The psychology of games is well understood. Offering incentives in the context of a positive experience generates better engagement and builds loyalty. The effectiveness of games helps explain why the global healthcare gamification market is expected to reach $13.5 billion by 2025.
Other industries have long used game elements that leverage behavioural science to drive desired customer behaviour (think airline loyalty programs that award points and status for miles traveled). And indeed gamification is increasingly being incorporated into health insurance design and wellness programs.
However, despite its growing use, there’s only limited evidence of its effectiveness in health care, and in particular whether existing gamification makes the best use of behavioural economic principles. Members of our group recently evaluated 50 of the most popular smartphone applications for health and fitness and found that while nearly two-thirds of the apps used game elements in their design, none incorporated several key insights from behavioural economics that could effectively influence desired actions and address predictable barriers to behaviour change.
A central challenge for all health-related gamification programs is engaging participation, particularly among high-risk patients. Several design elements commonly found within gamified health and wellness programs could be made more engaging by incorporating behavioural insights. For example, most programmes invite patients to join, framing their choice as an opt-in decision. But we have found that opt-out framing significantly improves participation.
In a randomized trial, Harvard researchers tested how to engage adults with uncontrolled diabetes in a remote-monitoring programme. In the traditional, opt-in approach, only 13% signed up. But when the introductory letter framed the programme as standard care, but allowed patients to opt out if they wished, enrollment rates nearly tripled to 38%. We’ve found similar results when testing ways to engage patients in a medication adherence program after a heart attack.
As healthcare organisations look to the future, gamification provides a mechanism to improve business operations, increase engagement and create better consumer experiences.