game-design elements and principles for business, education and healthcare has been receiving increasing attention. At PAX I spoke with Tim Loew, the Executive Director of the Massachusetts Digital Games Institute (MassDigi). This state-wide center fosters collaboration for entrepreneurship, academic cooperation and economic development across the Massachusetts digital and video games ecosystem. As we munched on expensive crummy hamburgers, Tim walked me through the basics of how MassDigi is working with a variety of organizations to develop approaches that deliver great games that can improve performance and have a real ROI. MassDigi is working with several healthcare organizations on games. The potential applications run from behavioral and mental health, patient education and treatment compliance to wellness and prevention. The implications for mental health are particularly intriguing. Gaming may hold the key to new treatments for depression, anxiety and OCD. Tim told me there are even some companies that are considering going thru the FDA approval process so their games can be formally prescribed therapies (and therefore more likely to be covered by insurance).

I also talked with Dwayne Waite, Jr., marketing associate for Schell Games, a full-service game design and development company specializing in transformational games that “change people for the better.” The idea is to positively impact habits, attitudes, knowledge or behavior through fun, engaging game experiences.

Dwayne told me about Night Shift, a game they developed in a collaboration with UPMC with funding from NIH. Night Shift places the ED physician in different environments where they must solve diagnostic puzzles. The goal is to increase diagnostic accuracy and to “challenge the heuristics” of the clinician. Dwayne and I also discussed the possibility of games and gaming devices that teams could use to practice team-based care and simulate emergency procedures. This sounds like classic Crew Resource Management – a staple of safe industries like aerospace and oil refining and, increasingly, a part of health care team safety programs as well. Dwayne believes they could also be leveraged to discover improvements to treatment protocols.

PAX Floor

I also talked with my son and one of his friends since they were my two companions and guides into the world of gaming and PAX. In addition to the ideas discussed above, they emphasized the sense of community that gaming creates. “Many of us are introverts. We aren’t going to go out to a bar on the weekend. We connect with friends through games.” They also noted the gaming community embraces Cosplay so normally shy individuals can comfortably explore and display a more extraverted/creative side. “Gaming gives us a way to express ourselves and be with like-minded individuals,” they concluded. Given the research on the importance of friends, community and human connections to maintaining good physical and mental health, it’s quite possible gaming in groups has positive health benefits.

Wandering around the exhibit hall it was easy to believe how the powerful forces that drew all these people together really could be harnessed somehow for better health. Of course, the history of healthcare is littered with ideas that sounded plausible but turned out to be wrong. Quite simply, there’s a lot of promise here but we need to apply science. We need to run the experiments and analyze the clinical and financial outcomes. The good news is that it appears possible to do this relatively quickly and inexpensively especially when compared with more traditional approaches such as developing new drug therapies. It also seems like a great opportunity for more collaboration. We should be sure to bring together game theorists, artists, story tellers, tech leaders and healthcare experts to get the most creative and effective results.

Let the games begin!


Dave Levin, MD is the Chief Medical Officer for Sansoro Health where he focuses on bringing true interoperability to healthcare. Dave is a nationally recognized speaker, author and the former CMIO for the Cleveland Clinic.