care providers and by government. It’s
meant to be interdisciplinary.”
Determining the size of the sprawling
health games industry is no easy task,
Sawyer says. “To define the size, you
need to define the boundaries,” he says.
“Three years ago, Wii Fit [an interactive
game from Nintendo] began selling like
hotcakes. You could say it is now a $1 bil-
lion game in global revenue. The indus-
try spans hundreds of millions in other
consumer fitness products. Venture capi-
talists, angel funds and government are
pouring tens of millions into game com-
panies. It is very hard to pin this down.”
The health care industry itself is begin-
ning to take notice. A number of health
insurers and even large provider organi-
zations are jumping into health games,
either by developing games outright,
partnering with games companies, or
looking for new business opportunities.
The undeniable appeal of games for
consumers may create inroads for innovative approaches to disease management and healthy lifestyle maintenance.
But the economics of how games might
fit into the health care industry remain
murky.
The industry is just beginning to test
several financial models. High development costs pose but one obstacle to
games’ acceptance by the health care
industry. Passing clinical muster in an
evidence-oriented industry is another.
Nintendo’s games may be best sellers,
but that doesn’t mean employer-spon-sored health plans will rush in to buy on
behalf of members. Despite the unclear
financial path ahead, many experts think
the sheer popularity of interactive, online
games will guarantee a presence in the
years ahead.
One proponent of health games is Deb-
ra Lieberman, director of Health Games
Research, a department at the University
of California Santa Barbara that is funded
by the Robert Wood Johnson Founda-
tion. The department, says Lieberman,
attempts to measure the design and ef-
fectiveness of health games. More than
20 are under review. “We are trying to
raise the research bar. We want consum-
ers and industry leaders to understand
that good games are evidence-based and
designed for behavioral change beyond
just improving knowledge. I hope the
field trends to high quality and high ef-
fectiveness. I hope that games are taken
seriously as health interventions.”
No joking
Indeed, the very moniker of “health game”
may suggest something frivolous, as in
Angry Birds, a best-selling game in which
participants rack up points by launching
birds at pigs with a slingshot. That’s why
many health games proponents refer to
their niche as “serious games”—in part
to distinguish their intent from entertain-ment-oriented products and even more
dubious games (think Grand Theft Auto)
which emphasize violence and inflicting
harm.
For their part, large-scale commercial
enterprises creating games for entertain-
ment, however defined, steer clear of se-
rious health games. “The game entertain-
ment industry sees serious games as a
small sideline,” explains Noah Falstein, a
long-time video game designer who now
runs his own design and consulting shop,
The Inspiracy, based in San Rafael, Calif.
“It’s hard to get their attention. Yet older
game developers can get jaded at making
yet another shooter game. The thought of
doing something to change people’s lives
for better is very compelling.”
Falstein envisions health games
emerging from creative partnerships in-
volving game designers and health care
professionals.
“If people from the medical side can
reach out to game developers, and say
‘we see a use for this,’ they will find it easy
to find collaborators and do something
