Team Superlinear proposal for the Robert Wood Johnson Foundation: Games to Generate Data Challenge

1. Request to: Robert Wood Johnson Foundation
Team Name: Superlinear
Project Name: Games To Generate Data Challenge
Team Overview
Superlinear is a team of software engineers with a diversity of software
development experiences, ranging from creating computer virtualization
software to building Electronic Health Record systems. At the beginning of
2013 we came together with the goal of solving healthcare issues by
leveraging Information Technology.
Our organization provides systems development capabilities to address
the needs of our customers. We currently support the health IT
applications developed by the defunct iPathy Software LLC.
Current Activities
Our team is currently designing a framework utilizing games and
information technology to address issues within the health industry. Our
vision is to create a system that allows patients to interact with their
healthcare providers beyond what is currently typical in the healthcare
industry while avoiding the addition of significant additional load on
healthcare resources. Such a system would seek to aid healthcare
regimen compliance, identify at-risk populations, reduce recurrent hospital
visits, and increase overall community health.
Below, we present one of many possible games that harness the power of
computing platforms in information analysis and community outreach. We
hope to integrate it with our other efforts.

2. Proposal Abstract
We propose a simple and engaging game that attracts a large audience
and provides a sustainable source of data useful to the healthcare
community. The game will act as a vehicle to engage the community-at-
large, allow for the collection of both targeted and passive health metrics,
and will act as a launching point for community healthcare activities.
Software Overview and Rationale
The game will be developed both as a mobile application and an online
game (accessible via web browser). This will provide ready availability to
more affluent users, who are more likely to own a smart device, as well as
less affluent users who may not have the means to own a smart device
[1]. Ensuring that the game is enjoyable is of the utmost importance, as
the software would be useless without adoption by its target audience.
Specifically, our goal is to utilize the game as a platform to engage a large
audience, much like advertisers seek to do when buying advertising space
in popular games [2]. With this goal in mind it becomes imperative to
create “flow” in the gameplay experience to hook players and their friends
[3]. As such, the game will not have an overt focus on the goals of the
Robert Wood Johnson Foundation, but will facilitate participation in its
activities as a consequence of the mechanics. We feel that an overt focus
on personal or community health will diminish the size of the interested
audience, and will lead to the generation of biased data as a result of a
self-selecting audience that is likely already involved in the types of
initiatives being led by the Robert Wood Johnson Foundation. Instead,
participation in Foundation activities will be facilitated by a metagame
component and a voluntary participation component that will act similar to
the in-app purchases found in other apps and online games. The use of
this model allows us to integrate Foundation initiatives while preserving
flow; similar systems are used by 32 of the top 50 grossing games on the
iOS App Store [4].

3. The Game
Premise
The player is a virus that seeks to dominate the biological landscape of
the Earth.
Mechanics
 Player actions are performed by utilizing “tokens.” Tokens are
acquired in three ways: a set number are given to the player on a
daily basis, the player may acquire additional tokens by responding
to survey questions (which act as in-app purchase analogue), or by
participating in metagame activities.
 Players can perform a variety of actions with their tokens. Example
actions include adding symptoms to a virus which may either
benefit or harm a host, improving the virility of a virus, improving the
robustness of a virus, infecting non-player entities (such as
simulated human populations), and challenging other players in a
player-versus-player challenge mode.
 Groups of players may perform actions together, such as
attempting to jointly infect a resilient population center or
challenging other groups of players.
 The resilience of various population centers is determined by
available health ranking metrics and will be modified as new data is
acquired. For example, if Boston were the healthiest city in
Massachusetts it would be the most difficult city to infect, however if
it were to become the second healthiest city in Massachusetts its
resilience would then be modified to be the second highest.
 Rewards to players and modification of non-player entities can
additionally be determined by real-world community health
activities. For example, players may be rewarded with a special
ability for participating in a Foundation sponsored event, or a
population center may acquire resilience against certain types of
infection based on the community health initiatives it is leading.

4. Non-Mechanical Aspects
 Optional educational materials will be present in the game should
players become interested in the real-world aspects of the game
such as the causes or effects of certain illnesses, or the nature of
epidemics.
 We refer to “survey questions” as a place holder for a variety of in-
app activities that we can utilize to collect data. Players could be
directly asked health related questions such as “how frequently do
you get sick” or “how often do you exercise,” however other
possibilities exist for study-related activities within the app.
Participation in survey questions is optional, but incentivized by
providing tokens to the player so that he or she may perform more
in-game activities.
 Users may look at an analysis of the data they have provided
through survey questions. This analysis may provide healthcare
information to the user based upon their answers. For example, if a
user frequently responds that he/she smokes 10 cigarettes a day
the analysis may provide smoking-related health materials and a
breakdown of the money he/she could save by reducing or ceasing
their smoking habit.
 Metagame aspects were briefly touched upon in the final two
bullets of the “Mechanics” section. Metagames are integrated in a
variety of ways, and common components include leader boards
and badges to show in-game achievements. Currently, we seek to
go beyond the normal metagame components and include real-
world activities as part of the game. In addition to utilizing health
data from various geographies to modify the in-game world, we
seek to reward players and communities for participating in
activities aligned with the goals of the Robert Wood Johnson

5. Foundation. An elaboration of proposed methods of doing this will
be discussed below.
Metagaming for Health
The game serves to drive initial adoption of the application, while the
larger metagame establishes a framework for community access and
sharing. Within this framework, additional mechanisms can be included to
allow players to become involved in events sponsored or sanctioned by
the Robert Wood Johnson Foundation. Currently, sanctioned sponsors
would be AF4Q Alliance members, however a mechanism to allow
individuals and organizations to become sanctioned should be created.
Metagame activities could include simple activities such as blood drives
and flu shot initiatives, as well as larger community activities to raise
awareness of health issues. The effectiveness of metagame activities will
be determined by organizers: online donation drives may appeal to a
larger audience than a blood drive simply due to convenience. A variety
of possibilities can be integrated in this aspect and can be added as they
arise. We hope that by integrating a metagame we can expose our
audience to personal and community health initiatives in their localities,
however we do not seek to make it a necessary component of game play;
the game should have a large audience (acquired by its fun factor), and
the metagame should expose them to information and opportunities of
which they may not have been previously aware.
Data Generation Overview
 User data can be acquired directly by allowing them to participate in
surveys. The information to be collected in these surveys can be
changed as informational needs are identified.
 User data will be passively collected while playing the game. For
example, geographical location, date, and local time may be
collected when the user loads the game. This information may later

6. be analyzed to identify novel issues in the community, such as
wide-spread sleep disturbances (e.g. users in a certain location are
found to log in at 2 a.m. more frequently than the rest of the user
base). We seek to collect a number of metrics related to game play
in order to create a broad and generalized data set that can later be
mined to identify trends in populations that normal health metrics
may not be able to identify.
Utility of Data
 Data acquired through the game may be used by community
leaders to direct healthcare initiatives. For example, if users in
certain geographies frequently report that they do not get an annual
flu shot, community leaders may seek to raise awareness of the
benefits of vaccination. Widespread reports of chronic coughing
may hint at a pollution issue to be tackled by the community.
 Personalized data analysis provided to users may allow them to
inform their lifestyle choices and decisions. A combination of
reporting an inactive lifestyle and being overweight could provide a
user with the lifestyle benefits of moderate amounts of exercise.
Community Adoption Strategy
We seek to utilize a traditional game marketing strategy in driving
community adoption. Since the primary aspect of the game is gameplay
(with participation in non-gameplay aspects encourage, but not
mandated), a sufficiently fun game should attract a large and diverse
community. Uploading the game to game websites such as
www.Kongregate.com, uploading the game to App stores, providing a
standalone site, and integrating social media will provide a variety of
avenues for adoption and wide exposure. Funds from Phase I selection
could be utilized to purchase advertising space. Additionally, Robert
Wood Johnson Foundation allied health communities could encourage

7. adoption by hosting advertising material in waiting rooms, or directing
persons in waiting rooms (e.g. children) to the game for entertainment.
Projected Timeline, contingent on Phase I success
 March 11-June 15: Development, with demonstrations available for
evaluation by challenge sponsors.
 June 15-July 28: Closed beta release to evaluate functionality and
mechanics. Quality assurance and bug fixing, additional content
creation. Internal project evaluation.
 July 29: Submit finalized product for review.
Evaluation
User counts, duration of engagement, and feedback will be utilized to
evaluate whether the game is fun and engaging. Metrics related to the
use of “survey questions” and feedback on whether the analysis was
useful to players will be utilized to determine whether the non-gameplay
components of the game are being sufficiently utilized. Targets for
adoption of the game and utilization of its components will be determined
after consulting with the challenge sponsors, should our proposal be
accepted past Phase I.
Outcomes
Should our software pass evaluation, we feel the end product will meet the
objectives of the Robert Wood Johnson Foundation: Games to Generate
Data Challenge. Specifically the software will generate data that will
improve health and healthcare both at a personal and community level,
and will engage a large audience in so doing.

8. Conclusion
This game lays a stable foundation upon which a larger system can be
built. Our proposal outlines a powerful tool to reach out to communities in
an assuming and unconditional manner. However, there is much more
than can be done in the sphere of healthcare-community outreach, as
there is also much room for development in respect to the utilization of
games to augment patient care. We hope that our proposal can become
an integral component of future developments in these areas.
Citations
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http://pewinternet.org/Reports/2012/Smartphone-Update-2012/Findings.aspx.
[Last Accessed 2/21/2013].
2. Stephen Cass (2011). Exploiting the Fun Factor. [ONLINE] Available at:
http://www.technologyreview.com/news/425982/exploiting-the-fun-factor/.
[Last Accessed 2/21/2013].
3. Linda Kaye, Jo Bryce (2012). Putting The “Fun Factor” Into Gaming: The
Influence of Social Contexts on Experiences of Playing Videogames.
[ONLINE] Available at: http://www.ijis.net/ijis7_1/ijis7_1_kaye_and_bryce.pdf.
[Last Accessed 2/21/2013].
4. Ryan Morel (2012). Choosing the Right Business Model for your Game
or App. [ONLINE] Available at:
http://www.adobe.com/devnet/flashplayer/articles/right-business-model.html.
[Last Accessed 2/21/2013].