1. Games for Health 2012, Amsterdam, 5-6 th November Damian Brown and Simon Egenfeldt-Nielsen (PhD, Psychologist) CEO, founder Serious Games Interactive Lessons Learned from 5 projects on Games for Health

2. My Background MA Psychology PhD Games & learning Between industry & research Founder of Serious Games Int. Cofounder DIGRA Cofounder of Game Centre Developing games Three series for education +80 client projects

3. Who are we... Research-based company Using games for more than entertainment Won several awards for our productions First company starting with Unity3 9 Nationalities | 24 Employees | +80 Projects | 20 Products Current research projects Gala – Network of Excellence for Serious Games SIREN – Conflict resolution for children & Adults VISTRA – virtual game-driven assembly line training ETREES – Advanced narrative work-place training C2Learn – Creative learning environment through games Background

4. Agenda What is this talk about? Methodology & games studied Quick overview key results Recommendations and conclusions

5. Ambition That we, as researchers, game producers and end users, reflect on the processes we go through when developing health-based serious games, and ensure that every aspect of that process drives towards reducing barriers to uptake (otherwise, how will we create any impact, and how will we make any money?)

6. Agenda What is this talk about? Methodology & games studied Quick overview key results Recommendations and conclusions

7. Methodology Project post-mortem evaluation with 5 key project stake holders(new perspective) Qualitative analysis of the marketplace End user and service provider interviews – Reflections on design process of the relevant SG – Views on current SG-H market condition – Expectations for the future – 11 questions in all

8. Interview Content What is your view of the state of the market for health-focused serious games? Are there any particular challenges for health-based serious games as a result of the Danish healthcare system? What pre-requisites would need to be in place for you to start another serious game project? How important is evidence of efficacy? How were end users involved in the development of your serious game project? How do development teams need to evolve to improve production processes in future? Did you experience any particular positive or negative experiences during the serious game design and production? What usage patterns have you observed since your serious game has been released? Do you have any reflections regarding the project implementation? Do you plan to start any new initiatives in the area of serious games for health? Which areas do you believe are the most relevant for health-based serious gaming over the next 12-24 month?

9. Brain Lounge Client project, rehab. of elderly persons in Bispebjerg region Range of games for cognitive training & development Maintain and improve mental health, functioning and wellbeing Enjoyable and accessible for non- game playing user group Engage different areas of the brain (memory, problem solving, speed, flexibility, attention) Successfully working in real praxis. Change mgmt. more important that the game development.

10. Sex og Samfund (Sex and Society) Sexual health information: 2 games studied ”Me and my body”: ks 2-3, onset of teenage years and changes to body ”Kroppelop”: ks 1-2, introductory level sexual health information Mixed modality, mediated learning Highlights role of teachers for younger learners. Very succesful with teachers and students to learn about sensitive subjects.

11. StressMester (StressMaster) Client project (Knowledge Center for Work Environment) Dilemma RPG for public employee to frame stress positively (CATS) Browser-based, singleplayer Choose to plan different tasks, and depending on timing and framing will influence work done and stress. Goal: Get people talking about stressor and recognize they are not powerless to handle stress. Quite succesfull with public employees but limited long-time pickup.

12. Helbredsprofilen (Health Profile) Client project (Zealand Health Authority) MMO social gaming for patients >50 with chronic health conditions Browser-based, up to 720 simultaneous players Users create avatar with chronic condition and attempt to improve their health through lifestyle compliance Competitive gameplay, but... A strong social support element Closely embedded in new praxis around chronic patients.

13. Playmancer STREP FP7 Project (3 years) Hospital-based therapy for patients with chronic pain and compulsive disorders Challenges in a 3D island environment Motion capture and biofeedback sensors provide data to the medical staff Good data and patient response Difficult technology to set-up and use

14. Games 4 Health Danish-funded research project Post combat stress conditions for ex- military personnel Screening, diagnosis and therapy function Side-by-side gameplay with therapist ‘Flashbacks’ and civilian life scenarios Use of biofeedback, GSR and heart- rate monitoring in real-time Extremely effective assesment effect and player response – almost too effective in preliminary tests. Overly complex development cycle

15. Agenda What is this talk about? Methodology & games studied Quick overview key results Recommendations and conclusions

16. Current Market Condition SG-H is well established and certain to become stronger Evidence of efficacy is lacking – willingness and acceptance would increase dramatically Funding for innovative health projects is always less than we would like to see Regulations and documentation limits the chances of moving from experiments to mainstream use.

17. Reflections on SG Development Movement from a position of skepticism to enthusiasm based on results Willingness to be seen as an ‘early adopter’ Poor integration of end users in development cycle (despite impression of strong involvement) Collaborative dev. process held in high esteem by professional and contributes greatly to patient confidence in products (but can be overly complex and hard to manage) Overly long development cycles Impressive results through low- and middle-cost technologies (data outputs) A need for tools which make the development cycle transparent to pedagogic designers, SG designers, clients and users

18. The Future US military involvement in health space is attracting major insurance companies to invest in clinical trials of effectiveness Methods to develop ‘cross-over specialists’ are crucial (and we see some movement in this area, e.g. Odense University Hospital initiative) Common trend of development cycle cost reduction (time, and money) Promising signs regarding service sustainability

19. Agenda What is this talk about? Methodology & games studied Quick overview key results Recommendations and conclusions

20. Future Trends II Mobile/tablet-based Short games (mini-games) ‘Just-in-time’ approach Self-tracking & self-reporting – Emotional, psychologial, cognitive health – Stress-management – Anti-phobic training – Relevant health information in timely fashion

21. Key Points Expectation that the overcoming of lack of efficacy for effect will be driven from the US Some encouraging signs of improvement in the development process, but end users need to be more fully integrated Improvements in service provider understanding of the value propositions (in particular: data mining potential, ease of use, social value, and the potential to shift upstream to prevention rather than treatment) All pointing towards a maturing of the serious games for health space

22. Contact info Company details Serious Games Interactive Ravnsborggade 2-4, 2. floor DK - 2200 Copenhagen N www.seriousgames.dk My details: Simon Egenfeldt-Nielsen sen@seriousgames.dk | +45 40 10 79 69 www.egenfeldt.eu