Putting Serious Games for Health in the Chronic Care Model

Our healthcare system of today is based on a system that is very good at treating acute illnesses. If something is broken or diseased, a patient is admitted to the hospital and receives care by a team of professionals until they are well enough to go home.

This health care model is rooted in history. It worked well over 100 years ago when people lived to the age of 49 on average and they died either of an acute illness or of a chronic disease that had no cure at the time (e.g., cancer or heart disease).

This acute care model has less value in advanced societies of today in which the average life expectancy has almost doubled and most people are living a great portion of their lives with chronic illnesses. These people have to interact with the health care system on an ongoing basis. Then, when they are sent home from the hospital or doctor’s office, they still have a disease that they need to manage on their own outside of the watchful eyes of a health professional.

In sum, health care has shifted from the care of a passive patient to one that requires patients to be empowered to manage their health by engaging in behaviors that prevent disease and manage chronic diseases and disability over time.

What does this new model look like and where can serious games and gamification fit in?

There are efforts to move health care to a new model of care called the Chronic Care Model (CCM). The Chronic Care Model was conceptualized to address the growing burden of chronic diseases in a health system that was structured to treat acute illnesses and injury as described above. It focuses on restructuring health care systems to provide higher quality care and increase patient engagement in self-management of chronic illnesses in a way that addresses their physical, psychological and social needs.

The CCM model is based on a review of diabetes interventions that showed that multifaceted interventions that included one or more of four categories led to the greatest improvements in outcomes for organizations and patients. These four categories are

• Education programs, audits and feedback, peer reviews, and reminders focused on the physician,
• Patient-focused interventions that provided information or support,
• Interventions that promote more team-based approaches to care delivery, especially ones that enhance the role of the nurse, and
• The use of registry-based computer information systems to track patients.

One thing that the Chronic Care Model does not specifically acknowledge but is clearly needed, are strategies that are engaging, challenging and even enjoyable for patients and members of the medical team. These strategies should move patients from being passive to being more active. This is precisely where gamified approaches can step in to play a role. They may be able to support efforts within the Chronic Care Model to be more effective and appealing. There is already good scientific evidence that serious games for health can improve adherence to cancer treatment and help improve depressive symptoms as well as traditional face-to-face psychotherapy. These games put the power of health actively in the hands of patients. Reviews of games for health also show that games to improve physical activity and promoting physiotherapy are showing a pattern of positive results.

Health care is overdue for a change. By implementing serious games and gamification in the movement to improve healthcare, we may not only make the change more enjoyable, we might even make healthcare fun!