Request to: Robert Wood Johnson FoundationTeam Name: SuperlinearProject Name: Games To Generate Data ChallengeTeam OverviewSuperlinear is a team of software engineers with a diversity of softwaredevelopment experiences, ranging from creating computer virtualizationsoftware to building Electronic Health Record systems. At the beginning of2013 we came together with the goal of solving healthcare issues byleveraging Information Technology.Our organization provides systems development capabilities to addressthe needs of our customers. We currently support the health ITapplications developed by the defunct iPathy Software LLC.Current ActivitiesOur team is currently designing a framework utilizing games andinformation technology to address issues within the health industry. Ourvision is to create a system that allows patients to interact with theirhealthcare providers beyond what is currently typical in the healthcareindustry while avoiding the addition of significant additional load onhealthcare resources. Such a system would seek to aid healthcareregimen compliance, identify at-risk populations, reduce recurrent hospitalvisits, and increase overall community health.Below, we present one of many possible games that harness the power ofcomputing platforms in information analysis and community outreach. Wehope to integrate it with our other efforts.
Proposal AbstractWe propose a simple and engaging game that attracts a large audienceand provides a sustainable source of data useful to the healthcarecommunity. The game will act as a vehicle to engage the community-at-large, allow for the collection of both targeted and passive health metrics,and will act as a launching point for community healthcare activities.Software Overview and RationaleThe game will be developed both as a mobile application and an onlinegame (accessible via web browser). This will provide ready availability tomore affluent users, who are more likely to own a smart device, as well asless affluent users who may not have the means to own a smart device. Ensuring that the game is enjoyable is of the utmost importance, asthe software would be useless without adoption by its target audience.Specifically, our goal is to utilize the game as a platform to engage a largeaudience, much like advertisers seek to do when buying advertising spacein popular games . With this goal in mind it becomes imperative tocreate “flow” in the gameplay experience to hook players and their friends. As such, the game will not have an overt focus on the goals of theRobert Wood Johnson Foundation, but will facilitate participation in itsactivities as a consequence of the mechanics. We feel that an overt focuson personal or community health will diminish the size of the interestedaudience, and will lead to the generation of biased data as a result of aself-selecting audience that is likely already involved in the types ofinitiatives being led by the Robert Wood Johnson Foundation. Instead,participation in Foundation activities will be facilitated by a metagamecomponent and a voluntary participation component that will act similar tothe in-app purchases found in other apps and online games. The use ofthis model allows us to integrate Foundation initiatives while preservingflow; similar systems are used by 32 of the top 50 grossing games on theiOS App Store .
The GamePremiseThe player is a virus that seeks to dominate the biological landscape ofthe Earth.Mechanics Player actions are performed by utilizing “tokens.” Tokens are acquired in three ways: a set number are given to the player on a daily basis, the player may acquire additional tokens by responding to survey questions (which act as in-app purchase analogue), or by participating in metagame activities. Players can perform a variety of actions with their tokens. Example actions include adding symptoms to a virus which may either benefit or harm a host, improving the virility of a virus, improving the robustness of a virus, infecting non-player entities (such as simulated human populations), and challenging other players in a player-versus-player challenge mode. Groups of players may perform actions together, such as attempting to jointly infect a resilient population center or challenging other groups of players. The resilience of various population centers is determined by available health ranking metrics and will be modified as new data is acquired. For example, if Boston were the healthiest city in Massachusetts it would be the most difficult city to infect, however if it were to become the second healthiest city in Massachusetts its resilience would then be modified to be the second highest. Rewards to players and modification of non-player entities can additionally be determined by real-world community health activities. For example, players may be rewarded with a special ability for participating in a Foundation sponsored event, or a population center may acquire resilience against certain types of infection based on the community health initiatives it is leading.
Non-Mechanical Aspects Optional educational materials will be present in the game should players become interested in the real-world aspects of the game such as the causes or effects of certain illnesses, or the nature of epidemics. We refer to “survey questions” as a place holder for a variety of in- app activities that we can utilize to collect data. Players could be directly asked health related questions such as “how frequently do you get sick” or “how often do you exercise,” however other possibilities exist for study-related activities within the app. Participation in survey questions is optional, but incentivized by providing tokens to the player so that he or she may perform more in-game activities. Users may look at an analysis of the data they have provided through survey questions. This analysis may provide healthcare information to the user based upon their answers. For example, if a user frequently responds that he/she smokes 10 cigarettes a day the analysis may provide smoking-related health materials and a breakdown of the money he/she could save by reducing or ceasing their smoking habit. Metagame aspects were briefly touched upon in the final two bullets of the “Mechanics” section. Metagames are integrated in a variety of ways, and common components include leader boards and badges to show in-game achievements. Currently, we seek to go beyond the normal metagame components and include real- world activities as part of the game. In addition to utilizing health data from various geographies to modify the in-game world, we seek to reward players and communities for participating in activities aligned with the goals of the Robert Wood Johnson
Foundation. An elaboration of proposed methods of doing this will be discussed below.Metagaming for HealthThe game serves to drive initial adoption of the application, while thelarger metagame establishes a framework for community access andsharing. Within this framework, additional mechanisms can be included toallow players to become involved in events sponsored or sanctioned bythe Robert Wood Johnson Foundation. Currently, sanctioned sponsorswould be AF4Q Alliance members, however a mechanism to allowindividuals and organizations to become sanctioned should be created.Metagame activities could include simple activities such as blood drivesand flu shot initiatives, as well as larger community activities to raiseawareness of health issues. The effectiveness of metagame activities willbe determined by organizers: online donation drives may appeal to alarger audience than a blood drive simply due to convenience. A varietyof possibilities can be integrated in this aspect and can be added as theyarise. We hope that by integrating a metagame we can expose ouraudience to personal and community health initiatives in their localities,however we do not seek to make it a necessary component of game play;the game should have a large audience (acquired by its fun factor), andthe metagame should expose them to information and opportunities ofwhich they may not have been previously aware.Data Generation Overview User data can be acquired directly by allowing them to participate in surveys. The information to be collected in these surveys can be changed as informational needs are identified. User data will be passively collected while playing the game. For example, geographical location, date, and local time may be collected when the user loads the game. This information may later
be analyzed to identify novel issues in the community, such as wide-spread sleep disturbances (e.g. users in a certain location are found to log in at 2 a.m. more frequently than the rest of the user base). We seek to collect a number of metrics related to game play in order to create a broad and generalized data set that can later be mined to identify trends in populations that normal health metrics may not be able to identify.Utility of Data Data acquired through the game may be used by community leaders to direct healthcare initiatives. For example, if users in certain geographies frequently report that they do not get an annual flu shot, community leaders may seek to raise awareness of the benefits of vaccination. Widespread reports of chronic coughing may hint at a pollution issue to be tackled by the community. Personalized data analysis provided to users may allow them to inform their lifestyle choices and decisions. A combination of reporting an inactive lifestyle and being overweight could provide a user with the lifestyle benefits of moderate amounts of exercise.Community Adoption StrategyWe seek to utilize a traditional game marketing strategy in drivingcommunity adoption. Since the primary aspect of the game is gameplay(with participation in non-gameplay aspects encourage, but notmandated), a sufficiently fun game should attract a large and diversecommunity. Uploading the game to game websites such aswww.Kongregate.com, uploading the game to App stores, providing astandalone site, and integrating social media will provide a variety ofavenues for adoption and wide exposure. Funds from Phase I selectioncould be utilized to purchase advertising space. Additionally, RobertWood Johnson Foundation allied health communities could encourage
adoption by hosting advertising material in waiting rooms, or directingpersons in waiting rooms (e.g. children) to the game for entertainment.Projected Timeline, contingent on Phase I success March 11-June 15: Development, with demonstrations available for evaluation by challenge sponsors. June 15-July 28: Closed beta release to evaluate functionality and mechanics. Quality assurance and bug fixing, additional content creation. Internal project evaluation. July 29: Submit finalized product for review.EvaluationUser counts, duration of engagement, and feedback will be utilized toevaluate whether the game is fun and engaging. Metrics related to theuse of “survey questions” and feedback on whether the analysis wasuseful to players will be utilized to determine whether the non-gameplaycomponents of the game are being sufficiently utilized. Targets foradoption of the game and utilization of its components will be determinedafter consulting with the challenge sponsors, should our proposal beaccepted past Phase I.OutcomesShould our software pass evaluation, we feel the end product will meet theobjectives of the Robert Wood Johnson Foundation: Games to GenerateData Challenge. Specifically the software will generate data that willimprove health and healthcare both at a personal and community level,and will engage a large audience in so doing.
ConclusionThis game lays a stable foundation upon which a larger system can bebuilt. Our proposal outlines a powerful tool to reach out to communities inan assuming and unconditional manner. However, there is much morethan can be done in the sphere of healthcare-community outreach, asthere is also much room for development in respect to the utilization ofgames to augment patient care. We hope that our proposal can becomean integral component of future developments in these areas.Citations 1. Aaron Smith (2012). Nearly half of American adults are smartphone owners. [ONLINE] Available at: http://pewinternet.org/Reports/2012/Smartphone-Update-2012/Findings.aspx. [Last Accessed 2/21/2013]. 2. Stephen Cass (2011). Exploiting the Fun Factor. [ONLINE] Available at: http://www.technologyreview.com/news/425982/exploiting-the-fun-factor/. [Last Accessed 2/21/2013]. 3. Linda Kaye, Jo Bryce (2012). Putting The “Fun Factor” Into Gaming: The Influence of Social Contexts on Experiences of Playing Videogames. [ONLINE] Available at: http://www.ijis.net/ijis7_1/ijis7_1_kaye_and_bryce.pdf. [Last Accessed 2/21/2013]. 4. Ryan Morel (2012). Choosing the Right Business Model for your Game or App. [ONLINE] Available at: http://www.adobe.com/devnet/flashplayer/articles/right-business-model.html. [Last Accessed 2/21/2013].