Whatever you think you know about mobile health apps – how they’re helping patients stick to their pill schedule, or how they’re encouraging them to eat better or do more exercise – well, they’re doing it all wrong.
At least, that’s according to Michael Fergusson, CEO of Ayoga Health Inc. As the CEO of a company that develops social games for patients, he has spent a lot of time pondering what makes a health-related, mobile app not only useful, but also fun.
The problem with most mobile health apps today is they’re flat, without giving their users the context that games use to be effective, he says – and for patients who need to be encouraged to take their medication, eat healthier meals, or exercise more, they need that context to stay engaged with the apps.
It’s all a matter of providing patients – or players – with context, Fergusson says.
“The problem with patient adherence is, why can’t we get people to do it?” Fergusson said, speaking from Toronto’s Mobile Healthcare Summit on Tuesday. He gave the example of a person who might drink 10,000 cups of sugary, creamy coffee over the course of his lifetime. The problem is that individual never thinks about the consequences of all those cups of coffee – he only sees the one cup he’s enjoying everyday.
“It’s a context problem, and games are a context machine,” he said, adding they’re the perfect vehicle to reward people with something virtual in exchange for a physical activity.
“What tremendous power, we have as game designers, to put people in a context in which they will act in a way that is not intuitively what they would do, if you asked them,” he said, adding Ayogo has been applying this philosophy to its social games, while consulting healthcare providers on the best ways to ensure the games offer tangible health benefits.
“Get them to do something they don’t want to do, in exchange for something they want. This is the power of games.”
In his past lives, Fergusson was a fighter pilot and a terraforming engineer – but now, he’s turned to game design for a social good. In 2012, his work with Ayogo netted him the “social entrepreneur of the year” title for the Pacific region in Ernst & Young’s Entrepreneur of the Year awards, based on how he has been making improvements in patient adherence and driving social change.
For Fergusson, health-related apps are missing three things that game developers have been slotting into their games for years – first of all, a health app should be imbued with a narrative, something that tells a user a story. During his presentation, he flashed a screenshot of a generic mobile app showing users their blood glucose levels.
“There is no story here that matters to me. This is my health we’re talking about, where’s the story you’re trying to tell me? There’s a reason why [there's a] game called Candy Crush, and it is not called Workplace Deadline Crush,” he said.
“Candy is the perfect metaphor, the perfect narrative for a social game … What association do you want people to have with your application?”
One of Ayogo’s games was designed around just this type of problem. Recently launched in closed beta, Monster Manor was built for children who need to consistently monitor their blood glucose levels.
“Someone’s child is diagnosed with Type 1 diabetes. This introduces a whole new universe of monsters into that child’s life. Monsters like coma, and amputations, and stabbing your finger with a needle everyday, seeing your own blood. This is terrifying … and we can’t give them a tool like this to manage that fear,” Fergusson said, gesturing towards a slide of a spreadsheet.
“You have to put in a context they can understand. Monsters that you can care for – if you care for the monsters, the monsters will be your friend.”
The second thing game developers have learned is that games need to offer some degree of progressive mastery. Fergusson likens this to people who are learning karate. It’s great to be a yellow belt, but eventually karate practitioners will want to work their way up to a black belt. And while it’s no fun to do chores like pushups, they will do them if they understand there’s a larger context and a bigger goal at the end.
And while it might be easy to associate this brand of gamification with levelling up, receiving badges, and the like, Fergusson was quick to settle the point.
“Points systems do not work to motivate behaviour on their own,” he said. “The points only matter if they represent something that is truly meaningful to them.”
And finally, health-related games need to be social to encourage patients as they continue to manage their conditions.
For one of Ayogo’s games for adult patients, players help each other to unlock other achievements – and many of the players have reported feeling they should play again just to help others, even though they’ve never met these people in real life, Fergusson said.
While some might wonder whether a health app user would want to broadcast his or her condition to the rest of the world, he added some of Ayogo’s games only allow players to interact in a limited way. For example, players would be anonymous, and they are only able to send each other encouraging, preset messages to each other.
Ultimately, Ayogo is looking to harness the power of gamification to help patients see their own health in a bigger context, Fergusson said. It doesn’t even matter as much if people like the games, as long as they’re using them regularly to improve their health.
“Patient outcomes are the only thing that matter,” he said. “We want patients to know that the people who created the app understand what they’re going through, and that we’re on their side.”
For a related blog post on Fergusson’s talk, head on over here.
Plus, Fergusson tackles some FAQs on health and gamification in the video below, posted on Ayogo’s blog: