September 23, 2005

Games for Health 2

by Michael Mateas · , 9:54 am

I’m continuing my live blogging of Games For Health.

Chris Foster
Baltimore Business and Economic Development

Invests in life science industry. Spends most of the talk on the wellness crises facing the nation and the world.
Mentions that there would be a $165 billion a year savings from moving to an electronic, unified health care record; “how can we not afford to do that, given that we have a crisis of cost in health care?”

Maryland has the highest per capita number of Ph.D.s in the nation, mostly driven by the federal government labs (FDA, National Cancer Institute, etc. – 54 such labs), yet 1 in 5 Maryland residents are illiterate.

The world population explosion (we’re on track to hit 7 billion by 2010) is creating education and health crises around the world.

Havey McGee
Portfolio Manager, TATRC (Telemedicine and Advanced Technology Research Center)
TATRC is a US Army agency that supports medical research and development. The Medical Modeling and Simulation program was started to improve trauma training. The army trains 100,000 people in trauma medicine each year (!!, is this number right?) – there aren’t enough doctors to train all these folk.

We’re seeing a combat medic orientation video. It’s a bunch of quick cuts of Hollywood-style combat scenes, lots of grisly wounds, pounding musical sound track, mostly industrial with a bit of hip-hop, occasional red text overlays talking about the importance of being an army medic. The key points of the video are communicated with scrolling text fading to the horizon, like the text at the opening of Star Wars. This video is shown to young 18-20 year old army medics when they start their training.

“Some people just can’t get past the word game, don’t ask me why.” “Medical simulation is a disruption – medical gaming is a disruption within a disruption.”

Mentions of a number of TATRC-funded projects:
Medical manikins
Accurate physiology simulators
Chest tube insertion trainer
Tourniquet trainer
Many others…

Interested in the idea of gaming vignettes, small scenarios that can be embedded within training situations, without requiring that the entire training situation be structured as a game.

Panel: Game Technologies and Future Healthcare Opportunities
Ariella Lehrer, Legacy Interactive

In developing their ER game, they developed their own programming language, STORI, for character AI. Legacy is happy to license STORI to serious games developers. STORI is an “object-oriented, state-based, concurrent, knowledge driven programming language”. “State-based” implies something FSM-like, though it’s support of concurrency implies that you can be in multiple states at once (or perhaps, pursue multiple actions while in a single state). STORI compiles to a virtual machine (like ABL), so it can be easily decoupled from the game engine. STORI includes a predicate calculus/rules system – so a STORI agent can run queries against its memory (like ABL). They used STORI to implement ER, a Sims-like game. STORI controls diagnosis and treatment AI, character actions, story progression. The game has plot-lines; e.g. in one episode of the game, you are responsible for new interns.

The player has attributes, like constitution, intelligence, charm, dexterity (RPG-like).
The characters interact with each other and influence how they feel about each other – they model this dynamic as area of influence.

At any one time there > 100 characters in the hospital, all pursuing goals, interacting with each other, influencing how the characters feel about each other.

Like the Sims, the social interaction is “zoomed-out”, unlike Façade which has zoomed-in, intimate social interaction. STORI seems like Legacy’s version of Edith, the state-based scripting language for the Sims. I don’t think Edith has support for querying a predicate knowledge base; sounds like STORI is Edith++ with some ABL-like features. Sounds like the predicate-calculus features are used for the diagnosis part of the game (modeling diseases, symptoms, what different tests show for different diseases, etc.).

ER is an entertainment game based on the TV series, but Legacy feels that it could be easily adapted into an ER training game.

Jerry Heneghan, Virtual Heroes
Virtual Heroes developed America’s Army. A chunk of their IP is virtual human technologies; need to look into whether this is anything more than FSM approaches.

Omid Moghadam, Intel
Omid talked about the infrastructure necessary to support a unified digital personal health care record (PHR). Based on the number of times this has come up at the conference, creating a PHR infrastructure is a hot issue in health care.

Ian Bogost
Advergaming of Prescription Medicine

General advergaming stakeholders: game developer, web agency (because such games are often deployed online), ad agency, and brand manager. The problem: only the game developer has a clue what games are all about, so you have to manage three other stakeholders who don’t really get games. For pharmaceuticals, add regularators! Claims about the efficacy of a drag are discouraged; efficacy claims must also cover side-effects. This is why most drug ads are “hills and meadows” – general feel-good imagery that has nothing to do with the drug.

Case study of a blood treatment advergame Ian did for a “major pharmaceutical company”. Treat an abstract representation of the disease using different “fuels” that correspond to different treatments with different tradeoffs. The gameplay leads the player to prefer the advertised game. The pitch: Katamari Damacy meets Mercury.

Representation of the body – client was uncomfortable with representing the body and the bloodstream, wanted to turn the game into an abstract shooter.
Claims about the efficacy of the treatment – client was uncomfortable that the game actually talked about the efficacy of the drug.
“Implied” claims about the efficacy of alternative treatments – client was uncomfortable that the game talked about the efficacy of alternative drugs; the didn’t really want patients to know there are alternatives.
Exaggeration for effect (otherwise no gameplay!) – client was uncomfortable with exaggerated effects, even though exaggeration is necessary for game design.
Didn’t believe in the sophisticated game literacy of the target audience – ultimately, client didn’t believe the target audience would be able to read the game, make judgments, and draw conclusions.

But, ironically, the game design didn’t make efficacy claims even as bold as traditional TV advertising, so this was a game literacy problem. They came back with a Wipeout Pure design where you race around and pick up drugs on the track. This is a “hills and meadows” pharmaceutical advergame that doesn’t talk about the efficacy of the drug at all. Ian told them this was a terrible idea, and the relationship ended – no game was ever built.

Future of pharmaceutical advergaming: it could be that the whole area is dead. But it has the real potential to depict physical and social effects of specific drugs, creating educated patients who have real questions for their doctors. But will pharmaceutical companies see this as in their interests? “They want to sell us the drug, not the cure.”

TATRC session – discussion of current Army medic training
An army trainer talked about army medic training. A chunk of the training is on humanitarian treatment; added after the Abu Ghraib scandal. Described a combat video that was shot by Al Queda, in which an army medic is shot, got up (the shot hit his Kevlar), and later treated the people who shot him. In general, gaming would be helpful for making the training much more engaging; currently the training is pretty boring. Current training regimen is 80 days, 640 hours – only 298 are hands on – the rest are classroom. Would like to see a lot more interactive, hands-on training. Simulation training centers are being built for medics. Other specialties, like tankers or infantry, go to simulation centers every year where they get a report card on their current skills. Medics don’t have this; they are just building such centers for medics. Russell Schilling, sound designer for America’s Army, mentioned that simulation is effective for training on general procedural knowledge, but not as effective for hands-on skills, like tying a tourniquet. But, in a simulation, you can put your medics under fire, which is incredibly important. Noah Fahlstein thinks that games may not be so useful in the 640 hour initial training, but in games that medics and soldiers play in the field to review skills. He comments that he often sees pictures of soldiers in Iraq playing with hand-held or sometimes more sophisticated game systems in their tents in Iraq – this seems like the place to put training games. The trainer mentioned that there’s lots of waiting time during the training, when the medics-in-training are running around with pieces of paper, doing administrivia (not his word); would like to have games that can fill this waste time. Noah suggests that non-electronic, pervasive social games might be good for this.

2 Responses to “Games for Health 2”

  1. mark Says:

    As far as huge cost savings from computerizing medical records, this is well underway for about 15 years or so (longer in the early stages). It moves slowly though, since it’s a huge industry with a lot of regulatory framework, and requires some sort of agreed-upon standard if it’s to be of any use. People are still arguing over the best way to design such a system so that it maximizes efficiency while minimizing privacy risks (papers on the pros and cons of various approaches regularly appear in the major medical journals), but it seems some semblance of standards seem to be finally coalescing, organized by CEN in Europe and the ISO internationally.

  2. andrew Says:

    Ian Bogost published a summary as well on Gamasutra (in addition to his live blogging notes on WCG).

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