HIT Challenge 2016
Serious Games Association (SGA), National Healthcare Group (NHG) and Infocomm Development Authority of Singapore (IDA) officially launched the inaugural Health Innovation Technology (HIT) Challenge. The national competition is the brainchild of Ivan Boo, Chairperson of Serious Games Association, whom mooted for the signed a Memorandum of Intent (MOI) to formalize collaboration in the area of serious game application for healthcare.
Serious games refer to a growing field of gaming technology, which translates real world scenarios into games to encourage creative problem-solving and education. Valued at US$1.8 billion in 2014, the game-based learning industry has already shown benefits for patients and healthcare staff alike. Studies showed that users learn more effectively and retain information better when taught through gameplay. Patients whose treatment involved gameplay or simulations were more motivated and responded better to interventions. Virtual simulations also helped healthcare staff hone their skills in a safe yet challenging practice environment.
These key benefits of serious games are encapsulated in the theme for HIT Challenge 2016 – “Moving Towards Better Healthcare: Enabling, Education and Efficiency”. Teams across Singapore will compete in three categories – Primary Prevention & Care; Hospital Clinical Management; and Post-Discharge Continual Care. In Phase 1, participants will be judged based on their concept submissions. Shortlisted teams will then advance to Phase 2, and will have six months to develop their ideas, with support from technology mentors.
Two of the featured games were (1) Gear Up and (2) RE-MIND
Gear Up is a 3D serious game designed by a team from Tan Tock Seng Hospital’s (TTSH) Simulation and Integrated Medical Training Advancement Centre (SimTac), in close collaboration with Serious Games Asia. The game is targeted at healthcare providers who need to care and nurse patients suspected of highly virulent, highly infectious diseases, and aims to increase their knowledge on donning of personal protective equipment (PPE). Players navigate within a virtual hospital where they have to recognise diseases and their severities. They are then required to choose the right PPE and put it on using the correct gowning procedure. The learning process is supported by a scoring and feedback system. In this prototype, TTSH staff provided the content knowledge while the game design and development was executed by the commercial technology experts. This game was an lesson learnt from SARS and was definitely an essential for preparing for COVID-19.
RE-MIND, is a jointly developed, clinically-driven tablet- based smart application by Tan Tock Seng Hospital Rehabilitation Center and MAGES. RE-MIND endeavors to enhance and strengthen current in-and outpatient cognitive and functional rehabilitation programs, increase post-discharge physical, cognitive and functional activity. Through an interactive, individualized interface, gamification tailored to the learning abilities and cognitive limitations of moderate to severe brain injury survivors, client self-motivation and efficacy are encouraged. Targeted app content includes reality orientation therapy, daily/weekly schedule management, current affairs and components of brain injury education. Personalized avatars, tablet interface and interactive game-lets are key elements to promote learning in those within 3 -6 months of injury who are emergent from post-traumatic amnesia. Through app-driven data analytics, rehabilitation professionals and carers may also remotely monitor usage depth, content, performance, feedback and compliance.
A highlighted submission:
Using a Virtual Simulation Platform for Teaching of Inter-professional Communication using TeamSTEPPS
Communication is vital in any high reliability organization and is particularly crucial in the operating theater and the clinical wards of a hospital. With an increasing focus on the use of simulation in teaching teamwork and communication skills, inter-professional interaction in these environments are often re-created in the simulation training center using a high fidelity mannequin. Whilst this creates a high level of verisimilitude, it may not always be necessary or beneficial to conduct all such training using such advanced simulations. For one, the resources required to plan and implement such simulation courses are considerable from both a technical as well as a manpower perspective. Also, the high cognitive load on the participants often detracts from the key objective of teaching communication and instead sometimes results in the focus being shifted to protocol errors and other aspects of the scenario. In addition, the complexity that often results from a high fidelity simulation, means that it is often difficult to get the participants to communicate in the intended fashion or to get them to utilize specific communication tools.
We propose the creation of an app that will function as a virtual simulation platform. The application would be run on a laptop or iPad and the participants would be grouped into a team and would sit or stand around the device. The application would start by displaying a scenario in the operating theater or ward and the participants would then be prompted to turn on client apps on their smart phones. The client apps would then instruct, individually, the participants on the roles in the team. As the scenario progresses, the participants would be prompted or specific communication tasks that they are to conduct in real life and told to use the specific TeamSTEPPS tool to do so.
Faculty would still need to be present but mainly with the aim of ensuring that the communication technique is employed correctly and if not, to debrief the issue at the end. The faculty would also have the option of modifying the scenario on the fly if they were keen to reinforce a particular aspect of the TeamSTEPPS communication methodology. Using a virtual simulation would significantly reduce the resources necessary to conduct a simulation. In addition, it may in fact be a better tool for teaching and learning about certain aspects of team communication because of the reduction in complexity and hence reduction in cognitive load. Also by enabling a greater structure to the scenario it would be easier to ensure that all participants benefit to a greater degree from the exercise compared to a standard high-fidelity simulation. Whilst attempts have been made to create simulations using virtual environments in teaching communication however, such approaches are still limited by the ability to control the communication to highlight the specific educational aspects. We are also not aware of any similar use of simulation to teach team communication utilizing a server app displaying the scenario and client apps delivering specific instructions to participants and specific time points during the simulation scenario.
Of the 118 accepted, 92 teams proceeded to the semi-finals. Out of the 92 semi-finalist, we selected 10 for the finals.
HIT Challenge 2017
The 2017 HIT Challenge was organised by the Serious Games Association (Singapore) with more partners coming on board from the National Health Innovation Centre (NHIC) Singapore and Intellectual Property Intermediary (IPI) Singapore. The HIT Challenge 2017 brought together healthcare practitioners and technology partners to collaborate on innovative solutions to improve the delivery of health and social care services.
A highlighted submissions includes:
Conceptualising the Next Generation Incentive Spirometry
Patients undergoing moderate to major operations often succumb to postoperative lung infections due to poor breathing efforts, resulting in partial collapse of the lungs. Pre-operative and post-operative chest physiotherapy is important to prevent lung infections. Another group of patients who are susceptible to lung infections are patients who have been on prolonged bed rest. Even amongst patients who already have lung infections, studies have shown that they may benefit from quicker recovery by using incentive spirometry to improve their breathing efforts.
A device called incentive spirometry helps to motivate patients to inhale deeply, allowing for continuous chest physiotherapy even after their session with the physiotherapist has ended. The incentive spirometry requires the patient to inhale slowly and deeply through a mouthpiece until he/ she reaches the targeted volume, and then hold his/ her breath for 5 seconds. The device consists of an indicator which allows the patient to know when he/ she has reached the targeted volume, together with another indicator which lets the patient know if he/ she is inhaling too quickly. The incentive spirometry is effective because it provides visual cues to allow the patient to know the right volume and flow rate to breathe at. However, real life implementation of this device is let down by poor patient compliance. In order for patient to enjoy maximal gains from the use of the incentive spirometry, the patient must be self-motivated enough to use the device for at least 10 times an hour. The incentive spirometry device has been around for more than 30 years, with little change to its design.
Our team feels that more can be done to improve patient compliance beyond relying on patient’s intrinsic motivation to get better. We propose harnessing the use of gaming technology and kinetic flow sensors to translate patient’s breathing efforts into ‘mana/ magic points’ which will allow them to advance/ compete their characters in video games. Our team takes inspiration from the popular motion-sensor based Wii U/ X-Box One Kinect/ PlayStation 4 Camera, which require gamers to shake their controllers or follow a specific set of movements in order to play the games. However, instead of relying on bulky gaming consoles, we propose tapping into Bluetooth technology to link our next generation incentive spirometry devices to mobile phones and tablets to improve accessibility and portability. Patients will breathe through a disposable mouthpiece attached to a compact device coupled with a flow and volume sensor. The data collected will be transmitted via Bluetooth to their mobile phones or tablets, which will then be linked to their game of choice. The possibilities are endless. Aside from games, we may also modify the linked apps to cater the patients’ interests. For example, it may also be linked to music/ video apps, which requires the patient to acquire sufficient ‘points’ before the music/ video can continue playing.
Of the 60 accepted, 15 teams proceeded to the finals.
After HIT Challenge 2017, Integrated Health Information System invited Ivan Boo to re-brand the HIT Challenge series into the National HealthTech Challenge in 2018. Ivan Boo served as a consultant with IHiS in 2018.