Health Apps and eGames: A New Consumer Interface to PHRs

Shepherdstown 05 May 2009To date, less than 2 percent of the population are using computerized Personal Health Records (PHR) systems like Google Health or Microsoft's HealthVault. This is about to change. We are seeing a major sea change at work - the emergence of eGames and Health Apps as a major new fifth generation multi-media computer interface for consumers that can be used to obtain information and interact with Personal Health Record (PHR) systems.

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Examples of the many multi-media eGames for health that are emerging can be found at www.gaming4health.com. In turn, a list of some of the many of the new, easy-to-use mobile Health Apps designed for iPhones and PDAs can be found at http://www.shepherd.edu/surc/cosi/Health_Apps_For_iPhone.doc.

Traditional Types of Computer Interfaces

  • Command Prompts: 1st generation interface for computer users.
  • Question & Answer: 2nd generation interface for computer users.
  • Menus: 3rd generation interface for computer system users.
  • GUI: 4th generation Windows or web-based graphical user interface for system users.

Health Apps & Wireless Mobile Platforms

Wireless mobile solutions are changing almost everything related to the way people live and work. Smartphones and PDAs are being used not only for voice calls or text messages, but also for tasks typically performed using a computer workstation, including sending and receiving e-mail, browsing the web, managing personal information, and interacting with one's PHR. An excellent article to read about Health Apps and these new mobile health care delivery platforms is "No Small Change for the Health Information Economy" by Drs. Kenneth D. Mandl and Isaac S. Kohane in the New England Journal of Medicine - see http://content.nejm.org/cgi/content/full/360/13/1278

CellularMD is a suite of health care applications that can be loaded on many of today's smart cell phones and PDAs. The suite mobilizes the health care tasks of dictation, document signature, prescription, billing and more. To complete the picture, remember all of the functionality of today's organizer applications: calendar, scheduler, address book, e-mail, instant messaging and more. See http://www.softsource.net/products-CellularMD.htm

Skyscape is a worldwide leader in providing up-to-the-minute clinical information and alerts to medical professionals and specialists via their mobile phones or PDAs. Applications provided include a medical dictionary, drug information, medical calculators, access to Medline, and much more. See http://www.skyscape.com/index/home.aspx

MedicTouch is the developer of the first cellular wearable health and wellness devices. In collaboration with Sun Microsystems, they launched the Pulse Meter mobile health solution for Java technology-enabled mobile phones in 2004. MedicTouch Pulse Meter was the first mobile health and wellness monitor that allows users to monitor their pulse, view the results in a high-resolution screen on a Java technology-enabled mobile phone, and transmit the data to a Java compliant server. The Pulse Meter and Java mobile phone combination created a more ideal health monitoring solution for sport enthusiasts, the elderly, rehabilitation outpatients and health care providers; providing health monitoring anytime, anyplace, anywhere. See http://www.hoise.com/vmw/04/articles/vmw/LV-VM-05-04-25.html

The following table provides a list of just a few of the many Health Apps currently available for iPhones and PDAs for both patients and health care providers:

An article entitled "Cell Phones, PDAs and EHR Systems" published in Virtual Medical Worlds in June 2007 might also be worth a quick read. See http://www.hoise.com/vmw/07/articles/vmw/LV-VM-07-07-14.html

eGames for Health

The worldwide video gaming industry is a thriving business - with hardware and software sales reaching $43.5 billion in 2007 and projected to grow to more than $61 billion in the next 4 years, according to eFuturist, Doug Goldstein. It may be surprising to some that the health care industry has been among the first to recognize the 'game-changing' potential of games in business and other environments. Leaders in the health care sector are now beginning to embrace video games as an integral part of the digitally enabled health culture of the future. Today, there are more than 300 consumer focused Health eGames offering an active, multimedia video experience across multiple platforms - See http://www.iconecto.com

The following are selected examples of eGames aimed at specific health issues or conditions.

Virtual Reality Treatment (ViRT) System - As reported in an article in Virtual Medical Worlds, ViRT uses chromokey technology and gesture control software to insert a patient into a virtual game environment allowing him to have fun while exercising. The patient is stimulated to exercise for longer periods and more frequently whereas the system monitors the progress of the patient. This evolutionary physiotherapy treatment method which applies technologies borrowed from the entertainment and broadcast industries was successfully tested at the Riverside Campus of the Ottawa Hospital. See www.hoise.com/vmw/00/articles/vmw/LV-VM-06-00-26.html

Wiihabilitation - Nintendo's Wii video game system, whose popularity already extends beyond the teen gaming set, is fast becoming a craze in rehabilitation therapy for patients recovering from strokes, broken bones, surgery and even combat injuries. The Hines Veterans Affairs Hospital west of Chicago has bought the Wii system for its spinal cord injury unit. At Walter Reed Army Medical Center, the therapy is well-suited to patients injured during combat in Iraq, who tend to be in the 19 to 25 age range, according to Lt. Col. Stephanie Daugherty. See http://ducknetweb.blogspot.com/2008/02/docs-use-games-for-rehab.html

Dancetown - Touchtown, a company specializing in operating video and computer information networks in senior communities have built and rolled out a specific dance game product for the senior citizen market. Dancetown combines the fun of arcade games with the benefits of dance and physical exercise and applies it to the needs of mature adults. Unique to the design is a web-based system for recording a player's performance and tracking progress over time. A Dancetown player, family member, or medical professional can see at a glance how their dancing is progressing day by day, week by week, and month by month. Players can also see how their scores improve on standardized fitness measurements such as the Senior Fitness Test. See http://www.dancetown.us/

Brain Age - With the Brain Age games, there's a way to make mental exercise fun, even competitive. Just minutes a day, that's all it takes to challenge your mind. Inspired by the work of prominent Japanese neuroscientist Dr. Ryuta Kawashima, the Brain Age games feature activities designed to help stimulate your brain and give it the workout it needs like solving simple math problems, counting currency, drawing pictures on the Nintendo DS touch screen, and unscrambling letters. The handheld system also records your scores so you can track changes over time in your memory skills. With Nintendo DS portability, you can play Brain Age at work, on vacation, or anywhere your day takes you. See http://www.brainage.com/launch/index.jsp

Escape from Diab - Archimage Inc., in collaboration with the Children's Nutrition Research Center of Houston's Baylor College of Medicine, have developed a serious video game on healthy eating and exercise called "Escape from Diab". The project was funded by a grant from the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health. Childhood obesity rates have tripled over the past 40 years, raising the risks of Type 2 Diabetes. According to the Surgeon General, "America's obesity epidemic will dwarf the threat of terrorism if the nation does not reduce the number of people who are severely overweight." Diabetes is already the country's leading cause of new blindness, kidney failure and lower limb amputations. It is also the nation's sixth leading cause of death. This game puts players inside a sci-fi action and adventure where healthy lifestyle choices are the keys to winning. Visit http://www.archimageonline.com/diab.cfm

Amazing Food Detective - This game is aimed at children ages 9-10 and available to everyone at www.kp.org/amazingfooddetective. It complements Kaiser Permanente's nationally recognized childhood obesity clinical strategy. Based on a popular character from Kaiser Permanente's Educational Theatre Program, the Amazing Food Detective takes children through activities that show how to choose healthy foods and get more active. Children playing the game follow the routines of eight culturally diverse children whose activities or conditions would benefit from healthy food and exercise choices.

Life and Death in the Age of Malaria - Malaria is a disease that ravages not only those citizens who inhabit the countries it afflicts but also the many people who travel to such locals. Life and Death in the Age of Malaria is a simulation game currently in development at the University of Wisconsin's School of Nursing and is designed to especially help those traveling and working in areas of high risk for malaria. Visit http://elianealhadeff.blogspot.com/2008/03/g4h-2008-serious-games-enhancing.html

Scenarios

  • A young man cuts his finger on a rusty fence while working in the yard. He pulls out his iPhone and activates his Immunization Health App to quickly see when he last had a Tetanus shot and record this event.
  • A woman turns on her WiiFit system and begins to do her daily exercise routine. The system checks her weight, BMI, records her time spent exercising, calories burned, and more.

Behind the scenes, both the Health App and the WiiFit eGame feed have been interacting with the Personal Health Records (PHR) of these individuals, pulling and pushing data as needed, automatically and unobtrusively updating their health records.

Conclusions & Recommendations

The use of eGaming technology and Health Apps running on mobile communication platforms appear to be the next generation interface patients will be using to obtain medical information and interact with their Personal Health Record (PHR) systems.

The following are some recommendations and next steps health care organizations should consider taking with regards to these new consumer oriented interface solutions - eGames and Health Apps.

  • Consider establishing a work group to identify functional requirements and/or potential uses of eGames and Health Apps by your customers.
  • Conduct a detailed literature search and obtain lessons about the use of eGames and Health Apps by other health care institutions.
  • Identify potential organizations to collaborate with on the research, development, testing and use of eGames and Health Apps for use by patients to improve their health.
  • Conduct a feasibility and cost/benefit study into the use of eGames and Health Apps before fully committing to the use of these technologies.
  • Look for eGames and Health Apps with an interface to the Personal Health Record (PHR).
  • Initiate a pilot project involving the use of eGames and Health Apps for specific areas of concern, e.g. diabetes, physical therapy, etc.

Other Key References & Articles

Authors

Peter J. Groen is an adjunct faculty member of the Computer & Information Science Department at Shepherd University in West Virginia and is one of the founders of the Shepherd University Research Corporation (SURC) - see www.shepherd.edu/surc/cosi

Douglas Goldstein is an "eFuturist", author, speaker, and President of iConecto, Inc. which sponsors Gaming4Health.com. Visit www.douglasgoldstein.com or contact him at doug@iConecto.com


Peter Groen, Douglas Goldstein

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