Designing Digital Tools for Patient Engagement

A white paper published by Ayogo Health Inc. that looks into using “gamification” in developing digital tools to increase patient engagement. An interesting observation in this paper is that interacting with the world through game play is “one of humanity’s most important and universal characteristics” (Fergusson, 2015). The author notes that all societies and individuals play in some form or fashion. This is an important piece of SimStay in that there are many arguments that not everyone will play video games, or be familiar with technology. While this may be the case, it is important to note that everyone will be familiar with the concept of “play.” It may not be specific to video game play, but the feelings associated with game play are understood by all.

The paper notes that Nicole Lazarro identified four key categories for game-based experiences:

  • People fun
  • Serious fun
  • Hard fun
  • Easy fun

All four of these components are included in SimStay in some form or fashion. People fun is incorporated through the social elements of the game, serious fun can be found in the educational components and simulations within the game, hard fun can be found through serious games within the casual game area, and easy fun can be found within the non-strategic casual games.

Some interesting notes about the physiological effects of gameplay are referenced within the paper, including the release of dopamine, which is a neurotransmitter “associated with learning, goal directed behavior and motor behavior” (Fergusson, 2015). Rewarding a player’s participation can trigger the release of dopamine and encourage continued engagement. The paper also ntes that there are several game components that can trigger the release of oxytocin, which is associated with feelings of trust, honor, and affection. Experimentally, Facebook has been shown to release oxytocin, through positive messages from friends and family, and other game related actions such as receiving virtual gifts (Fergusson, 2015).

Serotonin and endorphins are two neurochemicals that have also been related to gameplay. Serotonin, which helps a person “gauge the value of an outcome in a game, using costs & benefits (risks and rewards) when making a decision” (Fergusson, 2015). This is especially important within a game that is meant to increase the health education and patient engagement in that patients must see value in participating in the game. Whether through long-term lifestyle changes, or more immediate benefits such as stress release during casual video game play. Endorphins, which are often times tied to the benefits of the placebo effect, are related to the “expression of gratitude, appreciation for the beauty of our surroundings, social interactions and challenges” (Fergusson, 2015). Social interactions are a large component of SimStay, whether through character interaction in the form of players meeting staff avatars, or through the interaction of other patients within the support groups.

Fergusson notes that as further research is conducted in the sphere of using games to improve health outcomes, there is a continual collection of “concrete evidence” that playful design will improve patient engagement and health outcomes (Fergusson, 2015).


Fergusson, M. (2015). Designing Digital Tools for Patient Engagement (White paper). Ayogo Health Inc.

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