By James A. Cooley

James Cooley works for a big Texas state agency doing health care policy analysis and research, with a specialty in health care IT. His research and analysis projects cover e-prescribing, telemedicine, EHR & PHR and beyond. That is his way-cool day gig. At night, he is a passionate computer gamer who builds his own custom rigs and struggles to squeeze out a few more frames per second with everything maxed out.

I admit to a fascination with Health 2.0. I see it as the place where a lot of the things that look promising in health care and technology are all mashing together.

As a follower of developments in both the health 2.0 movement and the gaming industry, I came across the following article that piqued my interest. It deals with the deal reached between Netflix and Microsoft to facilitate movie downloads to those using the XBOX Live network.

Reading this, I got to thinking it might have implications for Health 2.0. The question: Why not use these emerging gaming and movie delivery platforms to deliver interactive health care and fitness content.

Hmm, I wondered further: Would Netflix consider a deal with Microsoft to permit XBOX 360 users access to free download of certain interactive health care information content? I could see modules for management of certain diseases (including those that impact young people, such as asthma). There could also be modules with health and fitness activities that incorporate interactive video and gaming elements.

If the content was truly interactive and had fun gaming elements, it might encourage people to try it. There is rapid growth of the Wii as a tool for stroke and accident rehabilitation, so the use of video games to make medical procedures less clinical is already catching on.

Games as something good for you has also gotten a bit of health care policy research traction. The Center for Connected Health is exploring the use of Second Life as a medium to exchange health care information. There is also work done on gaming as a health promotion tool through the Games for Health project.

What still needs to happen, in my view, is for the major gaming studios and content distributors to jump in big-time. This needs to be something that becomes a strongly industry-supported and encouraged activity. It can only generate positive publicity for the industry to take a leading role with this.

Maybe Microsoft could add the “Achievements” perks they use in other games so players get some sort of rankings for participating in disease management or fitness activities. There is also the potential to use the social networking tools built into the platform to link people together who are trying to do something healthy and need a buddy system to spur them on.

A key is the enormous distribution clout of Netflix and the big platform of Microsoft’s XBOX network. If it works, similar content could be developed by companies specializing in other platforms (PC, PS3, DS, iPhone, etc.).

One key facet would be for games studios to permit their characters to be licensed for use in wellness/fitness promotion or disease management purposes. This could promote both their games franchises and the respective platforms that run them.

Netflix and Microsoft aren’t the only game in town (pardon the pun). Valve Software has put together a tremendous online content distribution platform with Steam. Adding some free content with a health and fitness focus extends the reach of their distribution platform. The point is that nothing in this requires anyone to try to go way beyond what they already do now.

I am pointedly not suggesting Netflix get into the health care data business. They have no business case for messing around with EHRs, PHRs, HIPAA, and anything else that involves actual health data exchange. Again, they specialize in audio-video content. However, health care information (as opposed to patient data) is often also a form of audio-visual content. For that matter, so is a computer game.

Health information or health promotion activities in a downloadable form that features game-like content is what would be the distributable item, not the health data itself.

The lines between traditional video content and games are becoming somewhat blurred, as even DVD movies often may have interactive game content. Some modern games, such as Bioware’s Mass Effect have taken movie-like interaction to new levels.

Adding complementary interactive health and fitness content to Netflix’ existing stock of materials would appear to have small marginal requirements for a company that streams such massive amounts of content already. Having content that is tailored to use the interactive features of the XBOX 360 (to include gaming elements) would seem a logical extension of this marriage of two services. It would seem inevitable that such “mixed-use” content will be developed, as movies played on games platforms becomes more commonplace. It is in the interest of the platform developers to see such content enabled.

If so, health and fitness content would seem a useful addition to the mix. A Halo 3 workout video with interactive game elements (and perhaps a USB plug-in heart rate monitor) promotes Microsoft’s other intellectual properties (to include their stake in PHRs, which feature health information). Anything that extends the reach of the platform and ties it into other services might have value.

There will also be a role for those who produce traditional health and fitness content to jump in and partner on developing new messages for this new medium. A number of these entities – ranging from public health agencies to medical societies to disease assistance advocates – produce free content now. It could be modified for distribution as in interactive product with game elements.

The technology to do all this is already around, though some of it might have to be modified a bit. Imagine jump pads where you get to do jumping jacks with the Halo’s Master Chief. Ponder being able to hook up your exercise bike to the computer and doing a virtual bike race with Lance Armstrong at your side. Think about the improvements the proper use of an asthma inhaler if the medic from Valve Software’s Team Fortress 2 was the one teaching you how to do it. Think of it as getting an asthma relief uber-charge! (If you play the game – and you should! – you will get the reference).

Would kids exercise more if they could platform jump with Mario? I think we know the answer.

What is required to unleash the addictive fun of these games and their characters? We need to tie the game-play with sustained activities that can be fed back into the game to either generate rewards or move the game forward. Instead of sitting there working a mouse or controller, you have to do something interactively that burns calories. Maybe we could add in a jump pad to facilitate a Guitar Hero 3 “charisma” bonus score for jumping around while you shred.

It may require some hardware modifications to allow various activities to take place while moving, but wireless gaming hardware is already starting to remove the tether to the computer or console. Hey, I am willing to try fragging while peddling if I can mount a keyboard and mouse to a stationary bike.

We can even try to take some of this interactivity a step further.

Just imagine if our juvenile couch potatoes could be virtually projected into a “workout version” of their favorite game with a webcam and some imaging software! Toss in some social networking and friends from around the world could join in with the activity.

The possibilities are endless to combine gaming platforms, modern content distribution methods, health monitoring and feedback devices, and social networking into tools to improve the delivery of health and fitness content. The best part: it could be a lot of fun!   

Modern interactive video and gaming content might fit in with some of the new health information and fitness promotion tools being pondered as part of Health 2.0. Let’s toss it into the mix for further discussion.