• Gamification
  • Three mHealth apps help with treatment adherence

    Adherence to medication is an increasing problem in primary health care in Africa. It is important for many things, from birth control to antibiotics to ARTs. When medications are forgotten or skipped, most treatments are no longer as effective.  This becomes both costly for the healthcare system and detrimental to a patient’s health.

    Factors impacting adherence are multifaceted and include social, economic and psychological motives.  A sub-Saharan study in 2017 reported the most common barriers to adherence were;

    ForgettingLack of access to adequate foodStigma and discriminationSide-effects of the medicationTraveling

    With the uptake of smartphones in Africa, mHealth apps targeting treatment adherence could be a simple solution.  Here are the top 3 downloaded treatment adherence apps on Google Play Store. 


    This app turns patient education into an adventure game and shows patients the importance of sticking to a treatment schedule.


    In addition to medication reminders, this app will notify friends and family if the user defaults. Medisafe also launched a low-tech version that sends reminders through automated phone calls and text messages. 


    After logging their medications on the MyTherapy app, users will receive reminders and alerts to take their medications.  Other features on the app include symptom tracking, healthy lifestyle tips and friends and family support groups.

    Improved adherence means a healthier society and ultimately, a reduced burden on healthcare systems.  Moreover, access to adherence data from these apps could help doctors and policy makers make better informed decisions about how to improve the healthcare system.

  • Gamification and eHealth join on the Baltic Sea

    For eHealth enthusiasts making their plans for March 2018, how does a cruise on the Baltic sound? You can take in an international eHealth event while you’re there.

    Not to be outdone by the 22nd ISfTeH conference, a superb event I attended in Casablanca, Morocco in November 2017, the 23rd ISfTeH event’ll be held on a cruise ship travelling between Helsinki, Finland and Stockholm, Sweden.

    The theme for the conference is "Health communities facing cyber transformation". The event’s a collaboration between the Finnish Society of Telemedicine and eHealth and the International Society for Telemedicine and eHealth.

    ISfTeH has become known for innovative collaborations. The 2018 event will include eHealth2018 Game Jam organised by Games for Health Finland. Game Jam brings together healthcare professionals and game makers to create new ideas and ways to use eHealth technology and promote eHealth using gamification. The challenge’s to create a new solution in under 29 hours. Game jamming is a constant learning process for beginners and pros alike, inviting all skills to participate, whether you’re a programmer, designer or story teller. 

    Conference topics also include:

    Citizens as partners: disrupting healthcareCyber era in leadership and educationBenchmarking nationwide eHealth communitiesBeating Cancer with the help of cyber communityTackling acute crisis in local and distant environmentsCollaborating innovationsMy solutions: eHealth around the world.

    So whether it’s the Baltic Sea or the eHealth experts you’re most keen to see, the 23rd ISfTeH Conference sounds attractive. I hope to see you there.

  • Three ways gamification helps people stay healthy

    If you measure your daily step count or chase after Pokemons, you’ve already succumbed to the charms of gamification and its habit-creating powers. Expect to see more. Gamified apps, devices, and therapies will appear in every field of healthcare, making behaviour change easier and more fun.

    Game play focuses and controls our attention, helping us tap into our innate strengths.  It compels us attain more powerful and effective skills. That’s why many believe it is perfect for behavior change that’s good for our health.

    A game is more than automated collection of vital signs and notifications. Gamified services engage us, keep us motivated and help us achieve change. It’s the combination of a great friend and a considerate parent. That’s why gamified solutions will spread like silent epidemics for better health. 

    Here are three ways gamified solutions are already helping large numbers of people stay healthy:

    Physical Fitness - Fitbit has been one of the most popular gamified devices in helping people attain their physical fitness and wellness goals.  Users may set up challenges on the Fitbit community interface and compete with one another to motivate better gym performance and step counts.  Medical aid schemes, such as  Discovery, further encourage fitness and wellness by providing points for step counts.  These points accrue to rewards and savings on selective lifestyle purchases for achieving members.Medication and chronic disease management - Mango Health developed a smartphone application designed to motivate patients to take their medications on time. Users set the times when medications should be taken, and the app reminds them. It also provides information about the medications and warns about drug interactions and side effects. By taking the medications properly, users earn points towards gift cards or charitable donations in raffles held weekly.Physical therapy and rehabilitation - GestureTek Health is a Canadian company that develops applications specific to health, disability, and rehabilitation. Its virtual reality exercise programs enable patients to have fun while stretching their physical and cognitive capabilities. MindMaze created devices, which use virtual reality, brain imaging and gaming technologies to retrain the brain in stroke victims. It also works on solutions for spinal cord injury and amputee patients. If you’re making healthy choices without thinking about it, and an App is helping to make those choices easier and more fun, you’re already doing it.  Us Africans want health to be fun and look forward to seeing much more gamification in the African health innovation landscape soon. 

  • Gamification can improve some short-term memory

    As people live longer, memory impairment becomes a bigger challenge. A study by a team led by Cambridge University, reported in The International Journal of Neuropsychopharmacology, found that episodic memory improved in the cognitive training group using gamified cognitive training. It also may enhance visuospatial abilities in patients with amnestic Mild Cognitive Impairment (aMCI), a potential precursor to dementia. aMCI’s a transitional phase between the normal forgetfulness of cognitive decline that’s a natural part of aging and serious memory problems of dementia’s onset and subsequent stages

    The gamification used by the study maximised engagement with cognitive training by increasing motivation. It’s seen as a potential complement to pharmacological treatments for aMCI and mild Alzheimer’s disease. Larger, more controlled trials are needed to replicate and extend these findings. 

    Cambridge Neuropsychological Test Automated Battery Paired Associates Learning Task (CANTAB), wittily, the same suffix shortened from Cantabrigiensis, used to reveal the origins of degrees from Cambridge University, was the game used in the study. It was accessed with iPads. There were several measures used to test performance. The Cognitive Training Group (CTG) achieved improvements on:

    Total errors by 23%Total trials by 25%First trial memory score by 21%Outperforming the control group on:

    o   Reduced errors at the second- and third-pattern stages

    o   Number of trials needed for completion

    o   Correctly remembering locations of more patterns after the first trial summed across all stages completed, the first trial memory score.

    Using the game for cognitive training improved the CTG members’ motivation. It maintained high levels of enjoyment and motivation and promoted confidence and subjective memory abilities. iPads probably increased active engagement. 

    Other features of the study included:

    Public and patient involvement during the game’s developmentReduction in negative stigmaCost effectiveNo side effectsPotential of combining neuropsychiatry with gaming technology to lead to more innovative non-pharmacological strategies for cognitive restoration and enhancementAlter public perception of cognitive interventions for memory loss. 

    It offers Africa’s health systems an effective option for the dementia services they’ll need. If these expand as the study envisioned, they could help to address the affordability challenges.

  • Sea Hero Quest helps dementia research

    Computer games are both fun and serious. Sea Hero Quest has both. It’s a spatial game on smartphones that collects global data about dementia. It’s claimed that data from 100,000 players each playing for two minutes could provide the volume of data from 50 years of laboratory research.

    It was developed by a team of scientists from University College London, the University of East Anglia and Alzheimer's Research UK. They built it round a character on a mission to find sea creatures his ageing father discovered when he was a sailor. 

    The challenges mainly involving navigating a ship to predetermined areas and encountering difficulties finding a way around familiar places. It mimics early signs of dementia. The game tracks players’ progress and the direction they’re facing. Elementary questions pop up during the journey. All the data collected’s anonymised and stored securely.

    The research objective’s to learn how well men and women perform at different ages and different places in the world. Data provides trends on dementia’s progress as a disease.

    User’s from landlocked African countries needed by daunted by a lack of seafaring experiences. The games objective’s to search, not to sail. It would valuable to have an African sub-set of the data by country.

  • What's gamification's future in healthcare?

    Games are fun. They have serious benefits too. The concept of using games to improve healthcare outcomes isn’t new. Although its been part of most health tech conferences the world over, it never seems to take central stage. At a late-day session at HIMSS16, Amanda Havard, Chief Innovation Officer at Health: ELT and Charlie Schroder, a digital strategist and consultant, talked about what’s holding the space back and how health stakeholders can launch gamified apps that really work, says an article in MobiHealthNews. 

    They cite several examples of healthcare gamification efforts with powerful effects. One game, from 1997, was designed to help children manage diabetes and led to a 77% reduction in urgent care visits. In another, people were motivated to exercise after virtual exercise in a game with an avatar that looked like them.  

    Havard and Schroder asked why such positive data hasn’t lead to broader adoption. “There are a lot of question marks over therapy that’s a digital tool — Where does that fall? Who needs to say that’s ok? Is there liability attached to that?” said Havard. “I tend to think that the unknown aspect here is what’s really keeping this from blowing up. If you think about what would happen if you had a drug that posted these kinds of numbers, that’s great, but that’s because there’s already a concrete vetting process of how you do a clinical trial, how you evaluate a drug.” 

    Havard had several suggestions for healthcare stakeholders looking to make gamified apps and health games work in the real world. The key theme was the importance of taking games seriously.  “You need executive buy-in,” she said. “Obviously every organization is different, but you need the people far enough to the top to understand what you’re trying to achieve with better health outcomes. Think ‘We have decided to start analyzing our populations in such a way that we can give them targeted health initiatives, and this is how we’re going to do it, we’re going to see it through.” 

    She said it’s vital to recognise the diversity in populations and build apps with specific groups in mind. “You have to have clearly defined goals in terms of clinical outcomes and clearly defined patients. You don’t have to reach every member via a gamified app, via a mobile platform, via a game, today, tomorrow, or whenever you roll it out. Figure out what your pain points are, what the golden outcomes are, and go from there.” 

    These are valuable insights. Healthcare organisations, app developers and startups developing and implementing healthcare games apps need to keep these in mind to build relative and effective apps. Is gamification an underused innovation in Africa’s health systems? It could be a bigger part of mHealth.

  • Brushing teeth's a game

    Tooth decay is the second most common disease. Cold is first. Paul Varga from University College London (UCL) can’t do much about colds, but he can help fight tooth decay. He told the Royal Society of Medicine’s Spring Innovation Summit 2015 about PlayBrush, his initiative with his colleagues to improve children’s dental health.

    About 30% of children under five have tooth decay. PlayBrush turns brushing into a computer game. As it measures brushing times, locations and effectiveness, a device in the brush connects through Bluetooth to a simple game on an iPad. Brushers are the game controllers. Children are the players. The result is brushing teeth is fun.

    Average brushing time’s less than a minute. With PlayBrush, 91% of users brush for two minutes. This achievement leads on to collecting individual’s data that dentists can use to frame bespoke advice for their patients.

    Two themes emerge from PlayBrush. One is, how can it roll out on a global scale? The other is, how can gamification help with many other health initiatives?

  • It's eHealth, Jim, but not as we know it

    Computer games are seemingly ubiquitous for some generations. It may be about to expand across age groups. A study in Nature shows that some video games can enhance cognitive control and multi-tasking in healthy people over 60. Dr Gazzarley, who works at Gazzarley Laboratories, a cognitive neuroscience research facility at the University of California, San Francisco (UCSF), studies the neural mechanisms of memory, attention and perception, how these processes change with childhood development, normal aging and dementia, and finding ways to intervene therapeutically to alleviate cognitive deficits.

    His team has found a way to use a video game designed to improve cognitive control to reverse some of the negative effects of aging on the brain. The findings are important for two reasons. One is the benefits for people over 60. The other is that UCSF reports that the research team says the study provides scientific support for brain fitness that has been criticized for lacking evidence.

    Multitasking ability diminishes rapidly over adult lifespans. Researchers call this “multitasking cost.” After training for a month on NeuroRacer, a 3-D video game developed by the UCSF researchers, they found significant improvements in study’s 60 year-old plus participants.  A chart in UCSF article shows the improvement as up by almost 60 percentage points after a month, and nearly 60 percentage points after six months, though on different parts of the curves.

    It seems that not all games have this effect, so there is no excuse for teenagers to lock themselves in their bedrooms for even longer, claiming they are putting off aging. They could be deferring their education.

  • Health, fun and computer games fit together

    Fun and games are both good for health. This applies to computer games too, that may be less mindless than some people think.

    Games for Health thinks computer games have a lot to offer health. It lists a range of computer games that aim to help people with a range of health issues from children’s healthy eating to improving cancer treatment. Many of the games are from Healthcare Social Media owned by Sympler, a Canadian company.

    The concept underpinning these is gamification, a term coined by Nick Pelling, a UK computer programmer. It uses game techniques, mechanics and dynamics as a psychological tool to realise people’s will for achievement. Next time you see young people hectically manipulating their thumbs on a smart phone, they may not be the mindless endeavours you thought they might be.

    It could be just another example of how social media is transforming many aspects of our lives. And who knows, some of these health gamers may be from the older generation who have become silver nerds, a future that might await us all.