Long scorned for contributing to a sedentary lifestyle and a host of other ills, video games are gaining ground as a way to get people healthier.
A video game can turn a child with diabetes into an empowered superhero who tests his blood sugar before taking on monsters. Give a new mother a game — with gift cards as prizes — and she’s more likely to show up for well-baby visits.
“Games tap into very deep and fundamental aspects of our psychology,” said Ken Werbach, a professor at the University of Pennsylvania’s Wharton School who wrote a book on gaming. “We love surprises, we love challenges, we love competition, we love fun.”
Insurance companies and health care providers see growing potential for “serious gaming” to promote healthy behavior and even treat disease. After a decade of slow growth, the $1.2 billion market for health gaming could explode to $10 billion by 2015, according to some estimates.
Rising interest in the field is spawning new careers, attracting the interest of deep-pocketed corporations and changing the way doctors, patients and insurers interact with data and each other.
“The amount of research going into it is increasing, the number of start-up companies is increasing, the amount of research in hospitals and medical centers is increasing,” said Bill Ferguson, editor-in-chief of Games for Health Journal, a peer-reviewed behavioral health publication that launched last year. “It’s growing very fast.”
National insurers such as UnitedHealth, WellPoint, Humana and Cigna are all players in the health-gaming world. The companies recognized early on that self-monitoring and healthy habits can prevent costly hospital stays. Games may also help address the costly and pervasive problem of noncompliance — when patients leave the clinic and don’t do what they’re supposed to do.
Businesses that want to lower costs or pump up their wellness programs are starting to turn to games as well.
“This stuff is based on sophisticated theories about learning and motivation,” said Dr. Reed Tuckson, chief of medical affairs at UnitedHealth Group. “How do you help people get good at making good decisions?”
There’s more to games’ potential than changing behavior. The National Institutes of Health is investing more than $38 million to fund more than 50 research projects using video games.
Games have been used to help veterans combat depression and post-traumatic stress disorder and have helped children with cancer develop more resilience and a “fighting spirit” during chemotherapy.
Scientists are looking at the influence of video games on brain activity and potential treatments for a wide range of conditions, including autism, Parkinson’s, Alzheimer’s and Attention Deficit Hyperactivity Disorder.
“We’re at a time of high need and high potential,” said Susannah Fox of Pew Internet Research, who studies cultural shifts in technology and health care. Widespread use of the gadgetry is fueling the growth of health gaming. More than half of U.S. adults now have a smartphone, according to the Pew Research Center, and more than seven in 10 adults track their health in some way. The time may be ripe for games to make a mark in public health, Fox said.
“Two-thirds of American adults are overweight, we’ve got a lot of folks with chronic illnesses — many with things such as hypertension and diabetes that could benefit from tracking,” she said. “The challenge for people developing games is to make it as easy as keeping track in your head and as enticing as ‘Angry Birds.’ ”
Projects at UnitedHealth
At UnitedHealth Group’s Minnetonka headquarters, an “innovation lab” showcases several gaming projects underway or in development.
Arrianne Hoyland, the insurance company’s first — and only — game producer, flicks through a few examples on her iPad.
There’s a scavenger hunt to make the workplace open-enrollment process less daunting. Another application incorporates a wireless tracking pedometer developed by San Francisco start-up Fitbit. The “OptumizeMe” game lets individual players or groups of people compete against friends, work colleagues or a broader social network to eat healthier, exercise and lose weight.
Hoyland’s job is unique among the legions of people who design insurance policies and handle claims at UnitedHealth Group, the nation’s largest health insurer. With a degree in fine arts, the 34-year-old brings a new brand of creativity to a corporate IT division that is focused on R&D and innovation.
“I grew up a gamer and a painter,” she said. “Now I’m painting video games that can help people.”
UnitedHealth’s Baby Blocks game site, targeted at low-income pregnant women and new mothers, is a prime example. As women show up for doctor’s appointments and take other healthy steps during pregnancy and through the baby’s first 15 months, they “unlock a block.” Achieving goals comes with rewards, such as a $20 Old Navy gift card, a free diaper bag or health and wellness items.
About 4,000 women covered by the company’s Medicaid program have used the website since November 2011, when UnitedHealth launched the game in a handful of states. Early results have been encouraging: The moms unlocked an average of three blocks each. The game is now available on the Web and through a mobile phone in eight states, with more expected to come online this year, the company said.
UnitedHealth Group is investing in gaming in big ways and small. It recently worked with the Japanese maker of “Dance, Dance Revolution” to address childhood obesity. United set up an educational version of the popular “exergame” at schools in Florida, Georgia and Texas. As students jump around and hit targets on the dance mat, teachers record a student’s body mass index, calories burned and improvements using a wireless smart card.
“We’ve got to get out of the mind-set that exercising and eating right is undesirable — take your dose of castor oil,” United’s Tuckson said.
Still on the drawing board is a prototype that might be used in physical therapy after a shoulder or knee injury. It uses cameras and motion sensors from Microsoft’s Kinect. As users stand before a large screen and do exercises, an infrared “skeleton tracking” device offers visual feedback to teach proper body position — red (way off) and green (movements are on target). There’s potential to connect with an off-site health provider for additional coaching.
“People leave physical therapy, get home and they don’t know if they’re doing it right,” Hoyland said. With better information, “there’s potential of getting better, faster.”
Still, some suspect that a heavy reliance on external rewards, such as point systems and prizes, may work in the short term but won’t lead to lasting behavior change. And privacy advocates are concerned about high-tech monitoring and the risks of giving access to personal medical data to employers, insurers and the government.
Ben Sawyer, co-founder of Games for Health, a project funded in part by the Robert Wood Johnson Foundation, is determined to prevent gaming from becoming the digital equivalent of the rowing machine folded up under the bed.
In its ninth year, the annual Games for Health conference brings together leaders in medicine, game design, business, venture capitalists and entrepreneurs.
Sawyer worries that the first wave of games, many with a focus on fitness, will be seen as a dieting aid, rather than something that could teach skills that could last a lifetime.
He envisions a game for young people about drugs and alcohol, or a game targeted toward healthy 20-year-olds that deals with health finances late in life.
“What we’d like to see is that it’s not just the consumerism version of health,” he said, “but that it’s embracing ... opportunities to deliver effective health outcomes.”