Gaming data as an innovative tool to monitor health behaviours

Gaming technology powered by behaviour analytics to monitor and predict health behaviour in different demographics in UK and US.

Carla Brown, PhD - CEO of Game Doctor

Problem:

A recent survey reported that 66% of Americans are worried that they won't be able to afford medical care in 2021 (AccessOne, 2020). These individuals face financial barriers when accessing healthcare and will therefore: A) Report their health conditions less frequently than other Americans and B) Engage less with health services in their lifetime.

These financial barriers are leading to massive gaps in our ability to monitor population health effectively. Traditional services require engagement and interaction from patients for data to be collected and recorded. These 'silent patients' represent a massive risk for future healthcare planning, as we don't fully understand the true picture of our population's health.

The impact of this has been demonstrated for COVID-19, where the rate of infection spread varied significantly between different cultures and communities - something we could of prevented if we better understood the distinct health behaviours of these groups.

It is time to innovate on how we monitor the health of our population, and look to using other methods and platforms that are accessible to patients with financial barriers.  This will be crucial for prevention of future pandemics, and also prevention and management of diseases.

The target audience for the COVID-19 technology is ages 18-30. Our target audience are individuals who have low salaries and cannot afford to access healthcare. They spend approximately $10-20 a month on mobile gaming products and use these platforms as a way to relax and escape real life.

They are not confident with their health, and often make poor decisions when it comes to diet, exercise and wellbeing. They may also experience mild mental health illnesses including anxiety or depression. 

They feel locked out and isolated from healthcare, and ultimately will lose their self-worth and motivation to be healthy.

Through our technology, our goal is to provide them a platform they understand and feel at ease with. Where they can relax and play games, and interact with health.

To understand their needs, we conducted a needs assessment in the UK with 350 individuals to understand their attitudes and pain points. 

We used this data to develop our beta game which we soft launched in November 2020 to gather organic data from the community. As we used a lean approach for the development, we are able to collect data from the community as we push new builds, gathered through traditional feedback data and our analytics.

Public Sector: Public health agencies and organizations (NHS, CDC) will have access to anonymized data for population health monitoring. Initially this will support their surveillance data during COVID-19 and in future will support other areas of health protection and improvement (obesity, mental health).

Health: By providing an application on the most commonly used platform, the mobile device, we can reach the majority of the population ensuring widespread coverage in areas that may otherwise be difficult to reach. 

Our products will give our users increased skills in health, promoting healthy habits and improving health outcomes.

For US users, this will reduce their expenditure on health services long-term, which will result in cost-savings. 

For UK, this will result in reduced pressure on NHS, reducing healthcare costs in the UK and capacity for patients and new services. 

Our COVID-19 application will improve their knowledge of virus prevention and control, reducing risk of them catching and spreading COVID-19 during the pandemic, and while virus is circulating.

It will also improve their confidence around vaccines, helping them make informed choices on COVID-19 vaccines.

To this end, the goal outcomes are:

- Reduced infections and cases in our players

- Higher than average level of vaccine uptake in our players

How to evaluate: 

Our data science team will analyze data obtained from analytics and segment players into different profiles (i.e. use vaccines alot in game; dont use vaccines in game). We will then measure behaviour change over time by creating pre- and post- profiles (i.e. day 1 vs day 30) for all domains in the Theoretical Domains Framework. This will help identify what domains are most important at influencing behaviour, and are more effective at measuring it.

To the database we will then add external and open source data available from Public Health Scotland and England, and CDC for COVID cases and vaccine doses.

Formal evaluation will be conducted by University of Stirling psychology research group using mixedresearch methods to compare gaming behaviour with real-life behaviour. This will validate analytics.

Strategic partnerships:

Public Health Scotland: Game Doctor will partner with Public Health Scotland to validate analytics methodology and improve dataset by supplementing game data with PHS surveillance data. This project will evidence and of value of our service and methodology, improving partnership with Public Health Scotland.

We will also explore working with NHS as a data partner to improve surveillance work.

Pharmaceutical industry: 

We will approach pharmaceutical companies and medical PR agencies in U.K and US developing COVID-19 vaccines and therapeutics to explore opportunities for marketing campaigns.

We have a relationship with Pfizer UK.

Game Publisher:

Game Doctor aim to recruit game publisher for future applications and products. This is now being explored with University of Stirling for COVID application. We will also explore publisher relationships with pharmaceutical companies for future applications.

Expansion plans:

Expansion plans include offering of service to consumers (B2C) through marketing on application stores and freemium + subscription models.

Expansion plans also include development of predictive algorithm for behavioural health using datasets obtained from applications. This will be licensed to customers with large volumes of social media and marketing data.

Users and player profiles

For our COVID-19 application, we need players to use the game for 5-7 days to be able to collect meaningful data on their behaviours. We will therefore use users and retained users as an indicator.

- Users of our application is first indicator. We currently have 1000 active users in UK and US

- By Year 2 we aim to have 100,000 users (approximately 33,000 player profiles analyses)

- By year 3 we aim to have 1,000,000 users (300,000 player profiles analysed).

Domains targeted:

With the current version of the application, we are able to collect data on 3/14 domains using the game features/environments we have included.

We will update the game over three years to ensure all 14 domains are targeted and collected on.

Year 1 (current): Knowledge, Skills, Beliefs about consequences, Memory, decision making, Goals, Intentions

Year 2: Knowledge, Skills, Beliefs about consequences, Memory, decision making, Goals, Environment, Social Normal, Social Identity, Regulation, 

Year 3: Knowledge, Skills, Beliefs about consequences, Memory, decision making, Goals, Environment, Social Normal, Social Identity, Regulation,  Optimism, Beliefs about capabilities and - Emotion (this will be the most challenging).

Partnerships and research:

Year 1 (current):

- Feasibility study with University of Stirling

- Data science research placement with The Data Lab, Edinburgh

Year 2: 

- Small clinical trial with University of Stirling to validate analytics.

- Complete all regulation and compliance required for NHS and public sector partnerships.

Year 3: 

- Feasibility study with NHS

- Large trial with University of Stirling and NHS/Public Health Scotland

Market:

The UK market is still very immature of healthcare gamification and a massive culture change is needed. Although COVID-19 has accelerated this culture change, clinicians and healthcare professionals are still hesitant about using 'games'. As a company we are determined to educate the community through attending and presenting at events and sharing progress with our stakeholders. The US is less of a risk for market acceptance.

Regulations and compliance

To work with NHS and public sector, technology and production methodology must meet certain compliance regulations. Ultimately this will increase costs due to the documentation required and audits involved. We will initially create a roadmap of our product development (low cost) and work on developing our regulation and compliance documentation in collaboration with NHS and government stakeholders.

Financial

We need to validate analytics methodology with player research to compare game behaviour with real-life. For this we need capital to fund the research and fund the R&D required. Our key goal for 2021 is to raise 500k angel investment, Carla Brown is spending 80% of her time on this from June.

University of Stirling - research partner for COVID-19 application and co-applicant for Innovate UK grant in 2020

The Data Lab, Scotland - partner for analytics work in Scotland. We are currently working with them for a data science project in summer 2021 where we have recruited a data science MSc student to analyze pilot game data from COVID-19 application

We truly believe we have developed an innovative solution for behaviour modification and measurement. We are a team of scientists and game developers located in US and UK.

We have the skills, passion and technology to solve massive health challenges but need both financial and advisory support to get our solution to the stage it needs to be.

Facebook - we would be interested in working with Facebook to improve our analytics design and game mechanics we use to capture the TDF data.

We would also be interested in working with psychologists research institutions in the US to allow us to conduct clinical trials with US users.