Gamification: Transforming Healthcare through Play

Gamification has emerged as a powerful tool for transforming various domains by incorporating game-design elements into non-game contexts. At its core, gamification involves the use of game mechanics—such as rules, challenges, and rewards—to engage users and solve real-world problems (Huotari & Himari, 2012). In fields like education, marketing, and business, gamification has been employed to foster innovation, increase engagement, and enhance learning experiences. This essay explores the application of gamification in the healthcare sector, highlighting its potential to revolutionize health management and patient care.

Introduction to Gamification

A game typically occurs within a defined "game space," serving as an abstraction of reality. This space is characterized by players who interact with the game, rules that govern it, and challenges that players must overcome to achieve objectives. Gamification leverages these elements to address real-world issues, offering a fresh perspective on problem-solving. The World Government Summit's 2016 report, "Gamification and the Future of Education," identified three key advantages of gamification: the freedom to experiment and explore new strategies, the ability to assume different identities and view problems from novel angles, and the reduction of effort needed to learn new information.

Traditional methods of learning and engagement, while effective, are continually being reevaluated in favor of innovative approaches. Engagement and intrinsic motivation are increasingly recognized as crucial drivers of success. When individuals are intrinsically motivated, they engage in activities out of genuine interest and enjoyment. Gamification capitalizes on this by creating environments that foster intrinsic motivation, making tasks more enjoyable and rewarding.

Technological Evolution in Healthcare

The rapid evolution of technology since the 1980s has dramatically transformed various aspects of daily life, including healthcare. Previously, obtaining medical assistance required time-consuming and costly visits to doctors, even for minor issues. Today, technology has made healthcare more accessible, efficient, and affordable. From ordering medications online to booking virtual consultations, technology has revolutionized healthcare delivery. The advent of smartphones and wearable devices has further propelled this transformation, introducing applications designed to monitor and promote health and well-being.

Gamification is now being employed to develop "games with a purpose" in the healthcare domain, offering stress-free and user-friendly ways to manage health. This paper explores the diverse applications of gamification in healthcare, examining current innovations and future prospects in this rapidly growing field.

Gamification in Healthcare

The concept of gamification is not entirely new; it has been used in military training and the airline industry (Orthogonal, 2018). As awareness of the importance of healthy living increases, innovative techniques are being explored to promote and maintain wellness. At Google's London campus, software engineers, scientists, clinicians, and investors frequently convene to discuss strategies for influencing health behavior through gamification (King et al., 2013).

In healthcare, gamification is used to motivate and educate individuals about health awareness and wellness. The primary goal is to change behavior by encouraging actions that benefit health. Gamification makes adopting a healthy lifestyle enjoyable and rewarding, turning health management into a fun and engaging experience.

Literature Review

Games are defined by the American Heritage Dictionary as "electronic or computerized games played by manipulating images on a video display." For a game to be successful, it must provide rewards and incentives, maintain healthy competition, and deliver an engaging user experience (Primack et al., 2012). Juul's observation that games are "half real" highlights the interplay between fantasy and rules, with games comprising six key elements: rule-based structure, variable outcomes, value assigned to outcomes, challenges that motivate effort, emotional investment in outcomes, and optional consequences.

The concept of "serious games" was introduced by Wilson (1970) to improve education through simulation and games. Chen and Michael (2005) later defined serious games as those that prioritize purposes other than entertainment. Initially used in learning and advertising, serious games have expanded into the healthcare domain. For example, "Re-mission," a game developed by HopeLab in 2006, was designed to help teenagers with cancer adhere to medication regimens (Tate, Haritatos, & Cole, 2009).

King, Greaves, Exeter, & Darzi (2013) suggest that mobile devices are effective tools for altering health behavior. As mobile technology advances, it provides features like GPS, which are leveraged by exergames like Nike+. The success of these games hinges on their ability to motivate and engage users, making "games with purpose" as entertaining as traditional video games.

Gamification is also being applied to improve mental health, with games designed to assist individuals with depression, PTSD, and other disorders (Lau, Smit, Fleming, & Riper, 2017). Designing effective games for mental wellness is challenging, as different users have unique characteristics and motivational needs (Siriaraya, Visch, Dooren, & Spijkerman, 2018). Therapeutic objectives must be clearly defined, and games tailored to achieve them.

Applications and Benefits

Physical inactivity is a significant contributor to health issues, and the World Health Organization emphasizes the importance of regular physical activity. Digital gadgets like fitness bands and apps have been introduced to promote activity. This section explores popular gamified applications and devices that impact healthcare, analyzing their benefits and suggesting improvements.

Pokémon Go: Introduced in 2016, Pokémon Go is an augmented reality game that encourages physical activity by requiring players to move around to capture virtual creatures. Studies have shown that curiosity and the appeal of Pokémon characters motivate users to start playing, while the aim to achieve higher levels keeps them engaged (Rasche, Schlomann, & Mertens, 2017). However, issues like poor AR and lack of social interaction have led some users to quit. Enhancing user experience and maintaining motivation are crucial for the game's longevity.

Mango Health: This smartphone application aims to manage prescription adherence by using game elements to motivate users to take medication on time (Cutler, 2013). It provides notifications and information on potentially harmful drug interactions, rewarding users with in-game currency for adherence.

Fitness Trackers: Wearable devices like smartwatches track physical activity, calories burned, and heart rate. A study from 2011 to 2017 identified 423 unique fitness devices from 132 brands (Henriksen et al., 2018). These devices encourage users to move more by setting goals and providing feedback.

Fitbit: Fitbit devices offer benefits such as tracking steps, calories, sleep, and heart rate. They motivate users to achieve goals and monitor health metrics, contributing to improved physical activity and well-being.

Zombies Run: This immersive running game uses GPS to track speed and distance, motivating users to run by incorporating zombie chase scenarios. The game combines entertainment with fitness, making running enjoyable and engaging.

Super Better: This application helps users achieve health goals and tackle personal challenges. It evokes psychological strengths like optimism and determination, supporting mental wellness and personal growth.

Bayer's Didget: Designed for children with diabetes, this blood glucose meter connects to the Nintendo DS gaming platform, converting test results into rewards to encourage diabetes management.

Reflexion Health: A virtual physical therapy app that assists patients with therapy exercises, providing video-based feedback and correction suggestions.

Benefits of Gamification in Healthcare

The increasing popularity of smartphones has made health-related games more accessible and affordable. Gamification in healthcare offers numerous benefits, ranging from medical wellness to education and therapy. Applications educate physicians, motivate patients, and improve surgical skills. For example, video games have been shown to enhance surgical proficiency, while gamification simulators provide effective training for surgical residents (Patten, 2018).

Gamification also aids in weight loss by setting goals and providing incentives and feedback. These games foster a sense of community and healthy competition among users. The success of gamification in healthcare is evident in its ability to engage users, promote healthy behaviors, and improve patient outcomes.

Support for Innovation

In this essay, we have analyzed current gamification technologies in healthcare, assessing their impact and suggesting improvements. Gamification is a novel approach with significant potential to enhance healthcare awareness and management. As technology continues to evolve, new opportunities for innovation and business growth arise, promising substantial returns on investment. Gamification's ability to engage users and promote health is a testament to its value as a transformative tool in healthcare.

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