August 1, 2016 § 18 Comments
If we can believe what we are seeing, Pokemon GO is the world’s most effective, and most widespread, population weight loss intervention. Already, its users spend more time on the game than on other wildly popular mainstream social media platforms like Facebook, Snapchat and Twitter. Over the space of a few weeks, it has prompted millions of children and teens to get off the couch, turn off Netflix, leave the laptop in their bedroom, and walk out into the world to breath the fresh air. More than a few adults have done the same.
Healthcare should pay attention. While healthcare researchers are slowly coming to grips with ‘new’ ideas like gamification and social media to defeat obesity, the game industry has jumped the queue and may have already done it. Silicon valley has drawn down on its deep well of expertise in building large and complex software systems, and in embedding such systems into the real world. They have drawn on their deep experience with and understanding of the psychology of online social media, of what makes games ‘fun’, and what makes them ‘sticky’.
I doubt if Niantic, the Pokemon company, looked to randomized clinical trials to design and implement their system. The world of software moves too fast for that. It has an engineering culture of fail early, fail often. And because of that, it has as much right as scientists to claim that it is driven by experimentation and data, or as the philosopher Karl Popper would have said, conjecture and refutation.
For those who have not been drawn in to the world of Pokemon Go, it may be hard to understand what the fuss is all about. It is just another time-wasting, obsession inducing computer game. Yes it is interesting that it uses augmented reality and your physical location as part of the gameplay, but so what? People just walk around collecting different characters, oblivious to what is happening around them. The end result is a different kind of walking screen-time zombie, with the added risk of walking into the traffic or driving into a wall as you play the game.
There is another way to look at it. Firstly, irrespective of the game ‘medium’, the real world ‘message’ is that people are more than happy to exercise, and to engage with others in the real world, with the right motivation. For younger generations who have grown up in a world that is digitally augmented, the digital-social complex is the way to access their lives. Jogging with a fitbit is probably compelling for those who already run or are motivated to exercise. Pokemon GO does something more miraculous. It causes the Lazarus generation to rise up, and to move.
Pokemon GO makes walking the basic currency of the game. If you chance upon the eggs of Pokemon creatures, the only way to make them hatch is to walk a prescribed distance. Some eggs require 10k of nurturing before they crack. If you want to catch different Pokemon (and if you are a player, you #gottaacatchemall), then you will find spawning grounds in parks and open spaces. If you want to top up the items you need to catch Pokemon, then you have to walk from one Pokestop to another.
One of things that appears to make gambling ‘sticky’ is the uncertainty of reward. Each rare win reinforces the desire to keep trying for a bigger future reward. Pokemon GO has an interesting strategy of combining certainty in reward (eggs hatch after a defined distance is walked) with uncertainty (creatures appear unpredictably, and their behavior and value is unpredictable). As you progress in the game the rewards increase along with your status. Our brains are washed in an addictive dopamine broth with every reward, every step forward.
Pokemon GO also strives for social equity. When a creature appears in a given location, anyone who is there can see it and catch their copy of it. This means that there is real value in finding stronger players than yourself, because they will trigger the arrival of rarer creatures. These stronger players are also likely to have set lures to attract creatures, and the benefit of these lures is also socialized. Stronger players will have obtained their status by walking great distances, and so a sort of social modeling probably takes place influencing the behavior of newer players, further reinforcing the culture of movement.
Mass and spontaneous social congregation is an unexpected side-effect. Reports of many thousands of people all rapidly congregating in parks as rare creatures appear have been repeatedly reported. It is a sociologically fascinating emergent property of the game. It can also drive the locals crazy, blocking roads, and keeping people awake, as crowds chase the different creatures that appear at night. How wonderful if healthcare could trigger the same mass interest, with thousands queuing when Zika vaccination becomes available? Indeed, how can we mobilize such mass response for all sorts of health prevention activities?
The early uses of Pokemon GO in healthcare are examples of simple adoption. Placing Pokestops in the wards and surrounds of a children’s ward provides distraction and joy to hospitalized children who may be in dire need of fun. There are also of course the usual reactionary demands that the game be banned from clinical spaces .
Social media has already taught us a lot about how to deliver health services in new ways. The great potential for augmented reality in healthcare is yet to be tapped . Pokemon GO can teach us even more. We must learn to be more nimble and agile in the way we develop interventions to change behavior and deliver health services. The engineering worldview has much to offer, and it shares the same DNA of scientific reasoning so embedded in modern healthcare research. We are entering a time when more and more of the population will be embedded in an online social web, and that will be the universe in which we must engage with them, and where healthcare is delivered. And we must embrace that future, because in the end, we #GottaCureEmAll.
May 30, 2013 § Leave a comment
Can you smell revolution in the air? Social media like Twitter and Facebook helped catalyze the Arab Spring, and the Occupy movement’s global protests. Social media are often beyond the control of government, and allow citizen groups to form, share information and respond more quickly and with greater reach than ever before. With so much disaffection with modern healthcare, will healthcare too soon have its own Arab spring? Will old power structures be taken apart, and the compact between clinician, patient, industry and government reassembled into something new?
This is a theme I explore in a Croakey Health Blog:
It is a companion to my BMJ paper Social networks, social media and social disease.
There is a BMJ podcast to accompany the paper, and you can listen in on my commentary which starts at 9.54 minutes into the audio recording. The ABC Radio National Health Report also ran an interview on the topic and has both audio as well as a transcript.
Interesting times for healthcare I think ….
May 24, 2013 § Leave a comment
After two and a bit decades of working at the craft of innovation in technology, I was pulled up one day when one of my brilliant doctoral students asked me “How do you get a good idea?”. As I started to answer, I realised that innovative thinking is something I had learned, slowly and that in truth it could (and should) be taught explicitly.
My first attempt at writing down what I thought the ‘rules’ for innovation resulted in a series of twenty tweets – 10 do’s and 10 don’ts. It seemed like a fun way of keeping to the point, sharing, and seeing what others thought.
My bigger surprise as I embarked on the tweeting was the disdain my senior colleagues had for the social medium. I put my experiences down in a blog at the BMJ, as well as the twenty tweets.
I may return to these and expand, but for now, here is the original blog: