Games for Health 2013 Conference: What is Working in Mobile Social Games for Health?

7/28/2019 Games for Health 2013 Conference: What is Working in Mobile Social Games for Health?

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Haveyoueverfoundyourselfatthebeginningofsomethingbig,andnotrealizedit

un7llater,whenyoucouldlookback?

Iamluckyenoughtohaveexperiencedthis38mes.

First,whilebuilding2dentalprac8ces,oneofwhichfocusedonthemind/body

connec8onforbehaviorchange,Second,whileworkingasahealthcareanalystonWallStreetand,

Third,mostrecently,whenIbecameadigitalhealthanalystandconsultant

Beginningin2009,mycuriosityledmetointerviewover100expertsacrossmul8plediversedisciplines.

WhileresearchingMobileSocialGamesforHealth,Imetavarietyofacademics,hardwareandsoJwareengineers,behavioralandcogni8vepsychologists,aswellas

gamingandentertainmentprofessionals.

Next,inresearchingBigDatainHealthcare-HypeandHope,Imettechnology

peoplealongwithdatascien8stsandanaly8cexperts.Mostrecently,Ihavegoentoknowleadersinneurogaming,aswellasthoseincogni8vehealthandwell-being

communi8es.

ItisnosecretthatIlovethegamingcommunity;who,alongsidetechnologists,have

reignitedsparksofcrea8vitythathavebecomedimmedinhealthcare.


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MyAhahmomentinmyoriginalresearch,waswhenIfoundanemergingecosystemof

experimenterstryingtotriggerbehaviorchangeacrossthediseasespectrum-fromhealthand

wellnesstochronicdiseaseandaddic7on

Star8ngatyourleJattheWellnesssideofthisvisual,Ifoundanexpandingdefini8onofhealth

toincludelifebalanceandself-improvement.

ThesocietalshiJinaQtudestowardhealthandwellness,withconsumersleadingtheway,shows

intheriseofemployer-sponsoredemployeewellnessgames.

Socialnetworkingcanbringpeopletogetherwithinatrustedenvironmenttoshareinforma8onandworktowardcommongoals.Socialgamesencouragethreebehaviors:

teamwork,friendlycompe88onandaccountability.

BrainGamesisanexci8ngapplica8onofgametechnologythattakesadvantageofanewunderstandingofbrainplas8city.

DiseaseManagement:Interes8ngtousprovidertypesiswhethertheseprincipleswillworkinchronicdiseasemanagement.Earlysignsareposi8ve:

Mobilegamesarefindingaplaceindiseasemanagement,makingmundanetasksmorefun:glucosemonitoring,diet,exercise,insulinandotherdrugs;anddevelopinga

supportnetworkoflikepeople.

Ofnote,backin2009Ino8cedanexpandingdefini8onofhealthandwellness,whichincluded

habitdesignandself-care.Rememberthistheme,wewillseehowithasevolved.

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Mylatestresearchtappedintoafountainofinnova7oninthemobilesocialgamesforhealth

space.WHY?

Aconvergenceofmanyfactors:

Easeofentry,technologyadvances,Recep8veend-usermarkets(smartphones,ubiquitousconnec8vity),Accesstocapitalandincreasinginterestfromhealthcareorganiza8ons

Thegamingmarkethasgrown,especiallyamongwomenandpeopleover30yrsoldwith55

percentofgamersplayinggamesontheirphonesorhand-helddevices.

Gamifica8on,ini8allyoverhyped,mayneverthelessbeausefulengagementtool.Accordingto

aGigyastudyofbillionsofuserac8onswithpartnerslikePepsi,Nike,andDell,addinggamifica8on

toyoursiteboostsengagementbyalmostathird.

Albeitslowly,IthinkwearebeginningtoseeasocietalshiJintheimportanceofhealthand

wellnessasshownby

1. thegovernmentsefforts-Mrs.Obamascampaign,ReginaBenjamin2. celebri8essuchasSanjayGupta,Dr.Oz,DeepakChopraattheCESaretryingtomake

fitnesscool.

3. moreself-insuredemployersareembracinghealthandwellnessaspartofaproduc8veculture.

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Thisfountainofinnova7onhasfueledwildgrowthinourecosystem,butitalsomeansahighsignal-

to-noisera8oforfiguringoutwhatworks.

Ournewecosystemhasmanymorecompanies.Notonlydowehavethosechasingcogni8vehealth,buttherehasbeenaspurtincorporatewellnessprogramsusingsocialgames.Therearealsonext-

genera8oncompaniesrefiningtheirapproachtobehaviorchange.

Newplayersinclude:

BlueMarble AkiliInterac8ve Cognifit Fitocracy MangoHealth,Lark Shapeup Limeaide OmadaHealth

Isettheresultsbarhightoselectthisyears4casestudies:

Lumosity OneHealth

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Letsstepbackandexaminewherepocketsofevidencearebuilding:

Inchildhoodobesity-Zamzee,anac8vitytrackerwithamo8va8onalexperiencewrapped

aroundit,did12studieswithover1000kidsandfoundthattheythosewhousedboththe

mo8va8onalexperienceandtheaccelerometermoved60%moreovera6monthperiod

thanthosewhojusthadtheaccelerometer.Withtheseresults,theprogramisnowbeingusedasatoolalongwithexis8ngchildobesitydietprogramsandcamps.

Incorporatewellness-Shapeup-investedinresearchearlyon-5peer-reviewedar8clesin

scien8ficjournals-withmoreinthepipeline.Showingthatusingteammatesandsocial

compe88oncanhelpincreasephysicalac8vi8esandweightloss.

Inaddic>onrelapse-OneRecovery,nowOneHealth,inPilotwithaNa8onalHealthplan

theyfounda5%reduc8oninreadmissionsanda$1.4Millionincostsavings

Indiabetespreven>on-OmadasPrevent,thedigitalversionofa2002DiabetesPreven8on

ProgramknownasDPP,ina27-centerstudywithover3000pa8ents-theyfoundthata

modestweightlossof5-7%couldreducetype2diabetesby5%.

Allofthecompaniesagreethattheirestablishedevidencebasehasbeeninvaluableasithas

providedtheminstantcredibilityduringtheirdiscussionswithinsurancecompaniesandself-

insuredcorpora8ons.

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Onestrandofevidenceisadop7on:Whoisusingthesetools?

Iwouldhaveguessedthatmostoftheappsarebeingusedfordietandexercise,and

Iwassurprisedtofindoutthat,accordingtoarecentstudyofUSbroadband

householdsconductedbyParkandAssociates,70%areusingthesetoolsformemory

training.

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Theinterestinmemorytrainingisspurringarobustecosystemofbraintrainingand

brainfitnesscompaniessuchas:

Lumosity Dakim Posit Cognifit BrainScience AkiliInterac8ve

AttheConsumerElectronicsshowthisyear,Ibegantothinkthatconsumerinterest

isexpandingbeyondbraingamesandbrainfitnesstoabroadercontextofthemind/

bodyconnec8onandthedesiretopursuecogni8vehealthandwellbeing.

Ims8llworkingonthatone,sostaytunedformynextreport.

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Lumosityhascreateddifferenttypesofgamestotraindifferentareasofbrain

health,includingproblem-solving,memory,andbrainflexibility.

Lumositywasfoundedin2005,raised67.5M,andisusingtheproceedstofuelrapid

growth.Thisdirect-to-consumerbraingamescompanynowhas40Musers,with10

Muniquevisitorsamonth.

Clickabovetoenjoyavideodemooftheir3newgames.

Thereisnewevidenceinanindependentstudyofchemobraininpost

chemotherapybreastcancersurvivors,thatshowedthatLumosityscogni8ve

trainingledtosignificantimprovementsincogni8veflexibility,verbalfluencyand

processingspeed.


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Nowwhatisbehaviorchangeandwhyisitsoimportant?

Everyoneengagedinhealthcareisinthebehaviorchangebusiness:wearenudgedtoeatlessandexercisemore,followrecommendeddiagnos8cscreenings,takeall

yourmedicineon8me,dontputoffavisittoinves8gatesuspicioussymptomsandofcourseflossyourteetheveryday.

Asshowninthisvisual,onewaytothinkaboutusingtechnologytoolstonudgeBehaviorChangeisasaseriesofcumula8vesmallfeedbackloops.

Asimplefeedbackloopcanbedescribedas:theuserengageswiththemobiletool,dataiscaptured,feedbackiscreated.Thiscouldbeasimplerewardsystemfor

flossingyourwholemouthone8meperday.Morecomplexfeedbackloopsinvolve

mul8pleitera8onssuchaschangingyoursleepingrou8neoryourea8ngandexercise

paerns.

Theul8mategoalistofosterhealthybehavior,but,asweknow,changingpaernsof

behavior,orcomfortablerou8nes,isnoteasy.Theques8onofusingtechtoolstonudgebehaviorchangehasrecentlybecomeinteres8ngtomanymoredesigners,so

muchsothatthereisameet-upwithover1000memberscalledHabitDesign.

KudostoMichaelKimwholeadsthisgroupofimagina8veprofessionals.

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Nowthatwehavethoughtaboutgengstartedandgenggoing,wearenowset

toexplorehowwestayontrack.

Manyofusthinkthatsocialnetworks--peerpressureandsupport--plususerdata

analy>cs,couldhelpusstayontrack.AlcoholicsAnonymousandWeightWatchers

havebeenhelpingpeopleofflinefordecades,withrealsuccess.

Asyoucanseeinthisvisual,thereareseveraldifferentkindsofsocialnetworks

whichofferfluidityandflexibilitynotseenintheofflineworld

Informa8onnetworkssuchasEverydayHealth Pa8entsupportnetworksAllianceHealth Researchnetworks-PaCentsLikeMe,Genomera

Yet,peoplearecomplex,andinfluencingeverydaychoicesisnotaone-size-fits-all

solu8on.ustassocialnetworkscomeinmanyflavorssododatanetworks

Forsome,theoutputofbiometricdata,datacomingfrombodysensors,willhelp

themtofindtheirway.Forothersofus,largesetsofuserdatamayalsohelpdevelopersunderstandhumanbehaviorandclosethefeedbackloop.

Thekeymaybeinexperimen8ngwithpeertopeersupportnetworksanddataanaly8cswithamixandmatchapproach-usingmoreorlessofeachtoolasneeded

anddiscoveringwhichsuiteoftoolswillworkforwhomandwhen.

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AsconsumersembraceLumositysbraingames,corpora7onsareembracinggames

tospuremployeewellness.

Whataresocialgamesintheworkplace?

Smallteams,puttogetherintheworkplacecanplaysocialgameswhichencourageteamwork,friendlycompe>>onandcoopera>on.Accountabilityisaninteres8ng

mo8vator,becausepeoplefeelobligatedtopar8cipatesotheydonotletdowntheir

teammembers.

Buildinguponbasichumannaturedesireforcompe88on,statusandpeer

recogni8on,socialgamescanhelpsupportandpromoteaposi8vecollabora8ve

culture

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Exemplifyingthepowerofsocialgames,Shapeupspar8cipantshavecollec8velylost

onemillionpounds!

Clickonthelinkabovetowatchthevideothatshowshowtheirprogramsusesocial

networking,peer-to-peerhealthcare,gamemechanicsandbehavioraleconomics.

Asfarasusingsocialgames,Shape-upisoneoftheoldest,clinically-proven,

technology-basedsocialwellnesscompaniessellingtolargeemployersacrossthe

globe.Thepeer-to-peernetworksformagrassrootscampaigntorecruitteam

par8cipants,usingsocialsupportandgroupmo8va8onandaccountabilitytocreate

engagement.Nowtheyhaveaddedindividualandteamcoachingtotheirsuiteof

services.

Asadatapointrelevanttocorporatewellness,RhodeIsland,inastate-widewellnesschallenge,overthepastsevenyears,foundthatmorethan70,000RhodeIslanders

havepar8cipatedintheirprograms-walkingmillionsofmiles,losingthousandsofpounds,andprovingthatteamworkisapowerfulprescrip8onfortakingcontrolof

ourhealth.

Shapeupbeganin2006,coversmorethan2millionlivesacross200employersand

healthplans,raised$5MseriesAin2010,andtheyarenowprofitable.

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WhenIaskedWhatisworking?Threeelementsemergedincommonacross

companiesEPI-Engage,PersonalizeandIterate;allunitedbyaneedto

demonstrateeffec8venesswithsomekindofevidence.

First,capturepeoplesinterestengagethemwiththeuseofgamingelementssuch

asreward,status,achievement,self-expression,compe88onandaltruism.Once

peopleareengaged,itiscri8caltocreateevidencethatthetoolswork.

Thesecondelement,ispersonalize,customapproachesareessen8altosuccessful

behaviorchange.Thereisnoonesizefitsallinbehaviorchange,andgivingpeople

whattheyneedatthe8meofneediscrucialtokeepingtheirlimitedaen8on.

Thethirdelementisiterateandexperiment.Thisconceptisalsowellknownin

consumerproducts,butnotyetmuchrecognizedinhealthcarecircles.

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Pa7entengagementhasbeenapopulartopicoflate,withHIMMSpublishingabook

andconduc8ngaTweetuponthesubject,HealthAffairsdevo8ngitsen8reFebruary

issuetothetopic,andtheRWFounda8onandotherssugges8ngnewapproaches.

Reflec8nguponmydaysasaprovider,whereeachdentalpa8enthadadifferentviewoftheirneeds,itisnotsurprisingtomethatthedefini8onandmeasurementof

pa8ent-engagedcarediffersdependingoncontext.

Nowthatthediscussionhasmovedtoengagement,evidenceofeffec8venessseemstobethepowertrigger.

Healthplansaredemandingmul8plepilotstoprovethatthetoolswillgetpa8entsengaged,andkeepthemac8veintreatment.CompaniessuchasShapeup,One

HealthandOmadawhohaveevidence,cangrowtheirbusinessesinthecorporate

marketmorequickly.

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Togetengagementandbehaviorchange,thereisnoonesizefitsall,so

personaliza7onisessen7al.Formsofpersonaliza7oninvolveusingincen7vesas

wellasdataanaly7cs.

Thereisalotofexperimenta8onwithincen8ves,suchasmoneyorpremiumreduc8ons.Arecentsurveyof00largeandmid-sizecompanieswithmorethan7

MillionUSemployees,foundthat3%offerincen8vesforpar8cipa8nginprograms

thathelpemployeesbecomemoreawareoftheirhealthstatus.AonHewi'ssurvey

showsalmosttwo-thirds(64percent)ofemployersoffermonetaryincen8vesof

between$50and$500,andnearlyoneinfive(1percent)offermonetaryincen8ves

ofmorethan$500.

Althoughthereiscurrentlyalotofexperimenta8onwithextrinsicrewards-suchas

money-theliteraturesuggeststhatintrinsicmo8va8onissuperior.Thisisanarea

thatiss8llaworkinprogress.

Analy8csisanotherimportantelementofpersonaliza8on.Inbraingames,Lumositys

machine-learningalgorithmscustomizetheques8ons-givingtheplayertheright

amountofchallengeandinOneHealth,theyusedatatobebeerinformedhowto

tweaktheproductfeatures.

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Letsseehowtheseconceptsworkwhenyoubuildasystemwiththepa7entinthe

center.

OneHealthusesamixofgamemechanicsandmul8pleonlinesupportnetworks,

available24/7.Aswewillseeinthedemo,gamemechanicsincludebadgestomark

achievementlevels,suchasgoingtomee8ngs,geQngasponsor,sharingastory,

journaling.Emo8conshelpusshareemo8onandempathy.

Forsocialsupport,youcanbuildyourownsupportgroupwithvaryinglevelsof

privacy,customizedtopersonalneedsthatcanchangeover8me.Thisisvery

importantintheclinicalworld,wheremanypeoplesufferfrommul8plediseases-

suchasthemanypa8entswhostrugglewithobesity,depressionandaddic8on.

Thesesameprincipleshavebeenappliedtotheirnewmobileproducts.

OneHealthstartedin2007,raised16Mdollarstodatewitha7MdollarseriesA

followedby$9MseriesB.

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Whatifthesetoolsofbehaviorchangecouldbeusedtopreventoneofthebiggest

costdriversinhealthcare?

AsshowninthelandmarkDPPtrialbackin2002,pre-diabetescanbereversed

throughlifestylechanges.Itwasonlyrecently,in2011,thatOmadacleverlyfigured

outawaytodigi8zetheprogramusingdigitaltrackingtools(e.g.weightscales,

pedometers),personalizedcoaching,socialsupport,andaninterac8veweb-based

curriculumtomo8vatehealthyexerciseandea8ngbehaviors.

HereishowOmadas,16weekcourse,calledPreventworks:

Uponsignup,usersarematchedintosmallgroupsof12inaprivateonline

environment,basedonage,bodymassindex,andloca8on.Theyarethensenta

Path16wirelessscalethatrequiresvirtuallynoset-upandautoma8callysyncsto

Prevent,allowingthemtotransmitdailyweigh-instotheirprivatepersonalprofiles.

Thecurriculum-1xperweek,itsfun,andofferssomeinterac8veelements,with

minichallengesintheirskillcenter.Importantaspectsoftheprogramincludethe

peer-to-peersupportfromthegroup,aswellassupportfromthehealthcoach

Evidencefromlastpilotincludes:

74%completedthepilotin4months MeanweightlosssimilartoDPP-5-7% 40ofthe230par8cipantshaveappliedtobecoaches

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AhandfulofVCsIspokewithagreethatitiss7llearlyinthecycleofbusiness

modelevolu7on,however,incorporatewellness,wesee2differentapproachesto

revenuemodels:

ShapeupandOneHealthchargeemployerspermemberpermonth Preventisa2-8ersuccess-basedapproach,wherethereisonepaymentwhenemployeescompletetheprogramandanotherpaymentwhenthey

meetgoals

Ontheconsumerside:Lumosityusesamonthlyfeestructureforconsumers

Noteworthy,ShapeupandOmadaareprofitable.

(Shapeup-startedin2005andhasraised$5Minventurecapitalfunding.

Omada-beganin2011andhasraised$5.5Minseedandventurefunding)

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Asyoucanseeinthesegraphs,alltrendsareposi8veshowinganIncreaseinmobile

healthappdownloads,globalrevenuesandventurecapitalfunding.

ForMobileHealthappdownloads,124millionpeopledownloadedamobilehealth

appin2011and247millionpeopledownloadedonein2012.

Inglobalrevenue,therewas1.2billiondollarglobalrevenuefrommobilehealthcare

appsin2011with11.billiondollarsexpectedin201

ForVCfunding,therewas96milliondollarsin2011and1.4billionin2012.

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Reflec7ngback(inhindsight)thishasbeenayearofrapidinnova7on,soletssee

theupandcomerswhoarebraveenoughtotakeonthechallenge

Upandcomersinclude:

Fitocracy-Thefoundersaregamersturnedbodybuilders.Theonlinefitnesscommunityawardsyouwithpoints,theabilitytolevel-up,badgesandthestrongsocialcomponenthascreatedcommunitysupportwith

over1mdownloads.

MangoHealthusinggamedesigntohelpconsumersmangetheirhealth-earnpointsfortakingmedica8onssafelyandon8me.Pointscanbe

redeemedbymajorretailerssuchasTargetorbymakingcharitydona8ons

Lark-usingelementsofgamemechanicsandautomatedposi8vecoaching(withcustomalgorithms)tomakesleeptrackingmorefun-andtheyhave

theworldslargestsleepdatabase.

AkiliInteracCve-combiningthebestinneuroscience,withthebestofvideogamestocreateanewkindofcogni8veac8va8on,beginningintheareaof

execu8vefunc8on

Whowouldhaveguessedthatgamedevelopers,onceconsideredop8onal

consultantsinhealthrelatedproducts,wouldbekeymembersofproduct

developmentteams?

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Whatdoesthismeanforthefuture?

Aswehaveseeninour4casestudies,inour4up-comers,andothers,withgaming

andcompe88onstakingcenterstage,perhapsitis8metoindividuallyand

collec8velythinkBIG.

LeaveittoEstherDysontohavecreatedHICUUP(HealthInterven8onCoordina8ng

Council)thatusescommunitywideeffortstogetpeoplecompe8ngtowalk,exercise

andeatbeeracrossci8esandstates.Thecouncilisspurringpopula8onhealthand

provingthefinancialfeasibilityofpreven8vehealthonalargerscale

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Iamgratefultothe100pluscompaniesandthe25plusmee8ngorganizerswhohave

contributedtotheanalysisbehindthispresenta8on.

Iremainravenouslycurioustoseewhatwillbenext!


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Documents

Games for Health 2013 Conference: What is Working in Mobile Social Games for Health?