“Hey, let’s add some gamification elements! People will love it!”
While the concept of gamification—adding game-like elements and achievements to encourage and reinforce desired behaviors—isn’t as universally lauded as it once was, people still look to the technique as a way to make their application “stickier” (or more likely to keep users coming back to the application).
Duolingo is one of the most oft-cited examples of an app that combines learning and games competitions to spur users on to lingual greatness.
My daughter was just telling me at lunch recently about her participation “streak”—even though she had missed a few days along the way. Duolingo provides a few exceptions along the way to keep users engaged. We’ll see in a bit why this kind of softening of the rules is so important.
If gamification can work with learning a language, why not use it to help in healthcare scenarios? Healthcare has a number of different applications out there to help people achieve fitness goals or better adhere to their medication schedules.
Still, most of the conversation is around the patient or the person trying to improve their own health.
What about physicians? Would they benefit from having any gamification elements?
Let’s be specific about how this gamification could play out.
The idea for this article actually started out as a conversation with a client around how physicians use a dashboard to review their own performance in a procedure. (The “Projects” section of our site shows off the types of dashboards / portals we build.)
Here are a few simple ideas for gamification elements in this type of dashboard:
- A measurement of the number of procedures completed with the goal of achieving various milestones
- A comparison of the amount of time needed to complete a procedure to other physicians’ activity, either within a hospital or even nationwide
We could certainly come up with other examples of gamification, but let’s keep our list simple for the sake of this article.
Both types of gamification elements listed above could provide some benefit and may create some concern for how it could affect physicians’ behavior.
Let’s start with the benefits.
Keeping track of the number of procedures completed is a very common type of element to gamify.
Starbucks offer rewards if you complete a certain number of purchases. Airlines and hotels are famous for their point programs—with travelers literally going hundreds or thousands of miles out of their way to achieve their rewards.
Yes, there is precedent. But no, there wouldn’t be a true “reward” offered as we think about it in the above examples.
We’re not suggesting a deal like “perform 200 procedures, get a medical device for half off!”
So if there aren’t any rewards, why bother?
Medical device companies and the hospitals that invested could both use a running reminder of how their investments are doing.
Did the hospital actually get value from the device? Well, their level of usage indicated they thought it was worthwhile.
A quick meter ticking off each procedure could also help physicians talk about their experience more easily. “I’ve completed nearly 50 of these procedures with no issues.”
It’s a simple but powerful reminder.
Not So Different from What’s Happening Now
These kinds of achievements are being celebrated already by medical device companies and hospitals. How many times have you seen social media posts with healthcare professionals holding up balloons to signify their 50th or 100th completed procedure?
It’s great marketing. It’s a quick way to demonstrate social proof and to help a customer feel valued.
That said, I’m not sure how often the physicians or hospitals are reminded that they are closing in on those milestones. (Sales folks or customer success teams, please feel free to correct me on this point.)
In any case, adding a meter to a physician’s dashboard can keep that reminder in front of your customers on a regular basis.
Procedure Time Comparison
For comparing procedure times to other physicians, these metrics can help physicians understand how they’re doing at a tactical level.
The outcome of the procedure is clearly paramount, but understanding how efficiently a physician is using a device can be useful on a number of different levels.
- For one, is the physician more or less efficient in using a device than if he or she did the procedure without the device?
- Secondly, is his or her time in line with other physicians and national averages? Is the time greatly exceeding others who are using the device for similar procedures?
This understanding of efficiency could make a difference for scheduling procedures, for ensuring that healthcare professionals are using the device correctly, and for overall profitability for the healthcare facility.
One way to “reward” this type of efficiency might be to have a leader’s board or to show the physician how he or she ranks in comparison.
This type of overview may be may already be happening within a hospital, but it takes effort to compile and review this type of performance data. It could simply be an additional metric on a dashboard.
Concerns Around Gamification
One thing companies have learned over the past 15 years is that there are certainly unintended consequences to creating digital experiences.
Yes, gamification can be helpful, but it can also be problematic.
It can be a frustrating experience to have to go through several “levels” of instruction with your progress meter filling ever higher just to be able to start to use an application. It’s like having to watch a cut scene on a video game without being able to skip ahead even though you’ve already seen it six times. (If you’re as bad at video games as I tend to be, you understand that frustration.)
Amazon decided to make a gamification program meant to boost employee productivity as an optional experience for employees. In 2021, an Amazon spokesperson said, “[T]he program remains completely optional for employees; they can switch in or out of different games depending on their preference, can play anonymously, or not play at all—the choice is theirs.”
And not just because users might be annoyed by the elements.
Some folks face “psychological harms such as a sense of defeat” when faced with negative news on their progress.
While gamification has the potential to make an application “stickier,” it can also push users away if they do not see the level of progress they want.
It’s unlikely that a doctor would stop using a medical device because of some negative news. But, consider a scenario in which an application constantly displays negative trends without giving any recourse by which that physician may change the situation.
Whether from defeat or frustration, that physician is likely to not use the application much longer.
Perhaps instead of simply displaying the downward trend, a company could offer a consultation with a sales rep, a customer success leader, or a key opinion leader. Maybe the system could even help pinpoint some areas in the physician’s performance that could be causing slower times.
However a company decided to offer help, the key would be offering a way out of the “defeat” state.
Dependence and Addiction
What about the people who do achieve positive scores? To take it a step further, what about the people who are addicted to achievement?
For a point of comparison here, one study of how health apps for cyclists measure their performance found “that some users also found their autonomy constrained, as they did not expect they would be so easily lured into the game rewards and incentives, such that they would complete the game challenges sometimes at the expense of other important personal and social commitments.”
In other words, trying to complete goals in the app derailed other important commitments.
(The above quote comes from Ethics of Gamification in Health and Fitness-Tracking. You can find the referenced study here: Healthy competition: A qualitative study investigating persuasive technologies and the gamification of cycling.)
We certainly don’t want to introduce anything into a healthcare experience that could mislead a physician or medical team from administering care.
While this could be an overblown concern, people are inherently competitive. Doctors, too. (Maybe even more so?)
These considerations must factor into product design.
What Do Your Users Think?
One constant refrain I hope you see and hear from this site is that we have to go back to user feedback.
How can we avoid frustration, defeat, or even addiction caused by our application? First, we have to be aware it exists (or is on its way to existence).
You can gain some insight from a variety of analytic tools, but you will need to have some one on one discussions with people to understand what does and doesn’t work for them.
We’ve written a lot about usability and customer feedback, so I won’t rehash all the details here. The point is, make sure you’re checking for the potential concern areas and not just focusing on whether or not the application works.
There are enough complications in healthcare. Let’s focus on creating excellent, rewarding experiences for healthcare professionals.
Additional Reading + Articles Cited:
Sorry, no extra points will be awarded for reading these, but I found them helpful in understanding the current state of gamification.
- Amazon expands gamification program that encourages warehouse employees to work harder – The Verge
- App Usability in Medical Device Design for Patients, Physicians, and Product Engineers – Health Connective
- Ethics of Gamification in Health and Fitness-Tracking – National Library of Medicine
- Gamification: What It Is and How It Works (With 8 Examples) – BuiltIn.com
- Gamification for health and wellbeing: A systematic review of the literature – ScienceDirect.com
- Healthy competition: A qualitative study investigating persuasive technologies and the gamification of cycling – National Library of Medicine
- Maximizing Your Customer Feedback Strategy – Health Connective