Integrating Games into Medical Devices To Improve Patient Outcomes

By Lorenzo Gutierrez
February 13, 2023


• Categories: 04-Product Design & Development, Patient Engagement, Patient Safety, Product Design, RC - Device Design & Manufacturing, SaMD

 Digital games are a part of modern life. Looking at the popularity of computer games, it is easy to imagine that integrating games into a medical device could increase its adoption and use. Gamification could potentially help in the diagnosis, treatment, speedy recovery, and rehabilitation of patients.

There are several ways that gaming can be integrated via software apps, graphic interfaces, instructions, or audio/visual sub-components of the device, including:

Patient interface. Gaming elements can be integrated at the interface between the patient and front-facing display, software, or app (game component) to provide users with feelings of satisfaction, relaxation, and enjoyment while using the device. For example, a typical dialysis session lasts three to four hours. Game features could show procedure progress using game-inspired user interfaces, sensory feedback, motivational stimulations and/or a reward system.

Game components in the medical device. Game components can be integrated into medical device functionality and operations, including hardware or firmware run by the computer, a mobile device, or any other electronic processing unit that enhances the functionality and effectiveness of the medical device. The added component might include a sensory feedback mechanism to monitor patient response and performance. For example, a health monitoring device that encourages and even rewards (i.e., toys or gift cards) the patient for adhering to the recommended treatment.

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Games as a medical device. Full integration of gaming as a medical device could include software app or equipment for diagnosis, treatment, or rehabilitation from a stroke, accident, surgery, or therapy. One example is the use of an articulated robotic system for rehabilitation that exercises body parts after an illness or operation. Game features would encourage, motivate, and reward the patient as they progress in the therapy. Here, the core of the medical device is the game.

Basic Digital Game Elements

Games captivate people, keep the brain active, and bring out our problem-solving instincts. Some induce a psychological state wherein worries, pain, and uncertainties are lessened. How do they do this? Animation, visual presentations, interfaces, audio, and interactive feedback mechanisms capture attention and engage users in a fun and enjoyable manner that can leverage behavioral responses. Games trigger the brain to solve problems, become curious, or enter exploration mode through an environment of challenges and rewards.

Games provide positive feelings of achievement and satisfaction. They also catalyze engagement and motivation. Elements such as points and rewards challenges, feedback, exploration, and storytelling are very effective in engaging users.  Virtual personalities and locations can enhance the gaming experience and be employed based on the complexity and purpose of the game.

What Makes Digital Games So Enticing?

How do games affect human responses and psychological behaviors? This is a complex topic that has been the subject of much research. Many successful game programs include the following features.

Immersion. A feeling of engrossment within the game manifested by increased attention and the suppression of attention to external stimuli[1] can increase physiological arousal. An interesting study that measured the feeling of immersion using eye tracking found that immersion could be determined by measuring the duration of staring at the game without changing the gaze.[2]

Inducement of positive feelings or fulfillment. Computer games provide users with feelings of mastery and engrossment while completing a task. Games are capture players’ attention and create a desire to continue to the next level by imbuing a sense that the next level will be a more exciting, challenging, and fulfilling experience.

Feedback systems that measure and mimic virtual and real-world experience. Games use feedback systems to mimic the real-world through audio, visual, haptic, or other sensor technologies. In more complex gaming platforms, the feedback system simulates the feeling of a wind gust, drops, vibration, acceleration, or even, smell. Psychological and behavioral responses,[3] including emotions, can be measured using fEMG (facial electromyography), GSR (galvanic sensor response for electrodermal activity), ECG (electrocardiogram for detecting heart rate variability to determine the mental states, and level of psychological arousal), eye tracking  (to record the duration of stare and gaze), haptic feedback from both the game and the player, breathing sensors, and facial movement and recognition algorithms.

Content that addresses human instinct, needs, and desires. Games can address human aspirations, needs, and desires that a player is not able to achieve in the real world using sensory stimulation and feedback systems.

How Games Support Better Patient Outcomes

Getting sick is no fun.  Using a medical device that is complex and odd-looking scares many people and makes them very uncomfortable. This is one of the reasons some patients avoid hospitals for medical treatment. On the other hand, people spent many hours playing computer games and find them satisfying and rewarding.

Integrating games into medical devices is one way to make the medical device or treatment more enticing and fun to use. When implemented as the front-facing interface, a medical device graphical user interface, or a complete medical device gaming system for rehabilitation and therapy, games can reduce fear and enhance compliance with treatment.

There are many potential advantages and possibilities for the integration of games into medical devices. No. 1 being that gamified medical devices could make patients feel happier, more engaged with their treatment and motivate them to stick with their treatments, facilitating a speedier recovery.

References:

[1] https://www.med-technews.com/news/Digital-in-Healthcare-News/partnership-develops-video-game-style-technology-to-reduce-r/

[2] Drachen, A., Nacke, L. E., Yannakakis, G., and Pedersen, A. L. (2010). Correlation between heart rate, electrodermal activity and player experience in first-person shooter games. In Proc. Sandbox ’10, ACM, 49–54.

[3] Malińska, M., Zużewicz, K., Bugajska, J., & Grabowski, A. (2015). Heart rate variability (HRV) during virtual reality immersion. International journal of occupational safety and ergonomics: JOSE, 21(1), 47–54. https://doi.org/10.1080/10803548.2015.1017964