PORTLAND, ME – Once upon a time, the tools of medicine were pretty simple: tongue depressor, blood pressure cuff, stethoscope. Nowadays? Try exergames and first-person simulators, "wiihabilitation" and multiplayer mHealth apps.

 

For years, video games and virtual reality have been playing around the periphery of healthcare. Now, the market for healthcare gaming is starting to cohere into something more substantial, says Ben Sawyer, founder of Portland, Maine-based Games for Health.

 

He concedes that there's "still a long way to go." But seven years since founding Games For Health, he's noticed more and more games starting to “step across the quality chasm” and he’s excited to see “certain silos really maturing."

 

More clinical uses of video simulation and virtual reality (VR) technology are certainly finding footholds in healthcare – used for training on minimally-invasive surgical procedures and fast becoming “a key feature in software applications for radiology and other clinical IT systems," according to Bruce Carlson, publisher of Kalorama Information.

 

Kalorama put out a report earlier this year showing that the U.S. market for VR in healthcare reached $670 million in 2010, with a compound annual growth rate of more than 10 percent over the previous five years.

 

The study projected that rate to increase sharply through 2015.

 

When it comes to more conventional video games, the market is considerably more modest. But more and more titles, such as “Escape from Diab” and “Nanoswarm: Invasion from Inner Space," which were both developed by Houston-based Archimage as novel ways to help prevent diabetes and obesity by encouraging young players to change their diet and physical activity – have been well-received by health experts.

 

Writing in the January 2011 issue of the American Journal of Preventive Medicine, Tom Baranowski, professor of pediatrics at the U.S. Department of Agriculture, lauded those two examples as "epic video game adventures, comparable to commercial quality video games," opining that their "diversity of behavior change procedures" helped motivate players "to substantially improve diet behaviors."

 

Whether that usefulness translates into a more robust market remains to be seen. Popular consumer exergaming titles (blockbusters such as "Wii Fit" and "Dance Dance Revolution”) have generated billions in sales. But other health-focused gaming – educational simulation, psychological therapy, physical rehab – have yet to catch fire.

 

"We've seen some VCs pass through," says Sawyer, who organized the 7th annual Games for Health Conference in Boston in May. "We've seen large healthcare companies make small, experimental investments. It's not like there's this tidal wave at the moment.”

 

But, he says, “I think there are areas" – he mentions mobile technology and sensorimotor rehab games – "that are going to break free much more readily than others." He concedes, however, that "a lot of organizations are risk averse," and the idea of sinking capital funds into a video game regimen for patients might not be the easiest case to pitch to the C-suite.

 

In the meantime, Sawyer is still excited about the potential uses – "public health, personal health, therapeutic" – of the technology. "To have a game a child could play and, as a result of that game, they are a better chemotherapy patients, is amazing." (See "Re-Mission," from Redwood City, Calif.-based HopeLab, in which players go on a mission inside the body to blast cancer cells; it’s been shown to boost treatment adherence and improve patient morale.)

 

While most of the games in this space are the brainchildren of smaller, independent firms, Sawyer says to keep an eye on some of the big boys as well. "I'd be really interested in seeing what large companies like Philips eventually do," he says. "Or what Microsoft is doing over the long haul. They've done some interesting things on patenting healthcare ideas that could be heavily compatible with the Xbox."

 

Moreover, "out of all the video game companies, Microsoft is the one that actually has a healthcare business and the IT backend for a really connected health vision."

 

Meanwhile, Sawyer says he's intrigued by start-ups such as Portsmouth, N.H.-based Elbrys Networks and San Francisco-based Green Goose, which is working on apps that use mobile sensors and accelerometers to measure players' movements – thereby allowing games to potentially be used for remote health monitoring. Perhaps, Sawyer says, that biometric information could soon be transferable directly into a patient’s EHR.

 

The most probable bet for "a lot of little software developers" Sawyer says, is that "their product will be acquired by a larger company that can truly bring it to market,” or that they'll be boosted by partnerships the major health plans – Humana and Aetna have both experimented with games – or via contracts from, say, the Department of Defense.

 

(The military was an early adopter of simulation and virtual reality, and that interest in games' capabilities has filtered into its healthcare offerings for warriors and vets – as when the DoD employed "Second Life" earlier this year to help soldiers with post-traumatic stress disorder.)

 

"Is it going to be a multi-million dollar market? No," he says. "But there are some companies that are going to build a very profitable business by supplying the software and the systems and the tracking, all game-based, to hospitals, rehab clinics and occupational therapists."

 

Put another way: "I'd be shocked if in the next five to 10 years you couldn't point to several significant almost everyday things that are now happening, beyond exergaming, as a mass consumer product – where you can trace it back to this notion of using video games to improve people's healthcare. I would not only be shocked, I would be quite disappointed."