Pressing play on the gamification of healthcare

‘Retail therapy’ has long been thought to cheer us up, but what about ‘video game therapy’? It might sound like a dream come true to the gaming generation, but video games designed to treat conditions such as ADHD and depression are starting to break into the mainstream for real…

Video games have historically been blamed for a wide range of evils: causing attention deficit problems, obesity, eyestrain, aggression and anti-social behaviour.

Video games have historically been blamed for a wide range of evils: causing attention deficit problems, obesity, eyestrain, aggression and anti-social behaviour. But now gaming – in the guise of ‘digital therapeutics’ – may be the answer to treating a range of tricky health problems. Popping pills or gulping down horrible-tasting medicine might soon be a thing of the past, or at least something to avoid, as doctors can now prescribe approved video games as a treatment option.

What are digital therapeutics?

Digital therapeutics (DTx) are evidence-based technologies that use state-of-the-art software programmes to manage and treat a variety of chronic diseases, neurological conditions and behavioural disorders. 

According to the Digital Therapeutics Alliance – a trade association of industry leaders and stakeholders – DTx is an independent category within the digital health landscape, sitting alongside existing pure-play adherence, diagnostic, and telehealth products. 

Like these other digital healthcare services, DTx can be used on its own or in support of current medical treatments, as well as offering an alternative to pharmaceuticals. Most crucially, DTx are focused on medical conditions that currently aren’t being treated effectively, and can be delivered at a much lower cost to healthcare providers’ time.

What medical conditions can digital therapeutics help with?

• So far, we’ve seen developers and medtech companies creating various video game algorithms to help:
• ADHD
• depression
• grief
• anxiety
• autism
• multiple sclerosis
• lupus
• traumatic brain injuries
• stroke recovery

Digital rehabilitation for Substance Use Disorder and immersive virtual reality (VR) for pain management are also in the in the works.

While immersed in the digital game world, there may be increasingly difficult levels, distractions, strategies, puzzles or challenges that act as sensory and motor stimuli. These activate key areas of the brain, which, with regular practice, can improve cognitive function and neurological skills.

How do digital therapeutics work?

Essentially, what DTx does is to ‘hide’ neurological and psychological therapies within high-quality graphic gameplay. While immersed in the digital game world, there may be increasingly difficult levels, distractions, strategies, puzzles or challenges that act as sensory and motor stimuli. These activate key areas of the brain, which, with regular practice, can improve cognitive function and neurological skills.

Depending on the type of algorithm, medical condition and patient need, DTx can be highly personalised. The ‘dosage’ would be how often the patient should play and the level of difficulty. 

Using biofeedback, physiological responses such as heart rate, breathing, temperature, muscle tension, eyeline and sweating can be monitored, which together provide feedback on the patient’s attention and anxiety levels. 

What video game therapies are available now?

Akili Interactive is the first DTx company to receive FDA approval in the USA, as of June 2020. The startup’s video game-based therapy, EndeavorRxTM (also known as Project: EVO and AKL-T01), is now offered as a treatment for paediatric ADHD on prescription.

Akili Interactive is also working on therapeutic games for children with autism and adults with Major Depressive Disorder. Other developers like Pear Therapeutics, Affective Engine, and Spatial Navigation are also working on video game treatments. 

Some other existing therapeutic games (albeit without medical approval), include:

• Sea of Solitude by EA Games, to help develop coping mechanisms for feelings of loneliness and hopelessness
• Depression Quest, where you play through a series of everyday life events as someone living with depression
• GRIS by Steam, which uses puzzles and challenges to explore grief and loss

What does this mean for the future of healthcare?

During the COVID-19 pandemic, the US FDA relaxed restrictions and regulations for telepsychiatry, and with EndeavorRxTM now approved, it’s likely that the regulatory environment globally will begin being more conducive for digital health therapies. 

As for the role of providers and payors, companies like BrightInsight and Kaia Health have already secured millions of dollars of funding for developing digital therapeutics and building an infrastructure to smooth the way for biopharma and medtech companies. 

The very near future will see software at the very heart of modern medicine, with prescriptions for apps and video games instead of pills and medicine

The very near future will see software at the very heart of modern medicine, with prescriptions for apps and video games instead of pills and medicine for occupational therapy and psychotherapy, ASMR wellness treatments to alleviate anxiety, and the emergence of ‘digital nutrition’ to support our behavioural and emotional health in an increasingly digital world. The era of gamified healthcare is here.