Dan Baden's presentation at the 2011 G4H Conference.

1. Games and Innovation for Public Health Dan Baden, MD Centers for Disease Control and Prevention May 18th, 2011 Department of Health and Human Services Centers for Disease Control and Prevention

2. Topics Overview of CDC Examples of past & current efforts Speed bumps Innovation fund Partnering opportunities

3. What I’m Playing Civ V RRT3 7 Wonders Innovation Kinect Sports My Story

4. CDC Organizational Chart

5. CDC Mission Collaborating to create the expertise, information, and tools that people and communities need to protect their health – through health promotion, prevention of disease, injury and disability, and preparedness for new health threats.

6. Winnable Battles Each area is a leading cause of illness, injury, disability or death and/or represents enormous societal costs Evidence-based, scalable interventions already exist and can be broadly implemented Our effort can make a difference We can get results within 1 to 4 years – but it won’t be easy

7. Key Winnable Battles Healthcare- AssociatedInfections Nutrition, Physical Activity, Obesity & Food Safety Teen Pregnancy HIV Motor Vehicle Injuries Tobacco

8. What Public Health Can Do Help win these public health battles Priority issues at the local, state and federal levels Known, effective, scalable interventions Potential for large impact on health Collective and focused efforts Identify optimal strategies at all levels, across all sectors Rally resources and partnerships Communicate about successes and challenges along the way Accelerate efforts to make measureable impact on health

9. Highlighted Activities HealthBound Virtual Reality Resiliency Training Virtual Mine Sites Whyville: Whyflu Others

10. HealthBound Policy Simulation Game

11. HealthBound Causal Pathways

12. HealthBound Intervention OptionsA Short Menu of Major Policy Proposals Expand insurance coverage Improve quality of care Coordinate care Enable healthier behaviors Expand primary care supply Simplify insurance Improve primary care efficiency Build safer environments Change self pay fraction Create pathways to advantage Change reimbursement rates Strengthen civic muscle

13. Illustrative Scenarios Expand Insurance Coverage Reduces the uninsured fraction by 90% Implementation Cost = $20/beneficiary/yr. Coverage & Quality Improve Quality of Care Raises provider adherence to guidelines for preventive, chronic and urgent care (reducing non-adherence by 50%) Implementation Cost = $10k/MD/yr.; $500k/hospital/yr. Expand Primary Care Supply Raises the number of primary care providers per capita to the Disadvantaged by 60% over 15 yearsImplementation Cost = $300k/additional MD + Capacity Improve Primary Care EfficiencyRaises the fraction of primary care offices that run efficiently (reducing inefficiency by 90%)Implementation Cost = $10k/MD/yr. Enable Healthier BehaviorsIncreases the fraction with healthier behavior (reducing unhealthy behavior by 40% over 15 years)Implementation Cost = $2,000 per person helped + Protection Build Safer EnvironmentsIncreases the fraction living in safer environments(reducing unsafe environments by 50% over 15 years)Implementation Cost = $500 per person helped

14. Simulated Results: Morbidity Average Unhealthy Days per Month Days per month (average over entire population) 6 5.25 Coverage + Quality Coverage + Quality + Capacity 4.5 Coverage + Quality + Capacity + Protect 3.75 3 -5 0 5 10 15 20 25 Year HealthBound is designed for training purposes. Simulated scenarios cannot be interpreted as predictions for the future.

15. Simulated Results: Total CostsHealth Care Costs + Intervention Program Costs Dollars per capita per year 600 Coverage + Quality 300 Coverage + Quality + Capacity 0 Coverage + Quality + Capacity + Protect -300 -600 -5 0 5 10 15 20 25 * Undiscounted, constant 2003 dollars HealthBound is designed for training purposes. Simulated scenarios cannot be interpreted as predictions for the future.

16. Using VR in Resiliency Training 16

17. Virtual Reality Training cont’d Why are we doing this? Intent Provide simulated experience of likely situations Help participants feel/understand confusion of an emergency Emphasize & integrate importance of self-reliance & collaboration Train Deployment Safety and Resiliencey Teams (DSRTs) Increase confidence & competence; Decrease anxiety & stress Process Include relevant sights, sounds AND smells encountered in field Reach out to cross-cutting organizational units (content; participants) Select appropriate individuals for DSRT training Continue to refine, improve DSRT program and processes 17

18. Translation from Live to VRE 18

19. Recording Footage for VRE 19

20. Simulated Experience of Likely Situations

21. Demo

22. Sights, Sounds AND Smells… 22

23. Creating Virtual Mine Sites

24. Purposes of VR Training Engaging Immersive; Context-based Repeatable for single person and across multiple people Safely places trainees in dangerous situations Permits cost effective damage to (virtual) equipment by trainees while learning or to show faults and flaws Provides a way to experience the future before the equipment is delivered, the job designed, or that stage in the mining process

25. Mine Evacuation Training

27. Networked together

29. Surround sound

31. Virtual Simulation

32. MRET Lab

33. Comparable in complexity to mine rescue contest problemsGraphic provided by Commercial Training Solutions, L.L.C. 2011

34. Whyville: Whyflu

35. Whyville Infection interrupts chatting with “Achoo!” Proximity to infected avatars increases risk Hand washing decreases risk to you Covering decreases risk to others Social behavior has changed People now complain if you don’t cover Vaccination protects you

36. Whyville-Winter 2009 Two flu strains with different symptoms Vaccination station with two types of vaccine for the two flu strains Seasonal flu vaccine released first and H1N1 flu vaccine released later Modeling of two key hygienic behaviors: Hand washing: decreases likelihood of infection Covering: elbow covering of sneezes & coughs decreases spread of flu Opportunity to speak with CDC flu expert

37. Other CDC Efforts Pathways to Change PamojaMtaani Choose Respect BAM Second Life Hollywood Health and Society Dr. Leslie Snyder’s, Safer Sex Through Gaming

38. Speed Bumps 508 Compliance Visual Impairment Motor or dexterity impairment Cognitive/Intellectual/Age Auditory Seizures Certification and Accreditation (C&A) Clearance

39. Innovation fund A grant program designed to test new ideas Promote pilot investigations that challenge the status quo Fund new projects that are potentially revolutionary but early in their development

40. Partnering OpportunitiesDiscussion What do people need to create better games? How can CDC help?

41. Questions? Dan Baden, MD dbaden1@cdc.gov 770 488 6492

43. For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE, Atlanta, GA 30333 Telephone: 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348 E-mail: cdcinfo@cdc.gov Web: http://www.cdc.gov The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. Department of Health and Human Services Centers for Disease Control and Prevention