Gaming The System – SRQist :: SRQ Magazine article by Andrew Fabian
Moffitt Cancer Center and Ringling College are partnering to gamify patient care.
SRQ Review | January 2022
In Health and wellness
In an ABC report last June, Cancer survivor Richard Wright described his experience with a Magnetic Resonance Imaging-Guided Linear Accelerator (MRI-LINAC) at Moffitt Cancer Center as “a game, and it’s kind of fun.” His enthusiasm for cancer treatment seems confusing when directed at high-tech equipment used to treat an often fatal disease, and with good reason. But it was Wright’s treatment that inspired so much optimism.
The machine requires patients to remain as still as possible for 25-second intervals to ensure greater accuracy of targeted radiation dose. Even breathing moves the organs and other internal physiological components of the body. So patients like Mr Wright – already anxious to be placed inside a cramped, noisy machine for the treatment of a disease that for decades felt like a death sentence – have now the added burden of holding their breath. “I’ve had patients come in the morning of their treatment and say, ‘I couldn’t sleep, I was thinking about my breathing,'” says Dr. Sarah Hoffe, head of the gastrointestinal radiation oncology section. of the Moffitt Cancer Center.” But if you can get clients to go from a feeling of dread to a feeling of play, that’s powerful.” And to that end, virtual reality (VR) technology has a lot to offer. .
Although most people know virtual reality as a technology used in the video game or entertainment industries, its use as an immersive training tool is likely to bring more significant gains to society. Local coffee and ice cream store, Rise & Nye’s, uses VR training modules as part of its onboarding process for employees with developmental issues it hires. Dr. Hoffe, who is heavily involved in mentoring at Ringling College with its creative writing program, saw the potential in the school’s virtual reality program to “gamify” her patients’ pretreatment experience. After conversations with the university’s president, Dr. Larry Thompson, Dr. Hoffe helped orchestrate a partnership as part of the school’s INDEX (Industry Experience) initiative.
The goal of this partnership is to help acclimate new patients to the demands of an MRI-LINAC procedure. Joseph Janssen, a student at Ringling College, spearheaded this “gamification” of the preprocessing process. “During my first and second years in the program, I had a narrow view of game design and entertainment,” says Janssen, “but this INDEX project really opened my eyes to so much more. of industries where the technology can be applied.”
Already experienced in the basics of lens-based virtual reality experiences, Janssen applied his skills to an experiment that could coach future MRI-LINAC patients on the physical demands of remaining perfectly still during the procedure. The experience includes a series of cues that guide the patient through the treatment, with breathing prompts and timers along the way. “Working with the patient advisors was key,” says Janssen, “especially with Mr. Wright, because he had treatment with the MRI-LINAC and could be very specific about what worked and what didn’t.”
In his interactions with Wright, Janssen also embraced his idea of incorporating golf elements into one of the design options. “It’s something that seems so obvious with the demographics of the area,” Hoffe says, “but we didn’t think about it until Mr. Wright said something.” A small green serves as the graphic for the timer element, with the clock starting when a golf club impacts the golf ball and ending when it hits the hole. A VR controller attached to the patient’s chest starts the animation when it detects that the patient has held their breath. The other “game” option sees the patient hold their breath as a moon goes through its cycle in 25 seconds.
Both games seem fairly simple considering how advanced the technology can be, but from a skill development perspective, Janssen also got to practice communicating with the end user. “It’s already a very balanced field in terms of the use of design and logic,” says Janssen, “but adding the interpersonal element was a great learning experience.”
Morgan Woolverton, the college’s acting department head for game art and VR development, sums up the project’s impact perfectly. “Patients using this design are in a vulnerable place,” says Woolverton, “and Joe [Janssen] was simply the ideal person to lead this project. He has such a sense of adventure and curiosity.
As for the future of the partnership between the Cancer Center and Ringling College, there is still work to be done. Janssen graduates this spring and leaves behind a fully functional prototype for the next cohort of students to refine. Dr. Hoffe will look to take the design’s proof of concept and seek funding for research that can back up what she already knows intuitively: patients with less emotional stress have better outcomes.
“We have a great team of researchers here at the center and we want to consider measuring salivary cortisol along with other vitals,” says Dr. Hoffe. Cortisol is known as a stress hormone whose levels are directly correlated to the stress experienced. In addition to heart rate, blood pressure and respiratory rate, Moffitt’s team can track how effective the VR design is in reducing patients’ stress levels.
“And that not only leads to better patient outcomes,” says Dr. Hoffe, “it means they can get their procedures done faster and we can treat more patients on a machine that few hospitals have. . So now you are also considering more optimal processing times. The possibilities are truly endless, but it all starts with creativity. Creativity is the currency of innovation.