Technology Helps to Make Gamification a Game Changer

By Chani A. Cordero, Chief Information Officer, Defense Health Agency

Future trends indicate greater use of technology between patients, clinicians and staff. The App Store lists hundreds of apps for managing health and fitness and some electronic health records offer a mobile app to view personal data. Availability is usually not the problem, but usage and compliance remains elusive. This is where gamification may help.

As a CIO who provides IT support to the 800 faculty and staff who oversee 49 medical training programs for the Army, Air Force and Navy, I always am looking for opportunities to enhance their training programs using IT. Gamification is one tool we use to incorporate curriculum that reaches 18,000 students annually.

Gamification is the concept of using gaming design techniques to motivate behavior change to achieve goals through awards such as badges, trophies or status. The awards could be virtual or physical such as a cleverly designed graphical badge or a decorative medal pin that an employee wears on a lanyard. Gamification is an extension of the engagement model except that it is digital. The objective is to achieve the organization’s goals through the use of gaming.

There are several different avenues of gamification. One avenue is through the use of providing a type of award when a certain task is completed. Consider Boy and Girl Scouts of America. They reward members for completed tasks by giving them badges during a ceremony. The scout members proudly display their hard-earned badge on their uniforms. This concept inspires junior members to accomplish tasks so they can also display their knowledge.

In the digital engagement model, the concept is similar. Several popular health fitness trackers award users when certain goals are met. Like the scouts, they provide rewards for users who perform certain tasks such as reaching a certain number of steps. This allows users to feel a sense of accomplishment. More importantly, it changes the behavior of users to increase their physical fitness. This concept could increase patient compliance with medication usage, patient education or dietary goals. In our organization, the Department of the Army created a cyber awareness game that uses scenarios and awards trophies for users to enhance their cyber training.

Another gamification avenue is through the use of role-playing games. This is using augmented or virtual reality to provide realistic training in a more engaging way. This method may be a computer game or mobile game or a fully developed simulation center. The goal of augmented reality is to train a user in a simulated environment that provides several learning modalities such as visual, auditory and kinetic. It also provides muscle memory, giving the user familiarity with a task before experiencing it live.

This gaming concept could help with mandatory training, continuing education requirements or patient education. Consider the patient education opportunities such as properly administering Narcan or an EpiPen. At the Medical Education Training Campus, we have a fully engaged simulation lab that augments our training for combat medics. The lab simulates a battlefield with smoke, music and mannequins that mimic wounded patients.

Gamification aligns with intrinsic motivation theory, in which a user is motivated to perform a task because the task itself motivates them. Intrinsic motivation is when a user performs a task simply because they find it fun. The inverse is extrinsic motivation, which is giving a reward for doing a task. Receiving a paycheck is extrinsic motivation. Studies show that intrinsic motivation is more desirable than extrinsic because it is an internal desire. Reminding children to use their inhalers could be enhanced by giving game points and objectives for when they use their inhaler. It motivates behavior change.

User satisfaction lies within the game design itself, however, the main goal is to align the users’ desires with the organization’s desires. The game design must lead to intrinsic motivation, which is based on Maslow hierarchy of human needs of social, esteem and self-actualization. There is not a recipe for gamification, but the basic principles are the user experience, award methodology and some level of competition. First, an organization needs to determine where the lack of engagement exists. Next, determine if gamification is the right tool to accomplish the task. Next, decide the platform. It does not have to be high tech – a leaderboard on a white board can suffice. Then monitor the user for habituation by continuing updating the game. Lastly, reap the results of the changed behavior.

There are several opportunities for gamification. Our organization is looking to increase gamification with our staff development. Currently, we are looking at our onboarding process. Our goal is to streamline the process and use mobile technology to complete tasks.

The concept of gamification has been around for a long time. The only difference now is that we are using technology as a way to stimulate the user. Face-to-face engagement is always the preferred method but technology can enhance the encounter.

Lieutenant Colonel Chani Cordero, CIO of the Defense Health Agency’s Medical Education and Training Campus in San Antonio, Texas.

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