Games for Health | Can online and mobile games improve patient outcomes?

By Brian Mayrsohn, MS

Gamers are everywhere. More than 180 million Americans play games online or through mobile devices—and hundreds of millions more play around the globe. It only seems natural that the healthcare profession would turn to games as a creative and engaging way to educate patients; to promote healthier lifestyles; and enhance patient compliance/adherence to prescribed medical treatments.

Clinical evidence suggests that games related to health and wellness have tremendous potential to promote healthy behaviors and even improve outcomes and medical treatment adherence. I outline the impact of games on health and wellness in three chapters of mHealth Innovation: Best Practices from the Mobile Frontier (HIMSS Books, 2014).

Taking Control

Games offer several advantages over traditional in-person behavioral interventions, including availability, opportunities and frequency for interactive approaches, but they also reach individuals through the diffusion of tailored information and messages.

One such example is Re-Mission 2, a game designed by HopeLab for kids and adults with cancer. The game, according to HopeLab, “puts players inside the human body to fight cancer with an arsenal of weapons and super-powers, like chemotherapy, antibiotics and the body’s natural defenses. The game play parallels real-world strategies used to successfully destroy cancer and win.”

The game was designed to improve medication adherence. Players control an avatar and go on missions inside the virtual bodies of cancer patients to destroy cancer cells, battle bacterial infections and manage cancer treatment side effects. As part of the game, players fight enemy cells by using weapons armed with common treatments such as chemotherapy, radiation and antibiotics. Over the course of several levels, the player explores each patient’s history and current diagnosis, ultimately gaining medical knowledge.

While the applied scientific evidence and theory is critical for a game’s behavior change success, arguably the most critical component of a game’s success is fun. In Re-Mission, users fight cancer cells and feel rewarded. Players begin to form a positive attitude toward the game, and ultimately toward medication. In an interview with BBC news Cory de Gara, a patient with leukemia who plays Re-Mission explained, “When you play games you don’t even notice that you’re sick. That’s why I play. And it’s fun, of course.”

Empowering Patients

Apps like Zombies, Run!—a story-driven adventure game that plays like a hybrid of an audio book, self-monitoring app and video game—are already tracking movement and integrating the data into a fun game that allows users to utilize items picked up along their jogging route to build a base and defend against zombie attacks.

A new app that several medical students at the University of Central Florida are developing called MotiveAte provides users with a gamified photo-food diary that links to a virtual pet. This technology allows users to visualize the effects of their dietary choices on a virtual pet in real-time. Physical therapists are also beginning to use games. For example, Metro Physical & Aquatic Therapy of New York is experimenting with a MiraRehab’s Kinect based game platform that, according to many patients, takes the “monotomy out of physical therapy.”

In this rapidly growing and extremely collaborative field, technology continues to develop to quantify ourselves. Eventually, future games will truly be alternative reality games because Bluetooth and other data transmission processes on mobile phones easily collect physiologic data, social metrics, activity level, and behavior patterns and seamlessly integrate the information into games.

Furthermore, the data captured from playing these games has the potential to be integrated into our healthcare providers’ treatment plans. This integration will increase patient empowerment by enhancing patients’ learning through experiential and interactive approaches that ultimately drives behavior change. As a result, the diffusion of knowledge becomes a diffusion of enjoyment, experience and emotions.


Applying games to healthcare is not a trend or fad. It is a rapidly growing and extremely collaborative field, and as technology continues to develop, so will the capabilities of the games. By creating games that augment our healthcare providers’ treatment plans, we can empower patients by enhancing their learning through experiential and interactive approaches that ultimately drives behavior change. In doing so, people can live healthier and more fulfilled lives.

A special thanks to my co-authors Elizabeth Lyons PhD, Georges Khalil MS, David Metcalf PhD.

Brian Mayrsohn, MS, is a medical student at UCF College of Medicine. His research evaluates health games’ effectiveness in driving behavior change. He is co-author of three chapters on mobile health gaming in mHealth Innovation: Best Practices from the Mobile Frontier (HIMSS Books, 2014), which is available in print, eBook and Kindle editions.

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