MyPerformance - Integration of games and performance in healthcare

MyPerformance - Integration of games and performance in healthcare

United States
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Concise Summary: Help us pitch this solution! Provide an explanation within 3-4 short sentences.

Incorporating technology to support patient and family focused care and consumer driven health care decisions, concepts and methodologies that will transform the future of health care.

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Plot your innovation within the mosaic of solutions
Which of these barriers is the primary focus of your work?

Insufficient Evidence that Games Improve Health

Which of the principles is the primary focus of your work?

Physical Health

If you believe some other barrier or principle should be included in the mosaic, please describe it and how it would affect the positioning of your initiative in the mosaic:

This field has not been completed

What is your signature innovation in one sentence?

Incorporating technology to support patient and family focused care and consumer driven health care decisions, concepts and methodologies that will transform the future of health care.

Describe your innovation. What makes your idea unique and different than others doing work in the field?

Our innovation involves the integration of several concepts and methodologies:
• Focus on early post-op rehab processes and the impact can be extended beyond TKR or THR to not only other Orthopaedic procedures but also to all of early post-op patients (i.e. s/p heart surgery, vascular surgery etc....) along with many areas of acute post-op rehabilitation.
• Video games and exercise equipment which adapts to individual’s range of motion and fitness level.
• New techniques such as MIS and less invasive approaches and new technologies and most importantly, the new requirements by patients (i.e. consumer driven care), it is important to bring everything together to achieve the goals of both patients and care givers.
Our primary goal is to avert the attention of the user from the work involved in the physical activity by the interaction of playing the game. Although there are games and gaming systems currently available on the market today, our innovation has features and capabilities that make it unique. These features and capabilities are:
• Track, analyze, save and print user performance using memory card technology so the user can bring results with them to a doctor visit.
• Software adjusts to the level of fitness and/or range of motion allowing the user to exercise from start to end, along with fitness maintenance, without having to buy additional software.
• Motivate user with built in encouragement in the form of inspirational messages.
• Display visual goals and milestones that the user has pre-defined. In a physical therapy or rehabilitation setting this can be pre-defined by the therapist.

What barriers exist that are creating the problem your innovation is hoping to address/change?

In terms of barriers/questions that exist from an implementation standpoint are more directly related to:
• Increased user responsibility/involvement – training individuals to play a more active role in their physical well being and future health.
• Acceptance from the health care community that video games are an effective tool for physical therapy, rehabilitation and exercise.
• Cost – both for continued development and future enhancements.

Delivery Model: How do you implement your innovation and apply it to the challenge/problem you are addressing.

The idea of having an individual more involved in their health and well being is a concept that is quickly gaining acceptance. This is clearly evident with Consumer Driven Health Care, and our innovation is very similar; the only difference, and it’s a big one, is that along with more involvement, our innovation makes it fun for the individual. The point that our innovation integrates the user and the caregiver, which can be a primary care physician, physical therapist or specialist, will need to be at the forefront of all implementation efforts. This innovation will ultimately provide the user with more involvement in their health and well being.

The Innovation Center will leverage its partnership with Blue Belt Technologies (, which also has a partnership with Carnegie Mellon University, to capitalize on Blue Belt’s extensive experience with surgical navigation technologies, including both active and passive optical tracking technologies, which will capture and provide data as patients move through the rehabilitation protocols. This data will be used as input for all the games being developed. The in-depth precision tracking knowledge gained through Blue Belt’s work with surgical navigation will allow this innovation to reach patients with even the most limited mobility, which is not served by existing products.

The cost for continued development and implementation will be addressed by securing grants that will allow for more resources and quicker introduction to the market. Our goal is to introduce this innovation to the marketplace as quickly as possible but in following with the PFCC methodology; this will not be at the expense of quality and effectiveness.

In terms of gaining acceptance from the health care community that video games are an effective tool for physical therapy, rehabilitation and exercise, this will be accomplished by demonstrating results through data and feedback. The intention is to provide information, from our test environment(s), that will illustrate patient satisfaction along with involvement in the process by the patient.

How do you plan to scale your innovation?

The Innovation Center is fortunate to have several partnerships and entities available to use as resources. The idea is to work with these partners, one of which is Blue Belt Technologies, to develop software along with game graphics, that would allow for appropriate intensity based on the patient’s needs along with software to effectively track progress.

Blue Belt’s extensive experience with surgical navigation technologies, including both active and passive optical tracking technologies, will be used to measure patient’s motion in the initial stages of this innovation. These technologies have proven very effective; however the cost and physical size of these technologies may prove prohibitive in the long term and may be difficult to adopt for smaller practices. By securing grants, smaller, more portable, more wearable sensor technology could be used to track patient’s motion. This also opens up the opportunity for telemetry that could be sent home with patients as they continue their rehabilitation from home, and remotely transmitted to physical therapists to monitor patient progress, thereby increasing adherence to rehabilitation protocols and improving patient outcomes.

Initial plans are to implement the game in the gym of Orthopaedic Unit at Magee Womens Hospital and then system wide to the other 18 hospitals and various outpatient rehabilitation facilities. In parallel with the system wide implementation, we will also work to develop a strategy to introduce the innovation to the market.

Provide one sentence describing your impact.

Interactive games that integrate PFCC and CDHC with an individual’s fitness level and range of motion, allowing them to have an entertaining experience while seeing the progression towards better health.

What impact has your innovation had to date? Exactly who are the beneficiaries of your innovation?

This particular innovation is in the software design phase, but the beneficiaries of this innovation would initially be patients that are in the rehabilitation phase following TKR and THR surgery. The innovation will then be introduced on a larger scale to various individuals as a mechanism for extreme beginner fitness, individuals with medical conditions limiting both their range of motion and fitness limitations allowing them to progress towards and maintain an accepted fitness level. In an effort to initially introduce the concept of our innovation, we have retrofitted an existing exercise bike with a simulator that is currently on the market. This is only on one bike and the simulation is viewed on a 32” flat screen monitor mounted on the wall directly in front of individual.

How many people have you served directly?

Since the project is in the design phase, no one has been directly affected by this innovation to date.

How many people have you served indirectly?

Since the project is in the design phase, no one has been indirectly affected by this innovation to date.

Please list any other measures reflective of the impact of your innovation

Magee-Womens Hospital and the UPMC Health System, from which The Innovation Center has received a great deal of support, realize that in order to remain a world class leader in health care, new and innovative solutions to patient care must be sought and implemented. Integrating video games as part of an individual’s exercise or rehabilitation regimen and creating the technology, the idea of using the memory card, to track progress now takes user accountability to a new level.

What are the main barriers to creating your impact?

The main barrier(s) would be the ability to:
• Persuade health care professionals that utilizing a game in the rehabilitation plan not only enhances a rehabilitation session for a patient but is also more enjoyable thus leading to a more effective session than traditional methods.
• Convincing the end user that by tracking your exercise sessions, however intense they may be, will provide them and their primary care physician with greater detail in their health and well being. Thus creating a more consumer driven focus.

How is your initiative financed?

Currently this initiative is being funded internally completely through the Innovation Center’s budget. The intention is to apply and receive grants in order to further the development of the software leading up to the actual testing and implementation phase.

Provide information on your finances and organization: annual budget, annual revenue, number of staff:

The current annual budget for the Innovation Center is $750k. The staff consists of four full time employees which will be increased by two more in the near future.

What is the potential demand for your innovation?

Originally this innovation was geared toward a specific end user, orthopaedic patients with either TKR or THR. Although this audience is limited, the numbers suggest that procedures in both areas will continue to increase. According to a recent article in Newsweek, "As the baby boomers' joints wear out, more of them are turning to orthopedic surgeons for the procedures. Docs now perform more than 450,000 knee replacements and 208,000 hip replacements a year, and rising numbers of them are done to boomers willing and able to pay $30,000 an up. By 2031, one study predicts, docs will perform more than 3.5 million knee replacements alone - a 673 percent increase from current numbers."

After further observation and research it was discovered that demand could come from a variety of users with varying levels of fitness, range of motion and goals. This innovation has the potential evolve to help millions of individuals with their goal to a healthier life.

What are the main barriers to financial sustainability?

This innovation was conceived around the very progressive rehabilitation protocols followed by the Orthopaedic Unit at Magee-Womens Hospital. These protocols have demonstrated improved outcomes for both TKR and THR patients, as patients are encouraged not to be sedentary following their surgeries. Rehabilitation programs that have yet to adopt these innovative approaches may be slower to recognize the need for this innovation.

The Story
What is the origin of this innovation? Tell us your story.

The Innovation Center is guided by the Patient and Family focused Care methodology which involves not only the redesign of services but also of care and experiences which is why the idea of incorporating video games into a patient’s recovery was started prior to the actual Changemaker competition. After some research, it was discovered that many of the games and gaming systems currently on the market are geared toward fitness. While this is a growing global trend, these games are primarily marketed to an audience that has some level of fitness and range of motion making it difficult to take an existing game and adapt it to our environment.
Initially the idea originated from the need to develop a game with software that has the ability to track and analyze the progress of a patient that recently had undergone Total Knee Replacement (TKR) or Total Hip Replacement (THR) surgery but at the same time make it entertaining and motivating. Once again the idea of adapting an existing game was discussed but with a patient’s limited range of motion, existing games would only create additional frustration for the patient. During the observation of these patients it was determined that our innovation could be expanded upon to benefit a much broader audience with more features. Individuals need motivation to not only get started but also keeping them engaged in a physical activity and this can be accomplished by showing them progress through results after each session. The unique aspect of our innovation is that anyone having difficulty with initiating physical activity due to limited range of motion or a medical condition would benefit from our innovation.

Please provide a personal bio. Note this may be used in Changemakers marketing material

This submission is on behalf of Dr. DiGioia so I will therefore include a personal bio written on his behalf.
Anthony M. DiGioia III, MD is a practicing orthopaedic surgeon at Magee-Womens Hospital of UPMC Health System. Dr. DiGioia specializes in the treatment of hip and knee disorders including total joint replacement and other surgeries for the treatment of arthritis in these joints.

Dr DiGioia is a pioneer in the development of computer assisted surgical technologies and processes to promote patient focused care. Dr. DiGioia is a senior research scientist, founder and co-director of the Center for Medical Robotics and Computer Assisted Surgery at Carnegie Mellon University. He has received numerous professional awards for his clinical and technical achievements and received the Design News Special Achievement Award and the Pittsburgh History Makers Award in the area of medicine and health.

Dr. DiGioia has also developed a series of educational conferences to train practicing orthopaedic surgeons. One example is the MIS meets CAOS Symposium Series and is the first ever conference that merges the concepts of less and minimally invasive surgery and computer assisted orthopaedic surgery. This conference series was specifically developed to educate surgeons on these new techniques and technologies and focuses on the development of less and minimally invasive surgery for partial and total joint replacement. Dr. DiGioia has also recently developed a new Patient Focused Care (PFC) conference series which brings together all constituencies focusing on technology and re-engineering of processes coupled with unique training and educational programs in order to develop innovative solutions to support PFC. The goal of this conference is to ultimately improve every phase of healthcare delivery with the focus on the patients’ experience.

How did you hear about this contest and what is your main incentive to participate? (this is confidential)

The Innovation Center at Magee-Womens Hospital along with Dr. Antony DiGioia have entered several Changemaker competitions most recently Disruptive Innovations in Health and Health Care: Solutions People Want. As the Business Manager of the Innovation Center, I research various opportunities to fund our initiatives with RWJF being the main source. I know there are many good and some great entries in the various competitions and I consider every initiative that we undertake as always good and sometimes great but in every case definitely necessary and one that has the PFCC methodology as its focus. I also understand that not every project can be funded but I feel this particular innovation has the potential to make a significant impact but it needs a jump start and winning a RWJF competition will give it a tremendous amount of publicity and respectability to move forward. From a personal standpoint, I am fairly new to the grant process but I have years of health insurance and international government funded hospital projects and am well aware of the prestige of the RWJF so winning this competition and moving forward with this initiative means more than I can express. Thank you very much for taking the time to review our entry and I look forward to the announcement of the finalists and winners.