Serious Games and Game Development in Australia

There is a huge opportunity for Australia to take an international lead in developing a serious games developer sector.

Despite the widespread, possibly skeptical, perspective that games can only ever be an indulgent leisure time activity, games are considered ”serious” when they are developed and used in sectors such as health, education, defense, emergency planning, politics, engineering, urban planning, manufacturing and service delivery. Serious games have been defined as “a mental contest, played with a computer in accordance with specific rules, that uses entertainment to further government or corporate training, education, health, public policy, and strategic learning objectives”. Application areas are as diverse as engaging a person recovering from stroke in repetitive rehabilitation arm movements, to delivering critical incident response training to emergency personnel through to educating a child living with cancer about the impact of chemotherapy on their health or another about the impact of genocide in Dafur.

Games for health: an exemplar of serious games

Over the past few decades there has been a wealth of published scientific evidence for the physical, cognitive and social health-related benefits of increased physical activity, especially in older adults and people living with chronic disease. Despite the clear evidence base demonstrating the health-related benefits of physical activity, uptake and adherence is often disappointing. Furthermore, while people may be generally aware of the health benefits of physical activity, knowledge alone is often not sufficient to motivate a person to adopt and maintain physical activity behaviour. Therefore, interventions incorporating the principles of behaviour change are needed, both to maximise the reach of physical activity promotion initiatives and programs across the older community and to minimise attrition once people begin to be physically active.

One method by which we can increase understanding of the importance of, and compliance with, exercise programs involves the use of fun and engaging videogames. Consumer driven forces for new ways to interact with videogames have lead to development of sophisticated video capture and inertial sensing devices for measuring movement of the human body. Until recently, such technology could only be found in expensive and dedicated laboratory facilities. Devices such as the Microsoft Xbox Kinect are now at a price point (ca. AUD$200) that it is possible to relatively inexpensively deploy motion capture and feedback technologies directly into the homes of people for use in physical activity programs. Interactive videogames that combine player movement, engaging recreation, immediate performance feedback and social connectivity via competition, have been shown to promote motivation for, and increase adherence to, physical exercise amongst children and young adults.

Exercise-based videogame (exergames) have also been shown to improve cognitive abilities to be a feasible alternative to more traditional aerobic exercise modalities for middle-aged and older adults. Furthermore, exergames can be used to train stepping ability in older adults to reduce the risk of falls. More recently, videogame technologies are showing promise as a clinically feasible tool to deliver rehabilitation and training programs from issues as varied as stroke through to cerebral palsy.

Despite the potential utility of videogames to address the health-related needs of a diverse range of individual and patient groups, a number of challenges remain. Games designed for the general population are frequently too challenging or inappropriate for people living with a complex physical, cognitive, social or emotional capacities. For example, people living with spinal cord injury may experience difficulty manipulating game controllers or responding to activities that are too fast and visually complex. Globally there is an increasingly robust academic community (with its own peer-reviewed journal, Games for Health: Research, Development and Clinical Applications) addressing these challenges and an increasing number of game developers are now building games for health.

One of the first successful purpose-built health games, Re-Mission, was created by HopeLab to help young adults with cancer. In the game players control a nanobot named Roxxi who races through the human body fighting cancer with various weapons, such as the radiation gun. Players must also monitor patient health, learning about different forms of treatments and how they work along the way. In a randomized control trial of 375 patients, researchers found game players took their antibiotics more consistently and were more likely to adhere to chemotherapy treatments than others. The players also knew more about cancer and had a stronger belief in their own ability to reach goals while undergoing cancer therapy.

Despite the increasing evidence base on the impact of purpose-built serious games across a range of health issues, with much of the research being conducted in Australia, our Nation is lagging behind the rest of the world with only a few local developers exploring development of games for health. Sound Scouts (auditory health), Opaque Media (dementia awareness training) and Disparity Games (self esteem and anti- bullying) are examples of the few Australian game developers that are building games that can be applied to physical and psychological health. Revelian, a Brisbane-based recruitment consultancy has recently developed its own version of a psychometric assessment game, Theme Park Hero, which could be applied to clinical issues. Digital solutions specialists, The Project Factory (Sydney, London), have also developed game- based apps such as “This Way Up” to help combat depression and anxiety. Finally, Diversionary Therapy Technologies (Brisbane) have developed a hand-held multimedia platform (dittoTM) that uses elements of game design to reduce pain and anxiety, and improve healing times for traumatised children in the clinical environment. This solution is based on the outcomes of an extensive research program conducted by Director of Paediatric Trauma on the Queensland Statewide Network, Professor Roy Kimble. more recently, innovative Australian companies like Bondi Labs (Brisbane) and Enabler Interactive (Melbourne) are developing serious game-based approaches to education and training of the new workforce in agedcare and disability services.

“...we have to recognise that the disruption that we see driven by technology, the volatility in change is our friend if we are agile and smart enough to take advantage of it.

Malcolm Turnbull, 14th September 2015

It is time for a disruption of both videogame development and the healthcare sector through serious games. According to Clayton Christensen, disruptive innovation describes a process by which a product or service takes root initially in simple applications at the bottom of a market and then relentlessly moves up market, eventually displacing established competitors.

Traditionally dominant companies in a sector tend to innovate faster than their customers’ needs evolve, most organizations eventually end up producing products or services that are actually too sophisticated, too expensive, and too complicated for many customers in their market.

When we focus on the issue of videogame development, the vast majority of the commercially successful, frequently console-based, games typical of the industry, are vastly sophisticated, extraordinarily expensive (to produce) and absolutely not fit for purpose for the huge and growing health, aged and disability markets. Furthermore, traditional videogame developers pursue “sustaining innovations” (relatively incremental improvements on the status quo) at the higher tiers of their markets because this is what has historically helped them succeed: by charging the highest prices to their most demanding and sophisticated customers at the top of the market (console game players), companies will achieve the greatest profitability.

However, by doing so, game developer companies unwittingly open the door to “disruptive innovations” at the bottom of the market. An innovation that is disruptive allows a whole new population of consumers access to a product or service that was historically only accessible to consumers with a lot of money or a lot of skill (or indeed particular interests). The population of older adults with complex health conditions and people living with a disability or chronic disease and even those who are physically healthy but psychologically unwell, is enormous. Traditionally the game developer industry has only considered “their” market as people who like to engage in entertainment-based games. By reframing this perspective towards individuals who like to play games AND may be living with complex physical, cognitive, social and emotional health issues, the potential market for videogames becomes huge and growing. 

Games also offer the potential to disrupt healthcare delivery. For example, current rehabilitation practice (e.g. following stroke) involves a period of intense, guided rehabilitation during the early stages of recovery, often in an acute hospital setting. Patients are then gradually discharged back into the community, with limited funded ongoing support through transition care programs, to lead the remainder of their lives functionally impaired to various degrees. Often patients are discharged from rehabilitation with sheets of printed instructions for the kinds of exercises they should engage in to aid their recovery of physical, psychological, emotional and social function. For patients returning to regional, rural or remote Australia, the paucity of access to rehabilitation services is particularly distressing.

Imagine instead a world where the person recovering from a stroke is sent home from hospital with a videogame console, pre-loaded with a suite of engaging, informative games to engage them in their rehabilitation program. As they engage in rehab gameplay, their centrally located rehabilitation specialist can monitor performance and adjust challenge posed by the games, ensuring that progress of rehabilitation is guided, informed and encouraging. Furthermore, for the patient who may have formed close social bonds with others on the rehabilitation ward in hospital, they now have the opportunity to “play” against each other irrespective of the physical and functional distance that may separate them. 

Despite the opportunity for local development of game-based solutions for health/ageing/disability, the Government seem steadfast in its failure to respond to any of the recommendations of the Senate inquiry into the future of the Australian videogame developer industry

https://www.aph.gov.au/…/Environment_and…/Video_game_industry

Here's an open letter from the CEO of the iGEA to Senator Fifield expressing some of the frustration that those of us who see the potential for game tech in health, education etc. Will we get a response?