Beyond points & badges: How gamification drives behavior change
🥇Healthcare gamification means applying gaming principles, game design techniques, and game mechanics to non-game applications to improve clinical outcomes. These games are often termed ‘serious games’ to distinguish them from apps designed purely for entertainment.
Gamification in healthcare today goes far beyond simply adding points and leaderboards to existing tools.
When properly designed, gamification elements such as goal setting, challenges, progress bars, and rewards tap into fundamental neurological processes that enhance learning, motivation, and behavior change.
As Sam Glassenberg, founder of Level Ex, explains: "Video games excel at driving learning as an unintended consequence of play." This happens because game design is deeply rooted in cognitive neuroscience, striking the perfect balance between challenge and skill to maximize the release of brain chemicals that enhance learning and motivation.
Consider these real-world applications in healthcare:
Patient adherence: Diabetes management apps that reward medication compliance with points and virtual rewards have shown a significant reduction in HbA1c levels and improved medication adherence [ref]
Medical training: Surgeons who train using gamified surgical simulators show improved performance compared to traditional training methods [ref]
Mental health interventions: Apps that gamify cognitive behavioral therapy techniques provide patients with engaging ways to practice new coping skills [ref].
The science behind the play
What makes gamification truly powerful is how it taps into intrinsic motivation rather than relying on external rewards. When patients and healthcare providers engage with well-designed gamified systems, they find genuine satisfaction through mastery, autonomy, and purpose - psychological drivers far more compelling than simple achievement badges.
This isn't just theory - it's grounded in solid neurological research.
During gameplay, our brains release dopamine, a neurotransmitter crucial for neuroplasticity. When gamified healthcare applications trigger this release at precisely the right moments, they strengthen the neural pathways essential for developing new habits and skills.
By harnessing these cognitive neuroscience principles, developers can create healthcare experiences that don't just entertain, they fundamentally transform behavior.
Not all health gamification needs an app
🎲 BoardGains: This fitness board game, created by personal trainer Eric Mathura, combines exercise with gameplay mechanics. Players roll dice, move around the board, and perform bodyweight exercises corresponding to spaces where they land.
Launched in 2021 after a successful Kickstarter campaign, BoardGains requires no equipment and comes in two versions: a Starter Edition with basic movements and a Pro Edition with more challenging exercises. The game can be played individually or in groups, indoors or outdoors, and allows for exercise modifications based on fitness level. Used in homes, schools, and fitness facilities across 15+ countries, it represents an interesting approach to making regular physical activity more engaging through gamification.
Beyond superficial gamification
One important distinction highlighted in research is the difference between superficial "gamification" (simply adding points and badges to existing materials) and meaningful game design.
True gamification aligns game mechanics with specific healthcare goals, creating experiences that naturally motivate desired behaviors.
Consider these contrasting approaches:
Superficial gamification: A diabetes app that awards arbitrary points for logging blood glucose readings but doesn't connect these actions to meaningful outcomes or patient goals.
Meaningful game design: A diabetes management system that creates a compelling narrative where blood glucose monitoring helps a virtual character navigate challenges, with in-app rewards directly tied to health improvements and personalized to each user's specific diabetes management needs.
Bayer's Didget blood glucose meter, which connects to a Nintendo DS gaming platform, is designed for children aged 4–14. The device gamifies diabetes management by rewarding consistent blood glucose testing with points. As children accumulate points, they unlock new game levels and features. The platform includes leaderboards showcasing top-scoring children, interactive web games and an online community.
The most effective healthcare applications incorporate gamification that directly supports the core medical purpose of the app. When gamification elements are merely decorative, they have minimal impact on health outcomes.
What is driving the growth of health gamification?
“The global healthcare gamification market, valued at $3.15 billion in 2022, is projected to grow at a CAGR of 22.6% through 2030, reflecting its increasing adoption across diverse medical domains.”
Several key factors are driving the growth of health gamification:
Advancements in mobile technology and wearables: Sophisticated apps and devices now make it simpler than ever to track health data and deliver engaging experiences
Growing focus on preventative healthcare: Gamification motivates people to take proactive steps in preventing future illness
Need for engaging chronic disease management: Interactive tools help patients maintain commitment to their treatment plans and better handle ongoing conditions
Increasing awareness of mental health: Gamified apps offer accessible, engaging approaches to support mental wellness and emotional resilience
Desire for personalized health solutions: AI-driven gamification creates experiences that adapt to individual needs and goals
Proven effectiveness: Studies, including research by Deloitte and EY, show that gamified health apps maintain higher user engagement rates.
🛌🏻 SleepTown is an app that uses gamification to help users improve their sleeping habits. By maintaining a consistent sleep schedule, users create their own virtual town.
Here's how it works: Users set their bedtime and wake-up goals. Each evening, they open the SleepTown app before their target bedtime to begin constructing a building. When they wake up, they discover the new building that was constructed overnight.
The app has also added a social feature that lets users build their towns with family and friends by achieving shared sleep goals.
Potential Pitfalls and Ethical Considerations
Despite its promise, gamification in healthcare faces several key challenges. Research highlights these important concerns:
Regulatory oversight: Many gamified health apps operate without proper medical device classification and regulatory approval, potentially risking user safety
Evidence gaps: While certain gamified approaches demonstrate clear benefits, others lack robust evidence supporting their effectiveness
Over-reliance: Users may become overly dependent on gamified applications instead of developing their own internal health motivation
Data privacy: The extensive data collection by gamified apps raises significant privacy and security concerns.
Poorly designed gamification can even undermine health objectives. For instance, when a fitness app solely rewards step counts, users might fixate on walking while ignoring crucial aspects of fitness like strength training or flexibility.
🎮 Game on for better health
Gamification represents a shift in how we approach healthcare challenges. By leveraging the same psychological principles that make games so engaging, healthcare providers can transform sometimes tedious or complex health behaviors into more rewarding experiences.
As research continues to validate and refine these approaches, gamification is poised to become an increasingly important tool in the healthcare arsenal, not just making health more fun but genuinely improving outcomes for patients and providers alike.
📫 Subscribe to the Healthy Innovations newsletter for your weekly dose of medical advances, from AI diagnostics to gene therapies, delivered in a concise 5-minute read.
