‘”There are features of games that are highly engaging,” (Byron Reeves) says. “We want to figure out why they work, what ingredients they have, and then isolate them, recombine them in other areas that can be used explicitly for good.”’
If you agree with this, you’ll want to read this article from the Business Innovation Factory (BIF), “Work is a Serious Game.”
What follows is an interview with Leighton Read that is relevant to the conversation in these pages. Leighton has served for the past two years as Chairman of the National Advisory Committee of a program sponsored by the Robert Wood Johnson Foundation called Health Games Research. The RWJF is “the nation’s largest philanthropy devoted to the public’s health” and has a long history of supporting research and advocacy in health and health care. Health Games Research is an initiative within the Foundation’s Pioneer Portfolio, which “focuses on the future, seeking breakthroughs with the potential to generate significant health and social impact.” He was recently interviewed by Maria Chesley Fisk, Deputy Director of the program about the potential and the challenges for health games.
Leighton Read promotes games and ideas from games as tools for improving people’s health and the design of health care jobs and other jobs. The key is well-designed games that engage and motivate patients and employees alike to change their behavior.
When he was an academic internal medicine physician at Harvard in the early 1980s, J. Leighton Read channeled his interest in computer-aided decision support into the creation of the Original Boston Computer Diet, a text-based adventure game in which players could work to make positive changes in diet, exercise, and lifestyle. To design the game, Read brought together a team of providers who knew what it took to develop a healthier lifestyle: a behavioral psychologist, nutritionist, and exercise physiologist. Working with able designers, they created a game in which players selected a simulated counselor, set goals, and received feedback in the form of text, graphs and animation. Read describes the Original Boston Computer Diet as an “early attempt to combine what we knew about what was engaging and motivating in video games with what we knew were effective tools for behavior change.” The game, at $79.95 for the IBM PC and a little less for the Commodore 64 and Apple IIe, saw some success, and Leighton Read was captivated by the power of games.
Better known in Silicon Valley as a successful biotech entrepreneur and investor, Read is now Executive Chairman and co-founder of Seriosity and Chair of the Health Games Research National Advisory Committee. He remains passionate about the potential power of games to improve people’s health. He says, “In a wealthy country like the United States, the leading causes of mortality have a large lifestyle and behavioral component.” Read continues, “Whether it’s teenage driving and sexual behavior, or diet and exercise, there is a massive opportunity to impact health and health care costs by finding better ways to engage people so that they exercise more and have healthier lifestyles.”
And Read thinks games will play an important role because they can motivate people to change their behavior. Read believes we are now in the early days for health games, and he is convinced that we will see games with large numbers of followers in the future. Perhaps slowly, but he predicts surely, games will become useful and popular tools in our slow-to-change health care system.
Research on the effective design and efficacy of health games, including the studies now being conducted by Health Games Research grantees, is critical to moving health games into the mainstream. Read says, “The exciting thing is that Health Games Research is building a basic science to help us understand which design principles and game elements work and in which settings. Research is the way we can advance the field systematically—the only other way is inefficient trial and error.”
But Read does not believe that every game is worthy of inclusion in a study— researchers have to earn the right to study how a game works by first proving that it does work. As he puts it, “There’s little we can learn from games that don’t work. First, you have to have a game that produces a desirable health outcome.” Player participation should be voluntary. The game has to be engaging enough for people to play before it will have an opportunity to change health behaviors. In other words, Read says, “You need engagement before you can even get to efficacy. Then, we want to know how a game works, why it works, for whom, and under what circumstances.” He adds, “We want valid, legitimate health interventions that are safe, both physically and psychologically.”
Read asserts that lessons from today’s technologies, combined with guidance from research on successful health games, will allow us to create better and better games that can be scaled up and reach more patients interested in changing their behavior and improving their health.
Not only can games and ideas from games impact individuals, they can also help create other important changes in our health care system. Read maintains that improving the health care system requires thinking about the employees who keep the system running. He and co-author Byron Reeves have written a book that applies to health care and other business systems, Total Engagement: Using Games and Virtual Worlds to Change the Way People Work and Businesses Compete. Their thesis is that “the psychological power of games can be applied with the objective of improving productivity for employers and job satisfaction for employees.” Read explains further, “The common theme between improving health care and employee engagement is engagement. When someone is engaged, you have their attention. They are activated; they are in a better position to make choices and take action consistent with their own values and their own wishes.”
Read suggests that health care work be analyzed with a game developer’s perspective and infused with engaging game elements. Features of multiplayer games in particular can be highly motivating: inspiring narratives, opportunities to explore and build a trusted reputation, a need for productive teamwork, appropriately timed feedback via multiple senses, and explicit rules that help players (or employees) internalize a “can-do” attitude.
Imagine the job of the medical service provider who fields questions and complaints from patients: phone call after phone call requires polite responses that demonstrate understanding of the patient’s situation and the correct decision to resolve the issue or transfer the call to a manager. Reimagine this job set in a virtual world, say a visually rich pirate world, where points and status are earned for individual employees and their teams based on number of calls completed, complete call log entries, quality assurance ratings, real-time analysis of language and voice stress, and more. Employees can see their teammates’ rankings, aid and encourage them via on-line chat, and spur more quality work. Read calls on this example, similar to one in Total Engagement, to illustrate how many health care workers’ jobs— even those of administrators, doctors, and nurses— could be partially or completely gamified to increase engagement, productivity, and job satisfaction.
Games engage us and can motivate us to change our behavior. Leighton Read wants to use games to change health and healthcare by promoting healthy lifestyle behaviors for patients and productivity and effectiveness for employees. Let the games begin!
Have you watched Jesse Schell’s legendary DICE speech on the gamification of everyday life? If you haven’t, you should. And I mean really, all 28 minutes of it.
There are two main points that really hit home for me. The first because it deals with the thesis of Total Engagement (the Seriosity founders’ book on gaming in the corporate world), and the other because it is just so astounding. I’ll break them down below.
Point #1: Back to Reality. Schell points out that the recent major technological hits (WII, Farmville, Webkins, Guitar Hero) all have a few things in common. Paramount among these is the ability to break through to reality. Yes, these are games, but they all somehow bring us back to reality (WII=the physical body, Farmville=real friends on Facebook, Webkins=real stuffed animal, Guitar Hero= real guitar). This trend is also explored in the movie Avatar, for which we’ve already professed our admiration. Schell shows us that Avatar is all about how we can use technology to get back to nature—something ultimately real and genuine.
This is where the tie-in to serious gaming clicked for me. Employees can use games to cut through all of the corporate garbage that muddles up real achievement. Instead of PowerPoints and buzzwords, games allow people to focus on the task itself, and they are rewarded for doing so. By going virtual, real results are accomplished.
Point #2: Everything will be a game. Starting at about minute 21 of the video, Schell takes us through a day in the life of what he claims is the not so distant future. It’s absolutely riddled with games and bonus points and leveling up, and also full of advertisements for all of the companies that make these games possible. Just about when you’re sickened by the commercialization of it, he talks about how these games are making a living record of everything thing you do. For instance, your grandchildren will know every book you read because of the Kindle/Amazon game you played throughout your life. And then he brings up the ultimate question. Because of these games, and because of the everlasting record they create, will we make different choices and become better people? Or, could it drive unhealthy behavior, as we’ve talked about before?
Gamers already perform every category of information work imaginable, from grind-it-out drudgery to sophisticated analysis and team building, all in the course of digital play. We found evidence of every category of serious work we examined, even though the gamers were doing the work merely because they thought it was fun. Gamers organize, categorize, analyze, evaluate, diagnose, invent, buy, sell, lead, and follow. We found gamers who were manufacturing pharmaceuticals to sell to doctors who healed warriors, roleplaying CEOs who were negotiating financing packages for spaceship leases, guild officers conducting performance reviews for probationary players seeking admission to top teams, and hundreds of people performing jobs that were far less glamorous—casting a fishing pole in a lake hoping to catch (by mere random chance) a prize worth a few gold pieces, searching for hidden
Occasionally we’ll tweet excerpts from our book, Total Engagement, and then give more context here on our blog:
Twitter Tidbits #4:
“People should benefit from game ideas while they are making money for shareholders.” Pg 4
Tweet in Context:
Our major premise is that games can help—big time. We are not talking about gaining a better competitive spirit by learning how to shoot better or win at blackjack, and we are not talking about using video games as training tools. We believe that some people will soon do their jobs inside a game, and many more will thrive in information environments that have features borrowed from today’s best games. In other words, we think people should benefit from game ideas while they are making money for shareholders, not just while they are getting ready to make money for shareholders during training or school. Our thesis is inspired by sophisticated online multiplayer games that require extraordinary teamwork, elaborate data analysis and strategy, the recruitment, evaluation, and retention of top players in multiperson “guilds,” the cooperation of people who have complementary roles that require coordinated action, player innovations that come from everyone, and decision making and leadership behavior that happens quickly and with transparent consequences.
Have you ever watched a friend or offspring deeply engaged in a video game and performing a highly complex but completely artificial task with incredible competence? Could that focus and attention be bottled and used for something serious? We’re convinced it can. This is not so much about how you plan to win against competitors, but how you adapt to an extraordinary new form of media that will affect your enterprise: massive multiplayer online games or MMOs for short. Read the rest of this entry »