Interactivity in Healthcare Turns Games into Treatment

The impact of gaming on health and education is far beyond theoretical for American University Professor Robert Hone. As the former creative director for Red Hill Studios, a boutique interactive design company, Hone used numerous grants from the National Institutes of Health and National Science Foundation to develop innovative software that not only entertains, but helps children learn and patients improve their health.

Hone recently joined the faculty at AU’s Game Lab to help the next generation of innovative health and educational game designers unlock this medium’s seemingly limitless potential. Interactivity has taken the world by storm. In healthcare, visionaries such as Hone — along with his students at AU — are finding innovative new ways to address cognitive issues such as severe anxiety and pain management, as well as progressive neuromuscular conditions such as Parkinson’s disease.

“Over the next few years, I expect to see more behavioral games emerge that leverage advancements in neuropsychology and behavioral economics to help people break free from unhealthy habits and build new healthy behaviors to combat chronic diseases such as diabetes and heart disease,” said Hone, who manages AU’s Game Studio and teaches in the Game Lab.

Years ago, the notion of video games as treatment may have seemed frivolous or unrealistic at best. Today, health “gaming therapies” are finding widespread use in numerous health fields.

“The ubiquity of games has lowered people’s resistance to nonstandard forms of treatment,” Hone said.

Even so, games are not the end-all, be-all for healthcare — and they’re not always the best available option. Hone said the deepest benefits are for people who are dealing with a disorder.

“To develop an effective health game, you should think of it as a form of therapy that needs to be done or played repeatedly over a period of time. Just as you wouldn’t expect to get in shape with one visit to the gym, effective health gaming therapies engage patients over a long period of time to get a sufficient ‘dose’ of treatment,” Hone said.

Constructing a successful game-based treatment plan requires building a “difficulty staircase,” which involves a progression of gradually more difficult levels. As patients improve, that progression to harder levels keeps them engaged.

“It’s like building an entire ski resort,” Hone said. “You have to build the bunny slope, intermediate hills, advanced trails and the double diamonds.”

Games that fit this model are proving to be effective motivators for taking medications, rehabbing and exercising. To boost engagement is the simple yet powerful goal.

“Health games are good at helping people get engaged in things they want to do but that they have trouble getting motivated to do on a regular basis,” Hone said. “The opportunity is where people have specific diseases that require a lot of effort — a lot of repetitions. Stuff that takes a long, long time.”

Patients with Parkinson’s disease, a disorder of the central nervous system that hinders movement, tripled the amount of exercise they performed over a 12-week period in a game designed to improve their ability to get up and sit back. Hone worked on the game in conjunction with the University of California San Francisco. His other healthcare-related endeavors have included a game he designed to improve balance in children with cerebral palsy.

Much like most people who play them, patients often embrace games as a distraction. Focusing on something other than their pain helps many push through the challenges of treatment.

“The ability of games to enable players to reach a highly focused “flow state” serves as a productive form of distraction,” Hone said. “A well-designed game can keep patients engaged for a long time — not just 20 minutes, but perhaps as much three to four days a week for 12 weeks.”

There’s also great potential in cognitive games. Hone and two AU students two students from Hone’s “Designing Health Games” course recently developed a neurogaming therapy with researchers at the National Institute of Mental Health. The therapy includes custom-designed hidden number puzzles that help children with severe anxiety reduce their overactive “fight or flight” responses. This gaming therapy is currently being evaluated by the NIH in a formal clinical trial.

Those same two students course recently created fundable health games: one to help people combat Parkinson’s disease with structured exercise, and another to relieve stress by learning slow, deep breathing. They are discussing converting these prototype games into actual products through collaboration with outside companies.

The aforementioned breathing game, which matches the player’s breathing pattern with what’s on the screen, utilizes a new sensor that is highly accurate and cost-effective. It’s the type of advancement that first got Hone excited about engagement back in 1992, when he started down the path of video game and UX design.

For this MIT-educated chemical engineer and award-winning TV producer, director and writer, embarking on a new, then-obscure career in video game design 25 years ago was a bold move rooted in a passion for what’s possible.

“When people are playing interactive games, they’re completely focused on the task, and they’re not very self-conscious. You can read their facial expressions to get an honest reaction to what you’ve created, good or bad,” Hone said. “It turns the game designer into a kind of live performer, like a dancer or a stand-up comic. I relish those opportunities because they give me the energy to keep innovating.”

Learn more about the potential for gaming and interactivity to improve communities. Explore a master’s degree in Game Design from American University.

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