Pioneering Ideas

Introducing … DATA!

Next Wednesday at the IOM, HHS will do a big unveiling of its Community Health Data Initiative.  It will be a pretty big deal – HHS Secretary Kathleen Sebelius, White House CTO Aneesh Chopra and HHS CTO Todd Park will all be on hand and the expectation is that major tech companies will unveil prototype apps built off of some of the data sets that HHS will be making public.

The HHS/IOM event will be web cast, so check it out.  Either of these links should work:

1.    http://www.hhs.gov/open/
2.    http://videocast.nih.gov/summary.asp?live=9347

It’s an interesting headline when you step back and think about it.  HHS is making a major announcement – not about a new research breakthrough, a new vaccine, a new Medicare benefit or even a new grant opportunity.  It’s about **drumroll** … **drumroll** ... data!  Seriously.  The bet here is that the thousands (and I do mean thousands) of data sets that HHS maintains could actually support some useful applications – applications we can’t even imagine yet – in the same vein that the weather data produced by the National Weather Service generates so many services and businesses.  To some extent, these data have been available before, but they’ve been hard to get to.  The difference here is that HHS is planning to make access to the data easy and beyond that, make them available in ways that most lend themselves to application development.  It’s a conscious strategy to enable others to add value to these government data.

At RWJF, we’ve had a hand in one of the first major apps – the County Heath Rankings – which plots community health characteristics – for every county in America.  Go to the site and you can find both health outcome data, like premature death, and the social, behavioral and environmental factors that lead to those outcomes, like obesity, unemployment and air pollution.  And you can see how each county ranks on any of those factors compared to other counties in your state.  And the County Health Rankings data has even spawned an irreverent take on the data – the County Sin Rankings – winner of the Sunlight Labs Design for America contest for visualizing health data.  Check out the other contestants, who all offered imaginative ways to present health data to the public.  The point is that the government is not best suited to come up with creative ways to help people understand the health of their communities or the quality of the medical care they receive.  But creative designers, developers and activists, when given access to the data, can do it much better.  Once there’s a good platform, we always get happily surprised by the apps.

I’d love to hear what people think are the most exciting apps that get announced on Wednesday.  And while you’re at it, can you think of a more exciting name than “Community Heath Data Initiative?”

More Grantee Updates from GFH: Todd Miller on Incorporating Gaming into Phys Ed.

In case you haven’t visited Pioneering Ideas over the last couple of days, Marientina Gotsis has been busy guest blogging from the 6th Annual Games for Health conference for us. Her posts have offered some fantastic insights into the action that’s going on in Boston, and we hope to post some updates on her Wellness Partners project in the months to come. Before the conference came to a conclusion yesterday, we had the chance to catch up with another Health Games Research grantee who attended– Dr. Todd Miller, associate professor or exercise science at the George Washington University’s School of Public Health and Health Services. Todd leads a project funded by HGR to investigate novel gaming technologies and how those technologies can be incorporated into school physical education programs in Washington, DC.  In between sessions, Todd kindly provided us with a few updates from his work – which include the type of unexpected hiccups that are inherent in any research project that involve studying a concept with the potential for creating bold change. Although his research is nowhere near finished, we thought it was interesting to provide a glimpse into all of the variables (planned for and unexpected) that go into this work: “Our project is designed to compare caloric expenditure during three types of activity:  1)  Dance, Dance, Revolution, 2) Standard Physical Education Classes 3)  The Winds of Orbis  (a prototype game that integrates a DDR mat and Wii Controller).   We are also giving subjects a short survey following each play condition to see which activity they enjoy the most.

We spent this past semester collecting data at an inner-city middle school in Washington, DC.  Our subjects were mainly African American, low SES students from 3rd-7th grade.  In general, our data collection has gone smoothly and kids really enjoy playing both DDR and Orbis. We have experienced challenges with the school PE program though, and that's what I'd like to focus on.  For example, the PE teacher at the school we're working in quit very early in the semester, and substitutes have been taking over.  This has been problematic in that there usually is no scheduled curriculum for PE, and the kids are
often just given a sort of "free play" time, which is completely unstructured.  This means that some kids are active, but they also can simply sit there.  Furthermore, much of the activity is wrestling, chasing each other, and general goofing off.  This is problematic because we're trying to compare exgames to conventional PE, and I don't think that what is happening in our school is reflective of what PE is like in most places.  There also is a lack of PE equipment in our school because, according to the teacher, it gets stolen or lost pretty quickly, making structured PE activities even more unlikely.

The good news is we'll be collecting data all of next year, and there will be a new PE teacher, and we will be able to build a more solid relationship with that single teacher, in the hopes of improving the
PE experience.”

A big thanks to Todd and Marientina for adding their voices to the discussion during the conference – we’ll be sure to keep you up-to-speed as their projects conclude. We had a great time learning the latest of what they’ve been up to, along with the numerous other HGR grantees that were in Boston this week. If you were at the conference or following along online, we’d also love to hear your thoughts on the most innovative health game ideas that crossed your radar over the last few days.

Games for Health Conference: Day 2 Highlights

 

Yesterday we were fortunate to have guest blogger Marientina Gotsis, director of USC’s Games for Health Initiative at the School of Cinematic Arts, post a few of her Day 1 Games for Health Conference highlights on Pioneering Ideas. Today we’re excited to bring you more of an insider’s perspective from Boston, as Marientina sent us some more thoughts from yesterday’s sessions.

The conference opened in a big way this morning. John Lumpkin, senior vice president and the director of the Health Care Group at RWJF, warmed up the conference with a passionate discussion about the Pioneer Portfolio and new market segments reaching downstream. He presented the potential of games as the core intervention in the context of telehealth due to healthcare personnel shortages -- a compelling argument for evaluating comparative effectiveness. Dr. Lumpkin also made an important point I keep making to my collaborators and students: Health games generate health records. We have to figure out what that means. He closed his talk with an Arabic proverb: "He who has health, has hope; and he who has hope has everything." And she who blogs, agrees...

 

The opening festivities continued with Richard Marks, senior researcher at Sony who discussed balance in the context of the EyeToy, its history, and the evolution of their new Move controller. How do you balance the physical with the mental, interactivity with passivity, imagination with action, being social with being alone, and finally, delight with purpose? Marks talked about "somatic gratification" in interfaces and the ultimate balance of encumbrance versus empowerment. He showed compelling videos of simple virtual manipulations of glasses of water and slinky fabric and my hair stood up because I felt the sensation of what was shown without doing it myself. I experienced somatic gratification by proxy -- something I haven't felt since I was doing networked VR experiments many years ago. I know that everyone in the audience felt it too. Finally, I feel a little less alone in the world ;)

 

As Marks continued to demonstrate the Move controller, the audience was further impressed and delighted. I found myself smiling deeply because this technology and modality is finally out of research labs and in the consumer living room. And for cheap. And perhaps, may I dare say it is also somewhat robust and ready for content? It has been a long time since my research partner and I painted ping pong balls in different colors and wore silly hats to perform endless motion tracking calibration sessions. We were being geeky grad students but Sony is [ FINALLY ] making it cool and affordable, and that is revolutionary. Microsoft Project Natal is trying to achieve a similar goal. Pair that with a stereo 3DTV and call it real VR and now all of a sudden you have a powerful telehealth platfform that is deployable in the home. 

 

If you weren't moved (pun intended) by now, the Clem Burke Drumming Project was an energizing finale before sending people off to their sessions. A live display of real-time energy expenditure of drumming (check out the video above) proved to us that musicians get more exercise for their heart in an hour than most of us get in a month. I had never thought about music performance as a health intervention. One can learn something new every hour at the Games for Health conference...Stay tuned! 

Games for Health Conference: A Look Back at Day 1 From HGR Grantee Marientina Gotsis

IMD Media Lab Manager Marientina Gotsis and USC School of Social Work Associate

Professor Maryalice Jordan-Marsh, members of the USC "Wellness Partners"

research teaminvestigating how interactive games can improve health.

 

After attending sessions all day (and presenting one of her own) at yesterday’s opening of the 6^th Annual Games for Health Conference, Health Games Research grantee Marientina Gotsis was gracious enough to send us a few of her personal highlights from the event.

 

Marientina is an artist/technologist and director of the Games for Health Initiative at the Interactive Media Division of the School of Cinematic Arts at the University of Southern California. Her research explores the intersections of interactive media, medicine, public health and behavioral neuroscience. Marientina is co-principal investigator and project director for Wellness Partners, a pilot project for the HGR national program supported by the Pioneer Portfolio, for which her team has developed and tested a social networked game and activity diary for exercise within intimate social networks.

 

Below are her thoughts on yesterday’s sessions, concluding with some excellent words of advice for game developers to stay focused on what matters – connecting with the user:

What a difference a year has made! I was delighted to see the Out & About Mobile Serious Game Conference opening with a series of platforms and products that promise a great deal for DYI interventions by researchers. John Valentine, who created the location-based gaming platform SCVNGR, started the day with a discussion on the effects of location-based mobile gaming on personal fitness and overall health. One of our doctoral students timidly introduced SCVNGR to my class this semester and at least two of the students entertained the idea of using it for a project although it is not necessarily ready for deployment in academia. The company is gracious to understand that this type of application is much needed by the community and we look forward to seeing where they are headed. 

A few more platforms that stuck out yesterday: The Akoha application is a great example of the "small changes for humankind" philosophy that seems to energize lots of these startups and their followers. It is hard to tell whether the ability to do practically anything is empowering or overwhelming but the "pay it forward model" certainly works for highly motivated people. I am also looking forward to testing some of MIT's AR toolkits as our Mobile and Environmental Media Lab is always looking for quick and dirty ways to deploy storytelling that is location specific. There is a great deal of opportunity for funding around science education right now so long as these platforms remain stable enough for the lifecycle of a grant -- a threat looming over the head of any researcher considering any nascent or stable beta application.

 

Later talks in the day focused on assessment research which is urgently needed in this field. We're often surprised to hear what motivates people, what they want, what they like, and what they play. A word of caution: in our quest to seemingly want to "gamify" all experiences and be taken away by the promise of "virality" carried out by the social network, let’s not forget that the design of satisfying and lifechanging interactive entertainment experiences lies with understanding the emotional core of the user/player base and their interactions with whom they feel closely connected to.

Games for Health Conference is Underway

The 6^th Annual Games for Health Conference got underway today in Boston and will continue until May 27^th. This year’s event is expected to draw a huge crowd of game developers, technology experts, health professionals, researchers, policy-makers and educators to advance digital interactive games and game technologies that can improve health and the delivery of health care.

RWJF Senior Vice President John Lumpkin, Paul Tarini Games for Health’s Ben Sawyer, Health Games Research Director Debra Lieberman and a handful of that program’s grantees will all be representing Pioneer in Boston this week.

As covered previously covered, there are some really cool presenters and sessions that shouldn’t be missed. But don’t worry if you can’t actually make it to the conference, as there are numerous ways you can follow along online:

· Twitter – We’ll be live tweeting highlights throughout the week. You can join the conversation by following the #gfh2010 hash tag.

· Facebook – Our page will have frequent updates from event participants. 

· Pioneer Web site – Check regularly for special video content from the event.

· Pioneering Ideas – We’re hoping to get a couple of guest blogs up this week from Pioneer national program Health Games Research grantees. 

We encourage you to join the conversation by letting us know your thoughts on how video games can improve health and lead to better care. Feel free to post a comment below or chime in on Twitter!

 

Innovative Ideas for Battling Adult Obesity at Invitational Choice Symposium

Last week, I went to Key Largo, Florida to attend the 8th Triennial Invitational Choice Symposium, hosted by the University of Miami and the University of Technology, Sydney.  Pioneer has had an ongoing interest in behavioral economics – also called choice architecture or “nudges” – which explores ways to influence people to make healthier choices.  You’ll recall that we sponsored the “Designing for Better Health” competition with Changemakers last year to identify health nudges. The conference convened researchers, psychologists, marketing folks and behavioral economists from around the world to meet together in small groups for three full days to present and discuss whatever they wanted. 

 

At the Invitational Choice Symposium, there were about 15 different groups that discussed topics ranging from marketing and politics to the intersection of perception, learning, thinking and feeling. My group, which was simply called “improving medical decision making,” brought together researchers with expertise in psychology, financial incentives, nutrition, law and economics to discuss how to improve medical decision making.…by physicians, nurses, patients and other actors in hospitals, medical offices, minute clinics, schools, at home and in the workplace.

 

Being that I work outside of the academy, I was invited by Dan Ariely and Ziv Carmon to join Kevin Volpp, Brian Wansink, Anup Malani, Barbara Kahn, Peter Ubel and others to provide a real-world perspective to the conversation. When the academics get too high up in the clouds, I was told, you should bring us down to think in a more focused way about how incentives can result in improved health and health care through improved policy or other tools to motivate and sustain favorable behaviors of providers, patients and others.

 

I don’t want to speak for the others, but I assume they were as gratified as I was for having the opportunity to spend so much time thinking and learning with those who had some of the missing pieces of the puzzles we were attempting to solve. We talked about LOTS of problems (conflict of interest, patient comprehension, adherence to medication) and lots of potential solutions (requiring cash payment, default second opinions, videos to change norms). The main issue that ran through the three days was adult obesity.  Though we  tried to leave the issue aside because we worried about wasting time on an issue that even Oprah can’t surmount, the fact remained that it was such a thorny behavioral problem that we couldn’t escape it.

 

In our discussion about how to address adult obesity, we talked about needing to understand why and how obese people become obese. Are they eating a lot at meals? (in which case, restaurants offering to serve half portions at 2/3 the cost of a full serving could provide a partial solution). Are they eating a lot when they are with their obese friends (then targeting interventions at social networks sounds promising). Are they eating the foods that are cheaper? (a fat tax could help). Are they eating the same amount as non-obese people, but just have a worse metabolism (need a miracle drug)? Are they eating because they don’t know how bad some things are for them or how good something are for them (calorie counts and other informational materials could help)?

 

The discussion dug in deeper to get at whatmight work to change eating habits.  Rules and restrictions? Financial incentives? Financial incentives to people’s friends?  Virtual incentives like those provided through the Farmville game? Points for good behavior redeemable the way frequent flyer/spender miles/points are? Making the world a Canyon Ranch? Limiting serving size by law? Shrinking plates?  Hiding appealing-looking food? Taking away people’s “heavy clothes” and buying them a new wardrobe to incentivize weight loss and maintenance?

 

Here is one idea that I feel enough ownership to share, though it was born of the insights of others: I think that a lot of people screw up their “good” day by eating something they didn’t really want.  Though I think that people who bring sweets to work and leave candy on their desk for people to nibble on have the best of intentions, free food is hard to pass up and good-looking food is a good way to start your day on a slippery slope.

 

What would it take to change the culture? To have co-workers consider it a rude thing to do to bring in cupcakes,  donuts, or cookies to a meeting, or put out chocolate when it is potentially damaging to someone else’s health? Would signs in the bathroom stall or conference room doors be enough?

 

At the conference, I accomplished the goals I set out to accomplish: to learn more about cutting-edge behavioral economics and decision science, and come away with an idea with “breakthrough potential” for possible future development by Pioneer.

 

I’ll expand more upon these ideas on future blog posts.

 

 

Games for Health Conference Less Than a Week Away

The 6^th Annual Games for Health Conference is fast approaching. This year’s event – held in Boston May 25-27 – features RWJF’s John Lumpkin, Sony senior researcher Richard Marks, and independent game developer Chaim Gingold as keynote speakers. In total, the event will feature more than 55 sessions with 100 speakers, and will cover a wide-range of topics, including exergaming, cognitive and emotional health, simulation and learning, virtual worlds and more.

Just a few highlights include Grendel Games’ presentation on how the Nintendo Wii is being used for laparoscopic surgery, a talk on the health effects of drumming with the Clem Burke Drumming Project, and University of Warwick computers scientist Simon Carle’s discussion on how he’s using the Xbox 360 to both detect heart defects and help prevent them from occurring in the first place.

Additionally, winning prototypes from the upcoming Apps for Healthy Kids game jams will be on display at the event. The game jams, hosted by the IGDA and the U.S. Department of Agriculture, are a series of regional competitions drawing together game developers, graphic artists, and local youth together to brainstorm ideas and produce health video game prototypes from scratch in just 48 hours. Winning prototypes will be refined and submitted to the Apps for Healthy Kids competition after being displayed at the conference. Sponsors of game jams include the Games for Health Project and Pioneer national program Health Games Research.

As a long-time supporter of research into digital health games, we are excited to be one of the conference’s major partners and sponsors. With strong attendance expected, Games for Health will serve as a catalyst for greater awareness around the advances in health games. Online registration  is still open, so it's not too late to sign up if you're in the Boston area next week and would like to check out some of the biggest innovations in health games technology.

 

Leaders in Change, Part II: Archimedes' Dr. David Eddy

 

ARCHeS: Access to Better Health and Health Care Decisions from Pioneer Portfolio on Vimeo.

Part II of our “Leaders in Change Video Series” features a conversation with Dr. David Eddy, founder and chief medical officer emeritus of Archimedes.  Dr. Eddy is the project director of the Pioneer-supported ARCHeS project, a web-based interface that will dramatically expand access to the Archimedes health care simulation model for decision makers.

Archimedes, described previously as a medical or health policy researcher’s Sim City, accurately reproducing the complex interplay of human physiology, diseases, behaviors, interventions and health care systems. It’s designed to give an evidence-based analysis of a proposed intervention or treatment, taking all of the aforementioned criteria into consideration. Archimedes allows users to design their own virtual trials to inform the answers to their own specific questions – whether it’s prioritizing proposed treatments, revising guidelines or introducing new policies (or scrapping them all together) – based on expected cost and effectiveness before implementing decisions. It enables decision-makers to simulate massive, virtual clinical trials that would be cost-prohibitive and/or take years, or even decades, to conduct in real life. A recent simulation found that screening for Type 2 diabetes should occur between the ages of 30 and 45 — 15 years ahead of what established guidelines had been recommending.

A key limitation of the model is its complexity is that it is only accessible to large institutions with the resources and budget capable of supporting it; further, analyses can only be run by experts at Archimedes. Pioneer’s support of the development of ARCHeS will allow people, with training, to run trials from their desktops at far less cost.

Listen to what Dr. Eddy has to say about what that could mean.