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Serious Games and digital
  interactive technologies
            for Healthcare
                   Lucia Pannese


             Kranj, 25 September 2012
Brief History of Games for Healthcare




            Games and Simulations for Healthcare are not new!
The Nursery Rhyme “game” Ring a ring o‘ Roses is associated with the Plague
                Children play “Doctors and Nurses” etc…
Games for Collaborative Learning




  Collaborative Learning is growing in importance and
games are now being applied to support collaboration and
                  knowledge sharing
Fields of application of Serious Games 
         & simulations in Healthcare
 Supporting therapy, rehabilitation after severe illness
 Self‐management of illness /chronic conditions (e.g.  diabetes)

 “Exergames“ ‐ motivating and supporting physical activity and

 healthy lifestyle
 Anonymous group therapy

 Preventive medicine

 Behavioural change

 Healthy Nutrition

 Train healthcare professionals  (medical procedures, methods for 

diagnosis, patient monitoring …..)
 Doctor‐patient communication
Training of Medical Staff
Training for Rare and Hostile Situations




    Triage Trainer is a good example of training
   medical professionals in emergency situations
Simulation of Medical Conditions




“Dying Dave” and “Patient Rescue” are examples
   of high fidelity representation of medical
     conditions and link real‐world data to
                  visualisations
Pannese healthcare
Haptic Devices in Simulations




Haptic devices in simulations develop physical
   skills: multisensory learning experience
Virtual World Visualisations




Virtual World 3D visualisations help to orient staff
                  and patients
Games for Staff at Hospital
                               Hoists are used to move and handle
                               children in situations when manual
                               handling is a high risk.
                               There is a risk of injury if the equipment is
                               not used correctly. GOSH created a 30
                               minute simulation to reinforce practical
                               training for operators using a hoist in a
                               practical setting.




GOSH:
Great Ormond Street Hospital
GOSH Video
The ImREAL Project


www.imreal-project.eu     ImREAL    @ImREAL_project
The Mirror Project
The Virtual Pain Manager
‐ target group: nurses
‐ simulation contents: student nurses must use a Patient Controlled
  Analgesia (PCA) machine with a post‐operative patient in order to
control and reduce the patient’s pain sufficiently, ideally within 48 game
hours
Virtual ECG
- target group: students and professionals
‐ simulation contents: user is supposed to place electrodes correctly on the 
body of the patient in order to connect the ECG machine and record the ECG
‐ online, high fidelity, simulation that aims to reduce the incidence of 
inaccurate ECG scans by teaching accurate recording of ECG scans through 
practice. Learners attach the ECG electrodes and cables to a ‘patient’ and 
record an ECG.
Behavioural Change, Nutrition
Games for Behavioural Change




„Pos or Not“ is a viral game to raise awareness of
         HIV/Aids and change behaviour
Self‐management of illness and chronic conditions

Packy & Marlon: 


‐ adventure game for the Nintendo platform
popular in the early 1990s

‐ target group: diabetic children and adolescents

‐ game contents: player has to manage his character’s blood‐glucose monitoring, 
insulin use, and food selections while he tries to save a diabetes summer camp 
from marauding rats and mice. 

‐ studies and researches: clinical trial of outpatients at Stanford University Medical 
Center and Kaiser Permanente clinic, the game reduced their diabetes‐related, 
urgent‐care, and emergency room visits by 77 percent.
Smash Your Food
An award‐winning mobile game called Smash 
Your Food is making strides among kids by 
allowing them to virtually smash junk food into 
oblivion, aiming for both fun and gross‐out 
appeal, all while learning about nutrition.


• Created by Washington‐based nutritionist 
  Marta De Wulf, 
• game was released in late March as an iPad
  app
• winner in First Lady Michelle Obama's "Apps 
  for Health Kids" Competition, part of her Let's 
  Move! initiative.
MY FOOD FIGHT!®
  MY FOOD FIGHT!® is a fun interactive journey to combat the health 
 enemies that we each encounter daily. Focused on nutrient density in 
food, players are rewarded for their consumption of high nutrient dense 
                           and organic foods
Train Nutrition Seriously


        • Portal with recipes
        • Nutrition database
          • Mobile game
           • Community
Rehabilitation, Physical Exercise
Supporting therapy
Hope Labs Re‐Mission Game:

‐ target group: adolescent and young‐adult cancer
patients

‐ game contents: player controls a robot that enters
the bodies of cancer patients in order to destroy diseased cells; meanwhile he 
has to monitor and manage side effects of cancer and its treatment

‐ studies and research: improving of both treatment adherence as well as
  indicators of cancer‐related self‐efficacy and knowledge
Exergames: Dance Dance Revolution 


‐ developed in Japan for children

‐ game contents: music video game that requires players to
dance in progressively more complicated and strenuous patterns
in time with music. 

‐ studies and research: game has been implemented in schools in West  
  Virginia

→  improvements in aerobic capacity, blood pressure, and overall fitness
  level as well as children's self‐esteem
Exergames ‐ Recent design trends
Many incentives in the USA to fight against severe
health problems and lack of healthy culture (food, etc.)

The most recent Exergames are based on special
hardware / input devices (e.g. Wii Remote and Wii
Balance Board for Nintendo Wii, Kinect for Xbox
360, PlayStation Move for PlayStation 3 or Gamercize, 
which connects exercise machines such as stationary cycles
and steppers to diverse video game consoles)

→ players' movements are turned into the game's
controller                                                       Gamercize played on PS2


 Exergaming, nowadays, can be found in specialist rooms of
larger fitness facilities or gyms designed only for exergaming
programmes
Effectiveness of Exergames
A study by the University of California San Diego and San Diego State
University of 29 seniors and the Wii exercise showed a decrease in
depression as well as an improvement of mental capacity, emotional 
health, social aspects and pain

Studies have shown that Gamercize notably increases players' motivation
to keep up their exercise routine

Furthermore, combining cardiovascular exercise and balance practice has
been shown to increase academic success

Research projects have shown that exergaming can connect players over a
network and, this way, support the social power of exercising together
Microsoft Kinect Xbox 
Kinect is an input device developed by Microsoft for the Xbox 360 video game
console and Windows PCs

Features:

   Motion sensor:       tracks your entire body

   Skeletal tracking:   Kinect creates a digital skeleton based on depth data

   Facial recognition: Kinect collects physical data to be able to recognize you

Voice recognition: microphones recognize and seperate your voice from
other noises in the room
The Kinect Effect
People have started to use Kinect in creative ways: not only for
entertainment but also in education and healthcare sectors.

Some innovative examples:

Integration of Kinect into the therapy of autistic people (e.g. at the Lakeside
Center in Issaquah, WA)

Supporting the rehabilitation progress of stroke and other brain injury
patients by motivating them to move certain parts of their body (e.g. Royal
Berkshire Hospital in Reading, UK)

 Usage in hospitals, for example in operating rooms, to help doctors navigate MRIs
and CAT scans with a wave of their hand (e.g. Tedesys in Spain)
 → this way they can avoid bacteria infections since they do not have to
touch anything

   Usage for vitual anonymous group therapy through the creation of a Kinect avatar
More to come….
Rehab4Life:
Engaging Game‐based Home Rehabilitation for Improved Quality of Life

Combining Nintendo Wii / Sony PlayStation Move / Microsoft KINECT  + 
Serious Games for rehabilitation at home after hospitalization

REHAB4LIFE will transform the patient’s home in a place where physical and 
cognitive rehabilitation process can be performed in an intensive and 
engaging though properly controlled way, while promoting social inclusion 
and quality of life. 
Other scenarios
Scottish Qualifications Authority
                                       complete tasks related to the
                                       knowledge you would be expected
                                       to demonstrate in a real-life retail
                                       environment




Patient’s safety and risk prevention
The iSpectrum Project

Introducing autistic people into working environments:
                        • Office
                  • Gardening center
                     • Supermarket
Pannese healthcare
SEGAMED conference: 5‐6.10 Nizza 
Thank you!
                    Any questions?


Lucia Pannese                              www.i-maginary.it
CEO, imaginary srl                         @imaginary_italy
Innovation Network Politecnico di Milano   FB: imaginary
lucia.pannese@i-maginary.it                YouTube: imaginary srl
Skype: lueolli
@lpannese

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Pannese healthcare

  • 1. Serious Games and digital interactive technologies for Healthcare Lucia Pannese Kranj, 25 September 2012
  • 2. Brief History of Games for Healthcare Games and Simulations for Healthcare are not new! The Nursery Rhyme “game” Ring a ring o‘ Roses is associated with the Plague Children play “Doctors and Nurses” etc…
  • 3. Games for Collaborative Learning Collaborative Learning is growing in importance and games are now being applied to support collaboration and knowledge sharing
  • 4. Fields of application of Serious Games  & simulations in Healthcare  Supporting therapy, rehabilitation after severe illness  Self‐management of illness /chronic conditions (e.g.  diabetes)  “Exergames“ ‐ motivating and supporting physical activity and healthy lifestyle  Anonymous group therapy  Preventive medicine  Behavioural change  Healthy Nutrition  Train healthcare professionals  (medical procedures, methods for  diagnosis, patient monitoring …..)  Doctor‐patient communication
  • 6. Training for Rare and Hostile Situations Triage Trainer is a good example of training medical professionals in emergency situations
  • 7. Simulation of Medical Conditions “Dying Dave” and “Patient Rescue” are examples of high fidelity representation of medical conditions and link real‐world data to visualisations
  • 9. Haptic Devices in Simulations Haptic devices in simulations develop physical skills: multisensory learning experience
  • 11. Games for Staff at Hospital Hoists are used to move and handle children in situations when manual handling is a high risk. There is a risk of injury if the equipment is not used correctly. GOSH created a 30 minute simulation to reinforce practical training for operators using a hoist in a practical setting. GOSH: Great Ormond Street Hospital
  • 15. The Virtual Pain Manager ‐ target group: nurses ‐ simulation contents: student nurses must use a Patient Controlled Analgesia (PCA) machine with a post‐operative patient in order to control and reduce the patient’s pain sufficiently, ideally within 48 game hours
  • 16. Virtual ECG - target group: students and professionals ‐ simulation contents: user is supposed to place electrodes correctly on the  body of the patient in order to connect the ECG machine and record the ECG ‐ online, high fidelity, simulation that aims to reduce the incidence of  inaccurate ECG scans by teaching accurate recording of ECG scans through  practice. Learners attach the ECG electrodes and cables to a ‘patient’ and  record an ECG.
  • 18. Games for Behavioural Change „Pos or Not“ is a viral game to raise awareness of HIV/Aids and change behaviour
  • 19. Self‐management of illness and chronic conditions Packy & Marlon:  ‐ adventure game for the Nintendo platform popular in the early 1990s ‐ target group: diabetic children and adolescents ‐ game contents: player has to manage his character’s blood‐glucose monitoring,  insulin use, and food selections while he tries to save a diabetes summer camp  from marauding rats and mice.  ‐ studies and researches: clinical trial of outpatients at Stanford University Medical  Center and Kaiser Permanente clinic, the game reduced their diabetes‐related,  urgent‐care, and emergency room visits by 77 percent.
  • 21. MY FOOD FIGHT!® MY FOOD FIGHT!® is a fun interactive journey to combat the health  enemies that we each encounter daily. Focused on nutrient density in  food, players are rewarded for their consumption of high nutrient dense  and organic foods
  • 22. Train Nutrition Seriously • Portal with recipes • Nutrition database • Mobile game • Community
  • 24. Supporting therapy Hope Labs Re‐Mission Game: ‐ target group: adolescent and young‐adult cancer patients ‐ game contents: player controls a robot that enters the bodies of cancer patients in order to destroy diseased cells; meanwhile he  has to monitor and manage side effects of cancer and its treatment ‐ studies and research: improving of both treatment adherence as well as indicators of cancer‐related self‐efficacy and knowledge
  • 25. Exergames: Dance Dance Revolution  ‐ developed in Japan for children ‐ game contents: music video game that requires players to dance in progressively more complicated and strenuous patterns in time with music.  ‐ studies and research: game has been implemented in schools in West   Virginia →  improvements in aerobic capacity, blood pressure, and overall fitness level as well as children's self‐esteem
  • 26. Exergames ‐ Recent design trends Many incentives in the USA to fight against severe health problems and lack of healthy culture (food, etc.) The most recent Exergames are based on special hardware / input devices (e.g. Wii Remote and Wii Balance Board for Nintendo Wii, Kinect for Xbox 360, PlayStation Move for PlayStation 3 or Gamercize,  which connects exercise machines such as stationary cycles and steppers to diverse video game consoles) → players' movements are turned into the game's controller Gamercize played on PS2  Exergaming, nowadays, can be found in specialist rooms of larger fitness facilities or gyms designed only for exergaming programmes
  • 27. Effectiveness of Exergames A study by the University of California San Diego and San Diego State University of 29 seniors and the Wii exercise showed a decrease in depression as well as an improvement of mental capacity, emotional  health, social aspects and pain Studies have shown that Gamercize notably increases players' motivation to keep up their exercise routine Furthermore, combining cardiovascular exercise and balance practice has been shown to increase academic success Research projects have shown that exergaming can connect players over a network and, this way, support the social power of exercising together
  • 28. Microsoft Kinect Xbox  Kinect is an input device developed by Microsoft for the Xbox 360 video game console and Windows PCs Features:  Motion sensor:       tracks your entire body  Skeletal tracking:   Kinect creates a digital skeleton based on depth data  Facial recognition: Kinect collects physical data to be able to recognize you Voice recognition: microphones recognize and seperate your voice from other noises in the room
  • 29. The Kinect Effect People have started to use Kinect in creative ways: not only for entertainment but also in education and healthcare sectors. Some innovative examples: Integration of Kinect into the therapy of autistic people (e.g. at the Lakeside Center in Issaquah, WA) Supporting the rehabilitation progress of stroke and other brain injury patients by motivating them to move certain parts of their body (e.g. Royal Berkshire Hospital in Reading, UK)  Usage in hospitals, for example in operating rooms, to help doctors navigate MRIs and CAT scans with a wave of their hand (e.g. Tedesys in Spain) → this way they can avoid bacteria infections since they do not have to touch anything  Usage for vitual anonymous group therapy through the creation of a Kinect avatar
  • 30. More to come…. Rehab4Life: Engaging Game‐based Home Rehabilitation for Improved Quality of Life Combining Nintendo Wii / Sony PlayStation Move / Microsoft KINECT  +  Serious Games for rehabilitation at home after hospitalization REHAB4LIFE will transform the patient’s home in a place where physical and  cognitive rehabilitation process can be performed in an intensive and  engaging though properly controlled way, while promoting social inclusion  and quality of life. 
  • 32. Scottish Qualifications Authority complete tasks related to the knowledge you would be expected to demonstrate in a real-life retail environment Patient’s safety and risk prevention
  • 33. The iSpectrum Project Introducing autistic people into working environments: • Office • Gardening center • Supermarket
  • 36. Thank you! Any questions? Lucia Pannese www.i-maginary.it CEO, imaginary srl @imaginary_italy Innovation Network Politecnico di Milano FB: imaginary lucia.pannese@i-maginary.it YouTube: imaginary srl Skype: lueolli @lpannese