Jeff, the rapid increase in the popularity of Wiihab demonstrates the potential impact that Gaming for Health could have on rehabilitation and lifestyle medicines. The gaming consoles combination of cost, usability characteristics, social networking and ability to integrate with Personal Health Records and other personal medical devices has the opportunity to change the traditional paradigm of care. Our current paradigm of care is largely defined by the silos of care setting / level of care; providers and payers. Patient acuity and payers, or the ability to be paid, often define our care setting / level of care. Care setting / level of care defines in part who our providers are, and what information those providers have access to. Most rehabilitation patients move through multiple levels of care during their rehabilitative episode: Acute inpatient; Inpatient Rehabilitation; Outpatient Rehabilitation; Skilled Nursing and Home Care. Despite our best efforts, information and continuity of care are lost with each change of setting, and our ability to provide the best clinical resource available are often impeded by these silos. Gaming Consoles such as the Nintendo Wii and Microsoft Xbox present the opportunity to extend the reach of rehabilitative medicine beyond its traditional settings by becoming the virtual agent of the clinician: to prescribe, measure and manage rehabilitative therapies and enable interaction between patients and clinicians regardless of setting or location. The challenges to this paradigm shift are not small. Gaming consoles are not medical devices, and were not developed as such. Gaming is frankly a much more lucrative business, currently, than Gaming for Health. Payers do not consistently recognize and therefore reimburse these new forms of therapy. Personal Health Records are still in their infancy. But, as compelled as we were by Microsoft Windows, Cell Phones, Ipods, The Internet and other disruptive technologies; a glimpse into Gaming for Health imagines a bold vision of how it can transform the way we deliver rehabilitative medicine. Compelling technologies overcome their challenges: whether Xbox, Wii or some device not yet known, we are seeing the future of rehabilitative and lifestyle medicines unfold before us. - John Campbell, CIO Spaulding Rehabilitation Hospital and Rehabilitation Hospital of the Cape and Islands and Principal Investigator, "Technology-Enabled Therapy System"

In line with this, the issue is that leisure often works as the entry point for new technologies (TV, telephony, mobile, ...). In this case, it won't be less. The home-gaming platforms, once deployed in miilions of houses, is a clear gateway for bringing extra services to the house, like it happened with the TV set, Radio, PC, mobile phone and so on. All of them started their "home life" with much simpler purposes than the ones they actually have.
Gaming platforms are complete computers and customers are used to deal with them. That makes them the perfect tool for integrating network services, thrid parties applications, ...

John I think your comments "Gaming Consoles such as the Nintendo Wii and Microsoft Xbox present the opportunity to extend the reach of rehabilitative medicine beyond its traditional settings by becoming the virtual agent of the clinician: to prescribe, measure and manage rehabilitative therapies and enable interaction between patients and clinicians regardless of setting or location" truly summarize the main point of my article. Combine this with Luis' point about home-gaming platforms being a "gateway" for bringing services into the home of patients are the perfect ingredients for a new, at-home, more interactive paradigm of care.

What is even more impressive to me is the amount of interest and conversation this article has produced in the last few days. It has even lead to the launch of a new Linkedin in group called "Gaming for Health" (John Campbell, CIO Spaulding Rehabilitation Hospital and Rehabilitation Hospital of the Cape and Islands and Principal Investigator, "Technology-Enabled Therapy System"- Great Idea!). New members are joining daily!

Within Linkedin, search by "group" with the key words "Gaming for Health", Please Join!

Thanks Again

Jeffrey L Brown

The most important aspect of this phenomenon, in my opinion, is the effort to bridge the concepts of health care and games or fun. We've labored under the assumption for hundreds of years that health care is something very serious (and why not - for most of history an interaction with the health care system was a reasonable predictor of one's demise). There was a mini-trend a few years ago expounding the notion of laugh therapy. The idea of using gaming in rehab is similar. why not make it as much fun as possible. This also illustrates another important phenomenon - bringing care into people's lives using everyday (ambient) technologies. It is a very exciting trend.

I think funding is key for a paradigm shift. There's no doubt about the behavior changing potential of these games. Integration with EMR or PHR, however, may depend not only on incentives from payers but also on grants for health-gaming research. The Robert Wood Johnson Foundation is making some headway in the direction. Check this out:

http://www.healthgamesresearch.org/

Posted by Chhaya Shadra, MS Student at Northeastern University