Gamifying Healthcare: User Experience Students Challenged with Life or Death Design Problems

Believe it or not, not all health records are kept on an electronic platform. Yes, still. According to the Centers for Disease Control (CDC) and Prevention, of around 78 percent of all office-based physicians that utilize electronic health record systems (EHR)s , only 48 percent of those meet basic functionality criteria proposed by the CDC.

Moving health records to electronic systems is a complicated procedure that's taking place all across the country — largely because of the HiTech Act that was signed into effect in 2009, which poses monetary penalties on institutions that don't computerize records starting this year. According to HealthIT.gov, many health care providers focus on creating their own electronic systems by themselves, meaning that troubles with data interoperability between hospitals and offices poses a major challenge.

But let's put purely technological struggles aside for a moment. Another pressing issue slowing healthcare tech adoption is the way most of these systems are designed.

Creating something that's easy to use is one of the biggest hurdles for the EHR industry, according to Shareable Ink — an enterprise specializing in cloud-based platforms that simplify clinical documentation and EHR use. Health care institutions don't want to adopt software that is confusing and could make it more difficult to care for patients.

To help solve this problem, Shareable Ink partnered with students and faculty in Bentley University's Human Factors in Information Design master's program during the fall 2014 semester.

A Corporation Asks Bentley University for Assistance


Shareable Ink CEO, Laurie McGraw, credits Bentley's experience in user experience as the reason for seeking out this partnership. "Bentley University has both a world-class UI design lab and human factors program," McGraw noted. "We are excited to work with Bentley students to ensure our advanced solutions continue to be intuitive and easy to use for busy clinicians."

During the course of the semester, Bentley faculty and 22 graduate students grappled with how to improve the process for users (clinicians) and ultimately, end-users — their patients.

The number of physicians with basic EHR systems increased by 366 percent from 2006 to 2013, according to the CDC. "Physicians and nurses have to spend a lot of time filling out documents. This is a tedious and time consuming task, yet it is still extremely important to have accurate and complete records," said Roland Hubscher, Ph.D., a Bentley HFID professor. "Shareable Ink asked us to come up with solutions, using gamification, to improve this situation."

Gamification involves the use of intrinsic and extrinsic motivation to encourage and reward a certain desired behavior. Creating a successful gamification strategy that is the perfect combination of work and play is no small feat, though. Research giant Gartner Group predicted that 80 percent of gamified applications would fail to meet business goals thanks to poor design in 2014. That's because many developers attempt to create one-size-fits-all gamification programs.

"The challenge facing project managers and sponsors responsible for gamification initiatives is the lack of game design talent to apply to gamification projects," said Gartner Research Vice President Brian Burke. "The focus is on the obvious game mechanics, such as points, badges and leader boards, rather than the more subtle and more important game design elements."

Seriously Gamifying Medicine

Hubscher's class split up into teams to work on designs and prototypes of very specific gamification qualities that would make sense in a serious scenario like healthcare. They broke up into different groups to research specific motivations and criteria of different users.

"Each of the five groups came up with a different solution — like improving data input, improving motivation for physicians and nurses, involving patients more in the capture of data and the like," Hubscher said. "Each of those solutions required a different form of gamification as it has become quite clear that just adding a gamification mechanism "off the shelf" will not work well."

Research was one of the most important elements of the project. Aside from doing multiple iterations of a design processes, students were challenged to research how EHRs function and what tasks anesthesiologists performs during various stages of an operation — as Shareable Ink serves mostly these types of health care professionals.

Ultimately, Bentley's teams were able to provide detailed reports and several protypes that the health care company could use to drive and inspire their app development. And, it may not be the last time the two entities work together.

"It is my impression that we will have more interaction between HFID and Shareable Ink in the future given the positive collaboration we had last semester," Hubscher said. "Not just in my course, but also in others focusing on research or testing."

Working with operational businesses and their real-world problems can be a tremendous learning experience for students in any graduate program, according to Hubscher. It takes away the necessity to create a made up problem, which can be hard to motivate students with. Moreover, it can introduce students to different businesses and industries that they may not have considered, and are in need of user experience and human factors professionals. The opportunity to work with Shareable Ink and present work to company employees prepares students for the challenges they'll tackle after graduating.