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The Gamification of Health Chirag Patel @patelc75 Co-founder, Chicago Health 2.0 @CHIHealthTech Co-founder, Halo Monitoring @Halo_Monitoring Oct 26,  2011
What is "Gamification"?
 
How do  Health apps engage and even  motivate  ?
Delivering  bad or boring  news doesn't work
Nudging with  irrelevant or anonymous data  doesn't work 
The problem is changing  inagrained  BEHAVIOR
A start: wellness and fitness
Status is the  missing piece S tatus  A ccess  P ower  S tuff
Game Mechanic: "dot" behavior
  meets Game Mechanic: flying dragon
Negative    (annoying) Why aren't you wearing your device? Take 20 more steps today and you will be in 1st place Positive (encouraging) Game Mechanic: "actionable baby step trigger"
The gamification "layer"
I love @healthmonth. I am a happier, healthier person because of it."
 
of Health? the Is
Maybe not. They've  already pivoted
Is the Employer paving the way!?
Where's Google Health now?
Why does "Gamification" work?
Gamification: More than just fun
 
LEFTOVER SLIDES START HERE
 
Trigger

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"Gamification of Health" by Chirag Patel (Chicago Health 2.0)

Notas do Editor

  1. leaderboards achievement badges, achievement levels, progess bars Definition of gamification:  integrating game dynamics into your site,  service, community, content or campaign,  in order to drive participation,  engagement, and behavior change.    I think everyone agrees that gamificaiton hit the spotlight when location based services employed them and Foursquare often gets credit as the pioneer. --------------- StackOverflow much better use of points - results in contract and jobs What does good news look like? Gamification, the use of game design techniques and mechanics in non-gaming environments to drive engagement with your brand, started generating a buzz internationally in 2010 ocation-based platforms such as  Facebook 's "Place" feature,  Foursquare (social network) , and  Gowalla . [6]  Some of the techniques include: achievement "badges" achievement levels "leader boards" a  progress bar  or other visual meter to indicate how close people are to completing a task a company is trying to encourage, such as completing a social networking profile or earning a frequent shopper loyalty award. [7] virtual currency systems for awarding, redeeming, trading, gifting, and otherwise exchanging points challenges between users embedding small  casual games  within other activities. [4 Why Gamification is exploding, Gen-Y and the Social Beast NPR - Gamifying the system to create better behaviour  I've even more interested in RightBonus after hearing  yesterday's NPR story on Gamification . The example they brought up is getting points for  not  doing something in addition to doing something. eg. In our world, points for not committing code that breaks the continuous integration. Or points for no botched home installs in Halo's case. The SAPS (status, access, power and stuff) thing is very interesting too. Definitely listen and read if you haven't already.
  2. How can we take the fun and interactivity and bring it into healthcare? While the consumer is paying for the emergency response pice, the vitals signs vitals, heartrate, skin temperature are an ADDED BONUS Like most health tech companies, we're not going to rely on gamification as our core competency Fall prevention on why it's so important.  ------- I work for a company that makes "I've fallen and I can't get up" 2.0 systems. Which means we detect falls from motions and provide other vitals such heartrate, pedometer, and activity. We're delivering all these cool vitals in the world of panic buttons? So can we apply gamification to health?
  3. Not just fun and interactivty: One of approaches where considering is gamification but there is an overacching problem: "How do we engage and even motiavate"? ----- At Halo, we're trying to solve a problem that many consumer health tech companies are trying to solve. Including device companies like ours and more importantly personal health record (PHR) the one of the problem isn't providing data tools, the problem is engagement. 
  4. What better place to start than the PHR? Health tech's saviour  As you many of you may have heard, Google Health decided to call it quits recently.  Why? In a sentence, Adam Bosworth said, “It’s not social.” Wired > connected interactions I pesonally don't think that's the entire picture. Even 2 or 3 years ago at the health tech conference, I would hear  Google executives constantly preach that health needs to be fun.  PHRs really have no incentive to make their data portable for patient retention. Some of them have propietary PHRS.   With the provider's fee for service model, there really is no incentive to make sense of the data, let alone make it fun. Whether it's a proprietary provider PHR or a provider independent PHR like Google, PHRs deliver bad and boring news. ---------------- Wired Magazine recently published an article that one of the three reasons they failed were no "connected interactions"  -------------- http://techcrunch.com/2011/06/24/google-health-bosworth-social/ First, people are not really interested in entering information at a website unless they get value in return. And gathering personal health information from many different sources and entering it in an online database can be time-consuming and tedious. 

Dossia works with employers to pre-populate their employees’ health records with information from their group health plans. Second, Google Health failed because Google did not offer tools that allowed people to put their health information to good use. One of the greatest needs is for comparative pricing tools for purchasing medical services. Third, Internet consumers expect connected interactions that create real economic value. If Google Health offered such interactions, more people would have found a way to use the service--even if it meant arduously pre-populating an online record. For example, what if Google Health had a tool that allowed individuals to compare their own medical bills to those of others with health records stored on Google Health (anonymously, of course)? Or what if Google Health had a tool that searched for better deals from medical providers based on the aggregated experiences and claims of other health care consumers in the same geographic area?


  5. PHR side Nudge isn't enough Out of context (total carlorie count) not shown Anonymity doesn't work.   The author of the book Nudge serves in the Obama White House and there's a nudge unit on the British prime minister's cabinet Is 'Nudging' Really Enough? Calorie printing law would keep 150,000 New Yorkers from becoming obese anonymous and data not meaningful and not in contest: 297 calories is good or bad? meaningful > total calorie in context ----- The influence of behavioral economics is already visible in the halls of power. Cass Sunstein, a Harvard legal scholar and co-author of "Nudge," a best-selling survey of the field, is serving in Barack Obama's White House. British Prime Minister David Cameron, meanwhile, has established a "nudge unit" in his Cabinet office and regularly consults leading academics in the field. Consider the new regulations in New York City requiring restaurants to list the calorie content of all menu items. (Similar regulations were part of the 2010 federal health-care reform legislation.) Although proponents of the law hoped that the extra information would lead consumers to shy away from Caramel Macchiatos and McGriddle sandwiches—officials estimated that, over a five-year period, the law would keep 150,000 New Yorkers from becoming obese—that hasn't happened. Instead, initial analyses by researchers at New York University and Yale have found that, since the law was enacted, the average restaurant-goer has actually been purchasing slightly more calories. Show energy bill of neighbors
  6. With both PHR data and public health data, really what we're trying to do is change ingrained behaviour  We are now developing a semantic web and gamification is big part of that. Gamification is a "Means to an end" There's nothing new about 3 steps as they have been problem. But the difference now is the internet and n ow we can deliver small fine grained information instantaneously with a nice user interface due to the internet. The first wave of the internet was store and retrieving data. And the second wave is making it meaninful and semantic. And last the internet obviously allows to scale these things quickly to massive porportions ------------- #7 is the most applicable to health Why is behviour just now being studied by stanford. Well, my feeling is that following are much more manageable and interactive with the web and mobile apps 1. baby steps 2. triggers 3. new behaviors Why doesn't data alone work? Because  changing your ingrained behaviors may be the hardest thing you’ll ever do . In the case of managing your own health with a PHR or being proactive about wellness with calories,  ----------------------------------- http://www.slideshare.net/captology/stanford-6401325 http://blog.dietpicture.com/post/3178027832/the-top-10-mistakes-in-behavior-change-by-the-stanford Top 10 Mistakes in Behavior Change #1 Relying on willpower for long term change Imagine willpower doesn’t exist. That’s step 1 to a better future. #2 Attempting big leaps instead of baby steps Seek tiny successes, one after another. #3 Ignoring how environment shapes behaviors  Change your context & you change your life. #4 Trying to stop old behaviors instead of creating new ones.  Focus on action, not avoidance #5 Blaming failures on lack of motivation  Solution: Make the behavior easier to do. #6 Underestimating the power of triggers.  No behavior happens without a trigger. #7 Believing that information leads to action.  We humans aren’t so rational. #8 Focusing on abstract goals more than concrete behaviors.  Abstract: Get in Shape Concrete: Walk 15 minutes today. #9 Seeking to change a behavior forever, not for a short time. A fixed period works better than “forever” #10 Assuming the behavior change is difficult.  Behavior change is not so hard when you have the right process  We’ve spent time learning about true behavioral change because we think it’s what people need in an ocean of flawed quick fixes. We’re committed to continually embedding the latest science and understanding about creating lasting positive behaviors into all of our products.
  7. We looked at the PHRs/providersand public health, but we're really seeing new ideas to change ingrained behavior is on the consumer side, specifically health and welness Gympact is looking to do this specifically with gamification focused on baby step sizable actions unlike foursquare, accentuating the negative instead of positive ------------- http://nudges.org/2011/05/18/gyms-and-behavioral-economics-gym-pact-answers-your-questions/
  8. Staus is not in Stanford behavior labs top 10 but that's a key piece of Gym pact Gabe Zichermann, co-author of the book  "Game Based Marketing" Games has always worked. The internet can no deliver the information around games effectively especially now with mobile devices.  SAPS stands for status, access, power and stuff. Zichermann says those are things people want in their lives as rewards — in that order. "It turns out," he says, "that cash isn't that good of a reward. Status is a fantastic motivator for getting people to do stuff." Take  The Biggest Loser . In the popular NBC reality show, an activity that's normally thought of as embarrassing and private is made public. The contestants are given nominal rewards, and after being put through the ringer, Zichermann says, they lose weight. "What's interesting about  Biggest Loser  and other gamified examples of weight loss is they hew to a model for user rewards that I call SAPS," he says. http://blog.dietpicture.com/post/3221222223/apps-to-share-your-pride-at-the-gym http://www.npr.org/2011/03/27/134866003/gamifying-the-system-to-create-better-behavior I've even more interested in RightBonus after hearing  yesterday's NPR story on Gamification . The example they brought up is getting points for  not  doing something in addition to doing something. eg. In our world, points for not committing code that breaks the continuous integration. Or points for no botched home installs in Halo's case. The SAPS (status, access, power and stuff) thing is very interesting too. Definitely listen and read if you haven't already.
  9. Game mechanic: Focus on action instead of avoiding This is an example of a Standalone app ------ This is an example of what Stanford persuasive tech labs calls  “ dot” behaviors — one-time actions that can become pathways to  “ span” behaviors (those done for a period of time)  or even lifelong habits , which Fogg calls “path” behaviors.
  10. Personalized data: your pedometer steps Relevance: leaderboard Choice: do it or you don't Action: 15 more steps
  11. Health Month is game to help improve your diet, fitness, mental health, relationship health, and financial health – while enjoying it! Health Month is about taking the  SCIENCE  of nutrition and behavior change and combining it with the  SOCIAL GAMES  of the recent social web to help people improve their health habits in a fun and sustainable way. If you can enjoy the process of living healthier, you're much more likely to stick to it.
  12. Health Month is game to help improve your diet, fitness, mental health, relationship health, and financial health – while enjoying it! Health Month is about taking the  SCIENCE  of nutrition and behavior change and combining it with the  SOCIAL GAMES  of the recent social web to help people improve their health habits in a fun and sustainable way. If you can enjoy the process of living healthier, you're much more likely to stick to it.
  13. myBasis CEO of Eye-Fi Take all the aspects  Wii Fit, Nike+, Garmin Connect, Fitbit and Healthmonth
  14. GreenGoose - I like to think of this as "gamificaiton gone wild" “ Think FarmVille but with live data.” Krejcarek plans to open the platform to game developers, who he hopes will create games that are simple, easy, and sticky. A few hours of raking leaves might build up points that can be used in a gardening game. And the games induce people to earn more points, which means repeating good behaviors. The idea, Krejcarek says, is to “create a bridge between the real world and the virtual world. This has all got to be fun.” startup incubator > greengoose in providence Facebook news food. Live updates Functional solid Moving more into pets world - Petagonia Instead of employer or direct to consumer
  15. Tracking pets Last Fed Last Walked
  16. For the consumer, patient, the costs savings may not come until 10 to 20 years later from avoiding costs caused by heart disease or COPD shape up - Social gaming and competiton (friendly compeitition) weight lose, biometric. leveraging trusted social network with the company. already on teams. depts or workgroups to compete Gaming and healthcare competitions in the workplace, increase productivity pedometer  wireless > FitLinks How many of your employers include wellness programs? ShapeUp Platform , which includes social networking tools, wellness games, financial incentive management, integrated activity-tracking devices, and health coaching. 6 month cycle = not immediate •  Average employer spent  $154  per employee on  wellness programs in 2010  •  But spent  $430  per employee on incentives  Focuses on one specific aspect  of healthy eating each week.  Teams compete to achieve  highest compliance  Teams earn points for  healthy habits and lose  points for unhealthy ones and I have lost 7 pounds!  They also earn influencer points for  encouraging colleagues to get their  flu shot too 
  17. Consumers may not take action by themselves, but we are going to see a trend where employers are providing that nudge, trigger, and most importantly automatic social standing to drive consumers http://www.fastcompany.com/1763402/gamifying-health-keas-psychology
  18. Kleiner Perkins said "Every CEO should understand gamification because gaming is the new normal". I wouldn't see  But the able-bodied single independently living senior that battlling something just as significant as the  average of 2 chronic diseases that most seniors have, but rather apathy and isolation What'd I'd like to end the presentation with is that I'm excited about the future of not just gamification but  Not just of consumers engaged with their wellness. But in case seniors  End with "It's not just a matter of checking in to cool restaurants, but in this actually transforming lives" ------ Research by Elon University in North Carolina, after only a few sessions with the Wii Fit, older volunteers (average age 75) improved their balance scores significantly, lowering their supposed “Wii age” (a score assigned by the game system, based primarily on balance tests) by about eight years. The sessions began with balance tests, on either one or both legs. Everyone balanced well on two legs, but to the surprise of both subjects and scientists, the elderly volunteers “performed rather poorly” during the single-legged tests, said Caroline Ketcham, Ph.D., an assistant professor at Elon University and lead author of the study. “They thought they were in good shape and had good balance. It scared them a bit, frankly, to see how awful their balance really was.”
  19. BJ Fogg grid > dot behaviour and spanned behaviour BehaviorGrid.org > Show this slide > vernacular
  20. There are remarkable similarities in many of the behavioral health models that we come across that involve these  4 simple necessary steps . Personalized, actionable information, choices and SIMPLE actions that we can take starting now, along with the necessary support structures to make it happen.  http://www.slideshare.net/captology/stanford-6401325
  21. It's not that simple in health.  Honestly I use foursquare. I really don't care about my points and being the mayor of TacoBell. But if points could be used in a meaningful way (StackOverflow or Quora)