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Gamification of Health – Healthcare 3.0




                                               Gaming INDUSTRY


Thought Leadership   Kumaran Media & Information Communication Technology Practice
Confidentiality Statement

  The information contained in this document is proprietary and confidential. This document, in whole or in part, may not be copied or disseminated to any third party without
  the express written authorization of Kumaran Systems Inc.

  "Confidential Information" means any secret or proprietary information relating directly to Company's business and that of Company's affiliated companies, including but not
  limited to products, research programs, specific software, algorithms, computer systems, object and source codes, pricing policies, technology, employment records and
  policies, operational methods, marketing plans and strategies, product development techniques or plans, technical processes, designs and design projects, and other business
  affairs of Company and Company's affiliated companies.

  The recipient must keep strictly confidential all Confidential Information and will not, without the Company’s express written authorization, signed by one of the Company’s
  authorized officers, use or sell, market or disclose any Confidential Information to any third person, corporation, or association for any purpose.




Thought Leadership                                                             Kumaran Media & Information Communication Technology Practice
ABOUT THE AUTHOR
  Imran Shah Head - APAC Business, part of the Media and Telecommunication Practice at Kumaran Systems Inc., is responsible for shaping and executing business
  turn-around strategy. Execution focus has been on New Market Sensitization & launching New Service Offerings - managing the entire Lead to Cash cycles for the
  Telecommunication Vertical and can be reached at imran.shah@kumaran.com

  KUMARAN SYSTEMS INC.
  Kumaran Systems, founded in 1990 at Toronto, Canada with global delivery centers across Americas and India is a Major Software Services and Solution provider. With 20+
  years of customer orientation, over 1600 engagements across Media, Telecom, Education, Shipping and Banking & Financial services spread across the globe. Kumaran
  stands as a key advisor to some of the largest Fortune 500 companies in their business driven technology enablement drive.
  Kumaran Systems growth has been evolutionary that began with Migration Products to address industry challenges for legacy modernization to a Business driven Technology
  enabler aligned to focused verticals. Over the past two decades Kumaran System customer orientation has enabled its recognition as a major Technology enabler across
  industry segments delivering enhanced business value for its clients across the globe Kumaran System Customer Orientation is driven by a global delivery business model
  giving its customers to choose between an Onshore-Nearshore-Offshore mix. The delivery models enable multilevel touch points between the client, partner networks and
  Kumaran Systems enabling business driven customer sensitivity and agility.With 500+ employees across the Globe, Kumaran Systems offers comprehensive capabilities,
  resources, facilities (Onsite, Offsite and Offshore) and highly skilled personnel to meet your complex challenges for multiple domains and industries




Thought Leadership                                                           Kumaran Media & Information Communication Technology Practice
Gamification of Health – Healthcare 3.0

                                                                                                                    • Electronic gaming in all its forms is the number #1
  Many new 'experiential' software solutions have emerged and are now being deployed to meet the needs of           entertainment industry on the planet estimated to reach
  health care providers and consumers across the country. These include mobile Health Apps, Health eGames,          $76B in 2013 with CAGR of 8.9%.
  Virtual Worlds, Social Networking, and other related solutions. Many of these innovative next- generation
  interfaces, software applications, and tools can be used to interact with Electronic Health Record (EHR) and      • Facebook is an enormous success (with revenues
  Personal Health Record (PHR) systems used by health care providers and their patients. These new software         expected to reach $2 billion this year), where 500 million
  tools have been designed to be used by people to access a wide range of health information and resources,         members are active users connecting with friends and
  24x7, at home, work or play – moving us closer to the dream of “Healthcare @ Anywhere”.                           playing games such as Farmville. The Farmville game is
                                                                                                                    the biggest single experience on Facebook with 83 million
  This time around at CES Conference 2012, Las Vegas, NV- SensoryAcumen and Scent Geek left the summit              active players (more than any other computer game).
  smell filled (Smell Your games with Sensory Acumen and Scent geek-cetera’s New Gaming Gear ).
                                                                                                                    • Club Penguin, a virtual world, social network and gaming
  What kind of smells are we talking about? Well, in a racing game, if a player isn’t doing so hot, the smell of    environment for kids, was purchased by Disney for $350
  burning rubber will be strong. Another example is a zombie game, where a player could smell which way a           million.
  horde of zombies are hiding based on a rancid, decaying odor in a particular direction and make his way
  around them. This type of feedback adds a whole new dimension to the game, immersing the player in a              • Wii Fit has grossed more than $1billion dollars, and the
  more memorable experience.                                                                                        overall Health eGames industry exceeded $6B dollars with
                                                                                                                    the majority being spent with out of pocket dollars by
  While having the ability to smell gasoline fumes and decaying corpses doesn’t sound like the most appealing       consumers for games with a physical or brain fitness
  form of entertainment, there are also practical benefits to engaging the sense of smell in a virtual              benefit
  environment. The USC Institute of Creative Technologies created Virtual Iraq, incorporating smell into the
  simulation to aid psychologists treating patients suffering from post-traumatic stress disorder (PTSD). It is     • Facebook a social network is nearly equal to Google in
  known that smells can trigger emotion and evoke memory, and as patients become immersed in a life-like            terms of unique visitors. According to AdAge’s Michael
  replica of their stressors, psychologists can help actively guide them through their fears at a pace that works   Learmonth “Web users go to Google to figure out where to
  for them, potentially leading them to recovery. Sensory Acumen’s Game Skunk device will also be able to           go next; they go to Facebook to, well, hang out.”
  serve this purpose, and the company advocates this health care aspect with “gamed skunk.”
                                                                                                                    • Nearly 5 billion phone subscribers worldwide and the
  Games have a number of applications in healthcare.                                                                Mobile gaming market is growing 20% a year and is
                                                                                                                    estimated to reach $11.4B in 2011 with games
           Patients suffering from chronic diseases such as diabetes, asthma, heart disease and cancer can          comprising70 to 80% of all downloaded apps.
           use games such as Re-Mission to manage condition.




Thought Leadership                                                                 Kumaran Media & Information Communication Technology Practice
Games can be adopted in virtual and real physical therapy (e.g. Wii-Habilitation).

           Games with build in health education offer an alternative to traditional learning methods and can significantly improve health knowledge. Professional medical training
           games such as Burn Center™ can also be used in clinical practice.

           Wellness promotion games promote healthy lifestyle and behavioral change and can be classified into four main categories. Exercise games, or ‘exergames’ (e.g. Wii
           Fit Plus and MayaFit) involve physical activity, healthy eating games improve eating habits and knowledge on nutrition and weight management, mental health games
           (e.g. Fit Brains) are designed to improve cognitive abilities and smoking cessation games help smokers quit in an entertaining way.

           Healthcare marketing games have the potential to reach consumers in an impactful and non-invasive way. They can also be used in a social context to inspire
           behavioral change.

  Healthcare companies are becoming active in the Health eGames market. To qualify as a Health eGame, the multimedia gaming experience must be fun and deliver health
  benefits. Health eGames are beyond simple entertainment because they involve health literacy, physical fitness, cognitive fitness, skills development and condition
  management. Above all else, Health eGames are tools for behavioral change. For consumers, a change in behavior could mean regular exercise, stress reduction, smoking
  cessation, adherence to doctor-recommended medicine usage, weight management, healthy eating habits, or other positive lifestyle changes.

  Gamification will revolutionize fitness, health and health care by delivering a new interface with consumers and patients that capitalizes on the strong existing trends in how
  people want to receive information while developing new life skills. A gaming interaction engages people who are sometimes patients, while delivering need-to-know and want-
  to-know healthcare information and services in an enjoyable and often surreptitious manner while collecting data from consumers they willingly provide.

  Gamification, the process of turning work into play, is growing exponentially. It’s no longer a theory; it’s reality, our reality. Social media, gaming and internet connected devices
  from mobile phones and accelerators to geolocation, augmented reality and M2M (machine to machine) sensors are changing our way of life.

  Just like a hammer (which can be used to build a house or commit a crime) – the new media and technologies can be harnessed for good, or not so good, purposes. The
  technology tool is neutral; it’s what we as human do to use it that matters.

  The hook for the new model in gaming and especially Health eGames is that instead of escaping from reality to play games, now we are playing games to connect to reality.
  We can connect with friends and challenge them to a push up contest, walking challenge or diet program. The success of programs like Weight Watchers is that long before
  the current popularity of health-related games, they were using the power of social contagion theory and gaming to equal success. They were using the point system way
  before the current craze to link all our purchases and play to a points reward system.

  The rise of Medical Education 2.0 which is the application of virtual worlds, high and low fidelity simulations, gaming and virtual reality to medical and professional education
  has also proven that these forms of immersive training methods are more engaging than the traditional classroom and just as effective or even more effective to teach and
  learn new knowledge and skills. We humans like to learn by doing!




Thought Leadership                                                                  Kumaran Media & Information Communication Technology Practice
The idea of changing or shifting our paradigm from a “have to” to a “get to” mentality when it comes to health will make all the difference. It you get to play a game to monitor
  your compliance with a disease condition because it earns you points, or you get to meet up with friends online to compete in a challenge will and are driving better self care
  and WILL make us all healthier in the years to come.

  For patients, mobile social gaming is first and foremost fun, but it is also an engaging medium to improve health and fitness through an e-community of caring peers and
  professionals. By capitalizing on technologies embraced by billions of people worldwide, Health eGames can increase patient participation in a program, thereby improving its
  effectiveness. With 4.7 billion mobile phone subscribers worldwide, mobility is a key driver for increased “stickiness” of an application, especially when that application is in the
  form of an electronic game, which is the #1 form of entertainment worldwide. The mobile gaming market is experiencing significant growth at 20% per year, and 70 – 80% of
  applications downloaded are games. And the target demographic is not just young adults, since 42% of Americans over 50 are using social networking tools today.

  Gamification is a core essence of the big three of Engagement 3.0

           Work as play or Gamification for pure entertainment and for improving life, work or school skills as efficiently but more engaging then other learning methods

           Everyone is connected through Internet enabled Mobile Devices

           Social Media platforms from Facebook and Twitter to SharePoint along with the apps and compelling game experiences (Farmville) deliver the place to hang, play or
           do collaborative work

  All of this means that now is the time for investment in “Engagement 3.0” is the application of the popular new, experiential media used by billions – social media + mobile +
  productive entertainment – in all its various forms (video games, mobile games, virtual worlds, MMORPG, virtual reality, social utilities, etc.) to improve our lives. Engagement
  3.0 is a high touch, high tech connection with people that provides real utility in solving problems, improving convenience and enriching lives through social connections.

  The trends indicate that mobile social gaming is the increasingly preferred method for consuming content and information. For decades, there has been a disconnect between
  vast repositories of information that could improve health status and the targets of that information, the patients that most need to access it. Combining these two realities
  means that gaming is the ideal solution for a forward-thinking company to change the paradigm for delivering information that could lead to increased therapy compliance or
  collect information that could lead to earlier diagnoses, just to provide two examples.

  The gamification of health is a natural progression from the health education model of reading and learning to watching these videos and learning to learn by doing and play,
  which by the way is the natural way that all humans learn from the day we are born till the day we die.

  Every aspect of fitness, health and health care will be transformed by Engagement 3.0 tools, technologies, programming and experiences, just as every part of our everyday
  work, family and play lives are being transformed.

  For decades, there has been a disconnection between the vast repositories of information that could improve health status and the beneficiaries of that information, with
  multiple data sources on the fitness, health and medical side enabled by data driven Engagement 3.0 media delivers potential to tackle the difficult challenges. Leadership is




Thought Leadership                                                                  Kumaran Media & Information Communication Technology Practice
the key ingredient within forward-thinking companies and networks necessary to guide us from a culture of obesity and reactive care to a culture of health and proactive
  support of people in their lives.

  Health eGames Market
  Worldwide video gaming is a growth business with sales (hardware and software) of $42 billion
  in 2007, and estimated to eclipse $68 billion by the year 2012 according to a
  PriceWaterhouseCoopers industry report. Health eGames are a new and rapidly expanding
  market segment of video gaming that incorporates elements of three markets: casual games,
  serious games and exergames. According to the Casual Games Association, casual gaming is
  a $2.2 billion market composed of fun and easy to learn video games that can be played
                                                    1
  across mobile, PC, Mac and console platforms. The serious gaming market is estimated to be
                                                                                       2
  between $1.5 and $2.0 billion according to serious games expert Elaine Alhadeff. This market
  is focused on utilizing gaming applications to achieve benefits beyond entertainment, such as
  training, education and performance improvement across industries. Exergames, which
  involves digital interactive physical motion and fitness games, is a $6.4 billion segment and
  comprises the vast majority of the Health eGames market.

  Residing at the intersection of the casual gaming, serious gaming, and exergaming markets,
  Health eGames are estimated to be a $6.6 billion market segment within the $42 billion video
  gaming industry. This is illustrated in the diagram to the right.The $6.6 billion estimate reflects
  a bottom-up analysis detailed in the Market Profile section below.Health eGames leverage the
  easy-to-use, highly engaging and interactive nature of electronic gaming to increase health
  literacy, empower behavior change, and promote professional education. The Health eGames
  market is comprised of five consumer categories and one professional, including:

             Exergames (e.g. fitness, coaching, health promotion)
             Brain Fitness (e.g. cognitive fitness, brain training)
             Condition Management (e.g. diabetes, asthma, cancer, pain management)
             Healthy Eating (e.g. weight management, obesity)
             Professional Training (e.g. simulations for training surgeons, pilots, soldiers)




  1
      Casual Games Association, Casual Games Market Report 2007, page 30.
  2
      http://www.businessandgames.com/blog/2008/04/reconciling_serious_games_mark.html




Thought Leadership                                                                   Kumaran Media & Information Communication Technology Practice
Growth of the overall video gaming industry is expected to be significantly impacted by the non-traditional gaming markets which include serious games, casual games and
  Health eGames.


  Takeaway

  Health eGames Have Gone Mainstream

  Health eGames are gaining widespread acceptance across all age groups and customer segments. In the past few years, women Baby Boomers have readily adopted gaming
  largely due to the growth of casual gaming and also Nintendo’s strategy of targeting this traditionally under-served market segment. Pogo.com, a subsidiary of Electronic Arts
  which operates the largest community of casual gamers, reports that of its 18 million active users, 63% are over age 35 and 61% are women. While children and teens
  continue to enjoy Konami’s Dance Dance Revolution, today we find Boomers sharpening their cognitive skills by playing Brain Age while improving balance and strength with
  the Wii Fit. Meanwhile, seniors are enjoying virtual bowling and tennis from inside retirement communities by playing Wii Sports.

  Social Acceptance of Video Games

  Mainstream adoption of Health eGames is in part a function of a mass social acceptance of video games. 35% of parents play computer and video games while 93% of those
  parents have children who also play games, according to Peter D. Hart Research Associates. 61% of parents believe games are a positive part of their children’s lives
  according to research conducted by the Entertainment Software Association. Exergaming, the largest segment of Health eGames, is likely to gain further social acceptance
  and investment as the United States and other countries work to reduce youth obesity, Type II diabetes and sedentary lifestyles. For example, in 2007 the State of West
  Virginia began deploying Konami’s Dance Dance Revolution in more than 1500 schools as part of its effort to address the childhood obesity epidemic within the context of their
                                   3
  physicial education programming.

  Benefits of Health eGames Are Being Validated Through a Growing Body of Clinical Research

  Several dozen clinical studies have either reported positive results or are currently testing the health benefits of video games on improving health literacy, prevention and
  condition management. Completed studies have examined the impact of Heath eGames on cancer, physical fitness, healthy heating, asthma, diabetes, cystic fibrosis and
  cognitive fitness. For example, a randomized controlled study found that playing HopeLab’s Re-Mission game improved adolescent and young adult cancer patients’ cancer-
  related knowledge, self-efficacy and adherence to their prescribed cancer treatment plan, according to a August 2008 article in the journal American Academy of Pediatrics.
  Many other clinical trials of Health eGames are underway, including 12 current studies being funded by an $8.25 million grant from the Robert Wood Johnson Foundation
  (RWJF). In addition to the evidence base, the experience base of Health eGames is expanding based on the rapid adoption by consumers and professionals, which is being
  documented daily by the news media around the world.


  3
      New York Times, P.E. Classes Turn to Video Game That Works Legs, April 30, 2007.




Thought Leadership                                                                       Kumaran Media & Information Communication Technology Practice
Organizational Awareness and Support of Health eGames Is Accelerating

  For-profit corporations, start-up ventures, government agencies and nonprofits are adopting existing Health eGames and funding next-generation research and development.
  Humana operates HumanaGames.com (HG4H) so health plan members and consumers can “play their way to better health,” Kaiser Permanente is empowering consumers to
  make healthier food choices through award-winning online Health eGames such as The Amazing Food Detective, while CIGNA distributes Re-Mission to help teens win their
  battles against cancer. The Center for Disease Control and Prevention (CDC) has an active presence in the virtual reality game Second Life in order to advance education and
  drive healthy behaviors, such as encouraging flu vaccines. The National Institutes of Health (NIH) awarded a $9 million grant in 2005 to Archimage to create two Health
  eGames to modify children’s behavior regarding diet and nutrition. Johnson & Johnson (J&J) invited industry thought-leaders and entrepreneurs to a two-day learning summit
  on September 18-19, 2008 to examine ways in which Health eGames could enhance J&J’s consumer and pharmaceutical products.

  Quality and Quantity of Health eGames are Increasing

  Over 300 Health eGames have been developed for consumers, patients and professionals. The number and variety of Health eGames are growing rapidly as more developers
  and publishers seek to enter this high-growth market segment. At a September 2008 industry trade show in Montreal, Nintendo and Ubisoft showcased 17 new Health
  eGames in the fitness and life-coach genres, including a new cooking guide, a stop smoking coach, two new yoga trainers and a Pilates guide. One new high-profile example
  is Nintendo’s upcoming Personal Trainer: Cooking! which helps people shop for food, prepare healthy menus and cook meals with the help of a virtual guide who reads out
  instructions during meal preparation. The release of Apple’s iPhone has been a disruptive force across the media and gaming industries including the Health eGames market
  segment. As of mid-September 2008, more than 160 “health and fitness” game-like applications were available on the iPhone to consumers seeking mobile self-care tools.

  Rapid Innovation and Experimentation of Business Models

  The fast-paced video game industry is constantly evolving and creating new revenue models. At the June 2008 Social Gaming Summit in San Francisco, industry-veteran
  David Perry described more than 25 video game monetization methods. Health e-game companies are currently using several of these models and are expected to readily
  adopt best practices from industry pioneers. Examples of health e-game companies using a few of the top business models include:

          Consumer Direct: Nintendo’s Wii, Wii Fit, Brain Age; Ubisoft’s Easyway to Stop Smoking, Konami’s Dance Dance Revolution (DDR), Posit Science’ Brain Fitness
          Program; Fisher Price’s Smart Cycle
          Enterprise: Expresso Fitness’ S2U and S2R; Konami’s DDR, CogniFit’s DriveFit, Dakim’s [m]Power; Posit Science’ Brain Fitness Program
          Advertising: Fit Brains
          Subscription: Lumos Lab’s Lumosity, Happy Neuron
          Sponsorship: Kraft Game Pad, HopeLab’s Re-Mission
          Nonprofit/Government Grants: Archimage’s Escape from Diab (NIH); ArchImage’s Food Fury (Aetna Foundation), MyPyramid Blast Off (USDA)




Thought Leadership                                                             Kumaran Media & Information Communication Technology Practice

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Gamification of health – healthcare 3.0

  • 1. Gamification of Health – Healthcare 3.0 Gaming INDUSTRY Thought Leadership Kumaran Media & Information Communication Technology Practice
  • 2. Confidentiality Statement The information contained in this document is proprietary and confidential. This document, in whole or in part, may not be copied or disseminated to any third party without the express written authorization of Kumaran Systems Inc. "Confidential Information" means any secret or proprietary information relating directly to Company's business and that of Company's affiliated companies, including but not limited to products, research programs, specific software, algorithms, computer systems, object and source codes, pricing policies, technology, employment records and policies, operational methods, marketing plans and strategies, product development techniques or plans, technical processes, designs and design projects, and other business affairs of Company and Company's affiliated companies. The recipient must keep strictly confidential all Confidential Information and will not, without the Company’s express written authorization, signed by one of the Company’s authorized officers, use or sell, market or disclose any Confidential Information to any third person, corporation, or association for any purpose. Thought Leadership Kumaran Media & Information Communication Technology Practice
  • 3. ABOUT THE AUTHOR Imran Shah Head - APAC Business, part of the Media and Telecommunication Practice at Kumaran Systems Inc., is responsible for shaping and executing business turn-around strategy. Execution focus has been on New Market Sensitization & launching New Service Offerings - managing the entire Lead to Cash cycles for the Telecommunication Vertical and can be reached at imran.shah@kumaran.com KUMARAN SYSTEMS INC. Kumaran Systems, founded in 1990 at Toronto, Canada with global delivery centers across Americas and India is a Major Software Services and Solution provider. With 20+ years of customer orientation, over 1600 engagements across Media, Telecom, Education, Shipping and Banking & Financial services spread across the globe. Kumaran stands as a key advisor to some of the largest Fortune 500 companies in their business driven technology enablement drive. Kumaran Systems growth has been evolutionary that began with Migration Products to address industry challenges for legacy modernization to a Business driven Technology enabler aligned to focused verticals. Over the past two decades Kumaran System customer orientation has enabled its recognition as a major Technology enabler across industry segments delivering enhanced business value for its clients across the globe Kumaran System Customer Orientation is driven by a global delivery business model giving its customers to choose between an Onshore-Nearshore-Offshore mix. The delivery models enable multilevel touch points between the client, partner networks and Kumaran Systems enabling business driven customer sensitivity and agility.With 500+ employees across the Globe, Kumaran Systems offers comprehensive capabilities, resources, facilities (Onsite, Offsite and Offshore) and highly skilled personnel to meet your complex challenges for multiple domains and industries Thought Leadership Kumaran Media & Information Communication Technology Practice
  • 4. Gamification of Health – Healthcare 3.0 • Electronic gaming in all its forms is the number #1 Many new 'experiential' software solutions have emerged and are now being deployed to meet the needs of entertainment industry on the planet estimated to reach health care providers and consumers across the country. These include mobile Health Apps, Health eGames, $76B in 2013 with CAGR of 8.9%. Virtual Worlds, Social Networking, and other related solutions. Many of these innovative next- generation interfaces, software applications, and tools can be used to interact with Electronic Health Record (EHR) and • Facebook is an enormous success (with revenues Personal Health Record (PHR) systems used by health care providers and their patients. These new software expected to reach $2 billion this year), where 500 million tools have been designed to be used by people to access a wide range of health information and resources, members are active users connecting with friends and 24x7, at home, work or play – moving us closer to the dream of “Healthcare @ Anywhere”. playing games such as Farmville. The Farmville game is the biggest single experience on Facebook with 83 million This time around at CES Conference 2012, Las Vegas, NV- SensoryAcumen and Scent Geek left the summit active players (more than any other computer game). smell filled (Smell Your games with Sensory Acumen and Scent geek-cetera’s New Gaming Gear ). • Club Penguin, a virtual world, social network and gaming What kind of smells are we talking about? Well, in a racing game, if a player isn’t doing so hot, the smell of environment for kids, was purchased by Disney for $350 burning rubber will be strong. Another example is a zombie game, where a player could smell which way a million. horde of zombies are hiding based on a rancid, decaying odor in a particular direction and make his way around them. This type of feedback adds a whole new dimension to the game, immersing the player in a • Wii Fit has grossed more than $1billion dollars, and the more memorable experience. overall Health eGames industry exceeded $6B dollars with the majority being spent with out of pocket dollars by While having the ability to smell gasoline fumes and decaying corpses doesn’t sound like the most appealing consumers for games with a physical or brain fitness form of entertainment, there are also practical benefits to engaging the sense of smell in a virtual benefit environment. The USC Institute of Creative Technologies created Virtual Iraq, incorporating smell into the simulation to aid psychologists treating patients suffering from post-traumatic stress disorder (PTSD). It is • Facebook a social network is nearly equal to Google in known that smells can trigger emotion and evoke memory, and as patients become immersed in a life-like terms of unique visitors. According to AdAge’s Michael replica of their stressors, psychologists can help actively guide them through their fears at a pace that works Learmonth “Web users go to Google to figure out where to for them, potentially leading them to recovery. Sensory Acumen’s Game Skunk device will also be able to go next; they go to Facebook to, well, hang out.” serve this purpose, and the company advocates this health care aspect with “gamed skunk.” • Nearly 5 billion phone subscribers worldwide and the Games have a number of applications in healthcare. Mobile gaming market is growing 20% a year and is estimated to reach $11.4B in 2011 with games Patients suffering from chronic diseases such as diabetes, asthma, heart disease and cancer can comprising70 to 80% of all downloaded apps. use games such as Re-Mission to manage condition. Thought Leadership Kumaran Media & Information Communication Technology Practice
  • 5. Games can be adopted in virtual and real physical therapy (e.g. Wii-Habilitation). Games with build in health education offer an alternative to traditional learning methods and can significantly improve health knowledge. Professional medical training games such as Burn Center™ can also be used in clinical practice. Wellness promotion games promote healthy lifestyle and behavioral change and can be classified into four main categories. Exercise games, or ‘exergames’ (e.g. Wii Fit Plus and MayaFit) involve physical activity, healthy eating games improve eating habits and knowledge on nutrition and weight management, mental health games (e.g. Fit Brains) are designed to improve cognitive abilities and smoking cessation games help smokers quit in an entertaining way. Healthcare marketing games have the potential to reach consumers in an impactful and non-invasive way. They can also be used in a social context to inspire behavioral change. Healthcare companies are becoming active in the Health eGames market. To qualify as a Health eGame, the multimedia gaming experience must be fun and deliver health benefits. Health eGames are beyond simple entertainment because they involve health literacy, physical fitness, cognitive fitness, skills development and condition management. Above all else, Health eGames are tools for behavioral change. For consumers, a change in behavior could mean regular exercise, stress reduction, smoking cessation, adherence to doctor-recommended medicine usage, weight management, healthy eating habits, or other positive lifestyle changes. Gamification will revolutionize fitness, health and health care by delivering a new interface with consumers and patients that capitalizes on the strong existing trends in how people want to receive information while developing new life skills. A gaming interaction engages people who are sometimes patients, while delivering need-to-know and want- to-know healthcare information and services in an enjoyable and often surreptitious manner while collecting data from consumers they willingly provide. Gamification, the process of turning work into play, is growing exponentially. It’s no longer a theory; it’s reality, our reality. Social media, gaming and internet connected devices from mobile phones and accelerators to geolocation, augmented reality and M2M (machine to machine) sensors are changing our way of life. Just like a hammer (which can be used to build a house or commit a crime) – the new media and technologies can be harnessed for good, or not so good, purposes. The technology tool is neutral; it’s what we as human do to use it that matters. The hook for the new model in gaming and especially Health eGames is that instead of escaping from reality to play games, now we are playing games to connect to reality. We can connect with friends and challenge them to a push up contest, walking challenge or diet program. The success of programs like Weight Watchers is that long before the current popularity of health-related games, they were using the power of social contagion theory and gaming to equal success. They were using the point system way before the current craze to link all our purchases and play to a points reward system. The rise of Medical Education 2.0 which is the application of virtual worlds, high and low fidelity simulations, gaming and virtual reality to medical and professional education has also proven that these forms of immersive training methods are more engaging than the traditional classroom and just as effective or even more effective to teach and learn new knowledge and skills. We humans like to learn by doing! Thought Leadership Kumaran Media & Information Communication Technology Practice
  • 6. The idea of changing or shifting our paradigm from a “have to” to a “get to” mentality when it comes to health will make all the difference. It you get to play a game to monitor your compliance with a disease condition because it earns you points, or you get to meet up with friends online to compete in a challenge will and are driving better self care and WILL make us all healthier in the years to come. For patients, mobile social gaming is first and foremost fun, but it is also an engaging medium to improve health and fitness through an e-community of caring peers and professionals. By capitalizing on technologies embraced by billions of people worldwide, Health eGames can increase patient participation in a program, thereby improving its effectiveness. With 4.7 billion mobile phone subscribers worldwide, mobility is a key driver for increased “stickiness” of an application, especially when that application is in the form of an electronic game, which is the #1 form of entertainment worldwide. The mobile gaming market is experiencing significant growth at 20% per year, and 70 – 80% of applications downloaded are games. And the target demographic is not just young adults, since 42% of Americans over 50 are using social networking tools today. Gamification is a core essence of the big three of Engagement 3.0 Work as play or Gamification for pure entertainment and for improving life, work or school skills as efficiently but more engaging then other learning methods Everyone is connected through Internet enabled Mobile Devices Social Media platforms from Facebook and Twitter to SharePoint along with the apps and compelling game experiences (Farmville) deliver the place to hang, play or do collaborative work All of this means that now is the time for investment in “Engagement 3.0” is the application of the popular new, experiential media used by billions – social media + mobile + productive entertainment – in all its various forms (video games, mobile games, virtual worlds, MMORPG, virtual reality, social utilities, etc.) to improve our lives. Engagement 3.0 is a high touch, high tech connection with people that provides real utility in solving problems, improving convenience and enriching lives through social connections. The trends indicate that mobile social gaming is the increasingly preferred method for consuming content and information. For decades, there has been a disconnect between vast repositories of information that could improve health status and the targets of that information, the patients that most need to access it. Combining these two realities means that gaming is the ideal solution for a forward-thinking company to change the paradigm for delivering information that could lead to increased therapy compliance or collect information that could lead to earlier diagnoses, just to provide two examples. The gamification of health is a natural progression from the health education model of reading and learning to watching these videos and learning to learn by doing and play, which by the way is the natural way that all humans learn from the day we are born till the day we die. Every aspect of fitness, health and health care will be transformed by Engagement 3.0 tools, technologies, programming and experiences, just as every part of our everyday work, family and play lives are being transformed. For decades, there has been a disconnection between the vast repositories of information that could improve health status and the beneficiaries of that information, with multiple data sources on the fitness, health and medical side enabled by data driven Engagement 3.0 media delivers potential to tackle the difficult challenges. Leadership is Thought Leadership Kumaran Media & Information Communication Technology Practice
  • 7. the key ingredient within forward-thinking companies and networks necessary to guide us from a culture of obesity and reactive care to a culture of health and proactive support of people in their lives. Health eGames Market Worldwide video gaming is a growth business with sales (hardware and software) of $42 billion in 2007, and estimated to eclipse $68 billion by the year 2012 according to a PriceWaterhouseCoopers industry report. Health eGames are a new and rapidly expanding market segment of video gaming that incorporates elements of three markets: casual games, serious games and exergames. According to the Casual Games Association, casual gaming is a $2.2 billion market composed of fun and easy to learn video games that can be played 1 across mobile, PC, Mac and console platforms. The serious gaming market is estimated to be 2 between $1.5 and $2.0 billion according to serious games expert Elaine Alhadeff. This market is focused on utilizing gaming applications to achieve benefits beyond entertainment, such as training, education and performance improvement across industries. Exergames, which involves digital interactive physical motion and fitness games, is a $6.4 billion segment and comprises the vast majority of the Health eGames market. Residing at the intersection of the casual gaming, serious gaming, and exergaming markets, Health eGames are estimated to be a $6.6 billion market segment within the $42 billion video gaming industry. This is illustrated in the diagram to the right.The $6.6 billion estimate reflects a bottom-up analysis detailed in the Market Profile section below.Health eGames leverage the easy-to-use, highly engaging and interactive nature of electronic gaming to increase health literacy, empower behavior change, and promote professional education. The Health eGames market is comprised of five consumer categories and one professional, including: Exergames (e.g. fitness, coaching, health promotion) Brain Fitness (e.g. cognitive fitness, brain training) Condition Management (e.g. diabetes, asthma, cancer, pain management) Healthy Eating (e.g. weight management, obesity) Professional Training (e.g. simulations for training surgeons, pilots, soldiers) 1 Casual Games Association, Casual Games Market Report 2007, page 30. 2 http://www.businessandgames.com/blog/2008/04/reconciling_serious_games_mark.html Thought Leadership Kumaran Media & Information Communication Technology Practice
  • 8. Growth of the overall video gaming industry is expected to be significantly impacted by the non-traditional gaming markets which include serious games, casual games and Health eGames. Takeaway Health eGames Have Gone Mainstream Health eGames are gaining widespread acceptance across all age groups and customer segments. In the past few years, women Baby Boomers have readily adopted gaming largely due to the growth of casual gaming and also Nintendo’s strategy of targeting this traditionally under-served market segment. Pogo.com, a subsidiary of Electronic Arts which operates the largest community of casual gamers, reports that of its 18 million active users, 63% are over age 35 and 61% are women. While children and teens continue to enjoy Konami’s Dance Dance Revolution, today we find Boomers sharpening their cognitive skills by playing Brain Age while improving balance and strength with the Wii Fit. Meanwhile, seniors are enjoying virtual bowling and tennis from inside retirement communities by playing Wii Sports. Social Acceptance of Video Games Mainstream adoption of Health eGames is in part a function of a mass social acceptance of video games. 35% of parents play computer and video games while 93% of those parents have children who also play games, according to Peter D. Hart Research Associates. 61% of parents believe games are a positive part of their children’s lives according to research conducted by the Entertainment Software Association. Exergaming, the largest segment of Health eGames, is likely to gain further social acceptance and investment as the United States and other countries work to reduce youth obesity, Type II diabetes and sedentary lifestyles. For example, in 2007 the State of West Virginia began deploying Konami’s Dance Dance Revolution in more than 1500 schools as part of its effort to address the childhood obesity epidemic within the context of their 3 physicial education programming. Benefits of Health eGames Are Being Validated Through a Growing Body of Clinical Research Several dozen clinical studies have either reported positive results or are currently testing the health benefits of video games on improving health literacy, prevention and condition management. Completed studies have examined the impact of Heath eGames on cancer, physical fitness, healthy heating, asthma, diabetes, cystic fibrosis and cognitive fitness. For example, a randomized controlled study found that playing HopeLab’s Re-Mission game improved adolescent and young adult cancer patients’ cancer- related knowledge, self-efficacy and adherence to their prescribed cancer treatment plan, according to a August 2008 article in the journal American Academy of Pediatrics. Many other clinical trials of Health eGames are underway, including 12 current studies being funded by an $8.25 million grant from the Robert Wood Johnson Foundation (RWJF). In addition to the evidence base, the experience base of Health eGames is expanding based on the rapid adoption by consumers and professionals, which is being documented daily by the news media around the world. 3 New York Times, P.E. Classes Turn to Video Game That Works Legs, April 30, 2007. Thought Leadership Kumaran Media & Information Communication Technology Practice
  • 9. Organizational Awareness and Support of Health eGames Is Accelerating For-profit corporations, start-up ventures, government agencies and nonprofits are adopting existing Health eGames and funding next-generation research and development. Humana operates HumanaGames.com (HG4H) so health plan members and consumers can “play their way to better health,” Kaiser Permanente is empowering consumers to make healthier food choices through award-winning online Health eGames such as The Amazing Food Detective, while CIGNA distributes Re-Mission to help teens win their battles against cancer. The Center for Disease Control and Prevention (CDC) has an active presence in the virtual reality game Second Life in order to advance education and drive healthy behaviors, such as encouraging flu vaccines. The National Institutes of Health (NIH) awarded a $9 million grant in 2005 to Archimage to create two Health eGames to modify children’s behavior regarding diet and nutrition. Johnson & Johnson (J&J) invited industry thought-leaders and entrepreneurs to a two-day learning summit on September 18-19, 2008 to examine ways in which Health eGames could enhance J&J’s consumer and pharmaceutical products. Quality and Quantity of Health eGames are Increasing Over 300 Health eGames have been developed for consumers, patients and professionals. The number and variety of Health eGames are growing rapidly as more developers and publishers seek to enter this high-growth market segment. At a September 2008 industry trade show in Montreal, Nintendo and Ubisoft showcased 17 new Health eGames in the fitness and life-coach genres, including a new cooking guide, a stop smoking coach, two new yoga trainers and a Pilates guide. One new high-profile example is Nintendo’s upcoming Personal Trainer: Cooking! which helps people shop for food, prepare healthy menus and cook meals with the help of a virtual guide who reads out instructions during meal preparation. The release of Apple’s iPhone has been a disruptive force across the media and gaming industries including the Health eGames market segment. As of mid-September 2008, more than 160 “health and fitness” game-like applications were available on the iPhone to consumers seeking mobile self-care tools. Rapid Innovation and Experimentation of Business Models The fast-paced video game industry is constantly evolving and creating new revenue models. At the June 2008 Social Gaming Summit in San Francisco, industry-veteran David Perry described more than 25 video game monetization methods. Health e-game companies are currently using several of these models and are expected to readily adopt best practices from industry pioneers. Examples of health e-game companies using a few of the top business models include: Consumer Direct: Nintendo’s Wii, Wii Fit, Brain Age; Ubisoft’s Easyway to Stop Smoking, Konami’s Dance Dance Revolution (DDR), Posit Science’ Brain Fitness Program; Fisher Price’s Smart Cycle Enterprise: Expresso Fitness’ S2U and S2R; Konami’s DDR, CogniFit’s DriveFit, Dakim’s [m]Power; Posit Science’ Brain Fitness Program Advertising: Fit Brains Subscription: Lumos Lab’s Lumosity, Happy Neuron Sponsorship: Kraft Game Pad, HopeLab’s Re-Mission Nonprofit/Government Grants: Archimage’s Escape from Diab (NIH); ArchImage’s Food Fury (Aetna Foundation), MyPyramid Blast Off (USDA) Thought Leadership Kumaran Media & Information Communication Technology Practice