A Good Addiction? How wearable devices and gamification can change healthcare
While perhaps not as much a FitBit slave as many others, I too succumb to the thrall of the device. Something about hitting step goals, burning more calories than the day before, or rising to the top of my Fitbit friends list appeals to a primal pleasure center. Much like a hardcore gamer beating the next level, I invoke what a 2011 Psychology Today article, “Neuroscience Insights from Video Game & Drug Addiction,” refers to as “progressive achievement feedback.” Is this such a bad thing? In the case of fitness, no. Not unless you overdo it—my wife has commented on my recent proclivity for house-pacing, a habit that apparently unsettles and annoys her (we’re working it out).
The burgeoning field of health apps seeks to harness this “dopamine-pleasure reward.” At the University of Utah’s Lassonde Entrepreneur Institute, a “Games4Health” challenge awards over $60,000 in prize money for students with a promising health app that incorporates game-like characteristics. Across such categories as the “Clinical Health Challenge” and the “Adolescent Mental Wellbeing Empathy Challenge,” participants try to gamify everyday self-care and self-maintenance functions associated with a variety of conditions. Including the human condition. A past winner, Carb Commander, was designed for diabetics but can easily apply to anyone wanting to mitigate the inbound caloric torrent that besets us all.
“In order to win,” says Troy D’Ambrosio, “students have to surmount the game/health divide.”
D’Ambrosio, who heads Lassonde, explains that traditional video games, while fun, lack the rigor that healthcare demands. Conversely, apps designed by healthcare professionals tend to be anything but gamified. “Nobody enjoys using them,” D’Ambrosio says. “For a healthcare app to gain traction, it’s got to have the whole trifecta: be fun, meet healthcare standards and address a real health-related issue.”
Care Companion seems to fit the bill. The app took second place in last year’s Games4Health “Chronic Disease Challenge” competition. Designed around transplant patients and their copious medications, it aims to “encourage compliance and patient-held ownership.” In simpler terms, it helps patients remember to take their meds. And the need is real.
“The chances that you get full compliance on a medical regimen deteriorate with each medicine and each change,” says Dean Y. Li, M.D., Ph.D. on the app’s promo video. It’s a lot to keep track of, and many patients fail to follow through. The resultant rejection rates place a huge cost on society.
How does Care Companion address the problem? Doctors input a patient’s medication regimen into the app’s interface; the patient then remembers to take her meds by “caring for a digital avatar,” according to engineer Ajinkya Dhote. The avatar, whose medication needs, unsurprisingly, match that of its owner, alerts the transplant patient when each med is due. Patient and avatar take medications together—the patient drags the visual representation of each pill to the avatar, who responds with a happy bounce. “We are taking that Monday-to-Sunday pill box and turning it into something that people can really build a relationship with,” says Tara Mleynek, the team’s artist.
Addressing a need? Check. Sufficiently rigorous? Check. Fun? The avatar-human relationship has already been exploited to huge success with such games as Farmville, so people do, in fact, seem to derive enjoyment from “building an emotional connection to their own avatar,” as the video describes the process.
Esprit de competition
You know what’s more addictive than cute avatars? Even more satisfying than beating your all-time daily step record? Competition with others. And winning money. When it rolled out its TrioFit employer healthcare program, UnitedHealthcare sought to gamify an active lifestyle by appealing to this duo of human motivations.
“Activity tracking devices have been around for a while,” says Crain Hankins, UnitedHealthcare’s vice president of digital products. “So have employer-sponsored health initiatives. So, we thought, ‘what if we explore how the two go together?’”
The health insurance giant offers incentives to employers who participate in the program. Employers then reward employees who meet daily benchmarks. Additionally, a company dashboard, visible to all participants in the program, shows anonymized individual stats.
“I might be ready to relax after work,” explains Steve White, a corporate controller for Utah-based PermaPlate. “Then I look at the leaderboard and see that I’ve slipped from first place. So out I go for another jog.”
Others, less motivated by rivalry, participate for the money. “The return for participating can be up to $1,500 per year,” notes Hankins. “We reward them along three separate criteria: frequency, intensity and tenacity.”
According to Karen Johnson, PermaPlate’s vice president, some 30 – 40 employees participate in the TrioFit program at any given time. “People can earn $3 per day if they hit all three benchmarks,” she says, adding that she struggles most with the intensity component. “Frequency is no problem, because my job forces me to be all over our facility.”
White has the opposite experience. “I’m a fairly fit individual,” he says, “so I didn’t have to change a thing to hit the intensity and tenacity targets.” To his surprise, however, White found he needed to get up from his desk more often to meet the frequency benchmark. “I’ve changed my habits to incorporate short walks at routine times,” he says.
Needless to say, White is now pulling in all three dollars, every day, while battling other competitors for supremacy of the company fitness scoreboard. “Even though we don’t get to see names,” he says, “we have a pretty good idea of who each person is on the dashboard.”
Johnson admits that competition doesn’t motivate her at all. “My husband, on the other hand, doesn’t even work here”—spouses can participate as well, doubling the potential take-home for a household—“yet he’s always watching the leaderboard and trying to come out on top.”
If we’re going to be the addiction-prone, vain, greedy and competitive creatures that we are, we might as well gamify the system to use these less-than-desirable qualities to our advantage.