Chris Foster, CSO of Baltimore Business and Economic Development, spoke about the opportunities and problems that the state of Maryland is funding or considering funding, and though specific industries are not targeted, currently 45 percent of the total falls under “life sciences.”
Traditionally, medical device technologies and products have been the targets. However, looking forward the savings from electronic health records (in terms of lives and costs) are suggesting a number of new opportunities. Foster argued that the rest of the world looks to the U.S. to solve healthcare problems.Military Medicine, Modeling, & Simulation: How do Games Fit In?
The Telemedicine and Advanced Technology Research Center (TATRC) is a U.S. Army agency that applies physiological and medical knowledge and simulations for medical decision-making and training. They focus on medical research and development, specifically trying to create industrial opportunities in medical modeling and simulation.
J. Harvey McGee, presenting this session, explained that TATRC strives to improve trauma training and reduce medical errors through medical modeling and simulation. Out of gaming technology, TATRC hopes to help young army men and women perform their combat medicine jobs in the field around the world.
Magee showed a video that TATRC uses to introduce the very youngest and greenest soldiers to combat medicine and the challenges of providing acute care during live combat situations. The video claimed that simple procedures could help save up to 90 percent of people on the battlefield wounded in combat.
Simulated environments can affect trainees, and medical simulation is disruptive—but it can disrupt and revolutionize the medical profession. Simulation effectiveness is the biggest challenge in the area. Researchers are using digitally enhanced mannequins, PC training, and virtual reality training, environments that can provide case-based scenarios and courseware.
Personal Health Record: An Interactive Portal for Your Health
Omid Moghadam of the Personal Health Record Programs at Intel Digital Health Group spoke on this panel. The Intel Digital Health Group is an eight-month old initiative devoted to using silicon technology in diagnosis and software for healthcare. Moghadam talked about the idea of games for disease management.
Personal health records have a role in remedying the cost/quality disparity, unsustainable cost increases, and no reasonable consumer force in the market. Healthcare IT has some role in remedying this situation, but only in regional health information.
Personal health records (PHR) are patient-directed gathering and augmentation of consumers' own medical information, a method by which services can be delivered to consumers. The transaction systems for PHR include remote medical systems, patient data, pharmacies, primary care physicians, hospitals, and specialists. Right now, there is only patient-sourced data—information patients provide themselves. A new national infrastructure will manage hospitals, physicians, and labs.
Game Technologies and Future Healthcare Opportunities
Ariella Lehrer, Legacy Interactive, talked about a scripting language Legacy created to address character behavior.
There's a need for improved AI tools, including middleware and scripting languages, argued Lehrer. In response, Legacy created STORI, a scripting language used to create actor behavior in its ER game, which creates interactions between characters and their environments. Because STORI is a technology framework, it has cross-platform capabilities, and can be used with other higher-level game engines or graphics systems. STORI was designed to be a designer-scriptable tool to create interaction. While the language is still too technical for some designers, it increased the accessibility of the behavior authoring.
In ER, which released in June and contains STORI, you start as an intern and work your way through seven episodes of skills and missions. The AI language controls the diagnosis and treatment processes, interactions, and episodic content. You also have to keep track of hygiene, food, rest, and composure to manage patients effectively. The player selects attributes, and his or her skills are based on them. Each episode includes multiple plot lines, for example, assigning interns to new patients. If one of your interns kill a patient, you're fired.
The player is also affected by the attitudes of others. The characters are internally motivated but are managed by the STORI AI system. Your relationships can help or hinder your ability to treat patients.
STORI also controls patients in the waiting room, like waves of patients, totaling over 100 in the hospital, all interacting with one another. The game also adds perks and special abilities (such as kissing other doctors). A Sims-style affinity system allows players to build bonds with other in-game characters.
Though the game has no medical content, Lehrer suggested that the framework for the game could be extended with real medical information and problems to increase the depth of interaction for more formal training. Lehrer offered that while Legacy is not a tools company, it could license STORI to interested parties.
Interactive Entertainment Technologies for Healthcare Training
The ETC and University of Pittsburgh Medical Center are interested in textbook-to-real world training integration, of which gaming is a part. Simple initiatives can save lives in critical hospital situations as well as everyday situations.
Crisis Team Training, built in Panda3D, a low-cost 3D game engine, is a training program for seven people that teaches trainees how to respond to chaotic situations. They adapted NASCAR techniques: The pit crew has to work fast and accurately every time. Why can't doctors and nurses perform with this speed? The curriculum teaches this approach with traditional, real-life simulation, which is both time-consuming and expensive.
The groups developed a game in which players have to treat a patient while dealing with the softer issues related to managing the room and each other during crisis. For example, the simulation includes "blocking"—when doctors and nurses are in each other's way and the players need to contend with that immediate situation in the environment. The players communicate with each other in the same room to accomplish the healthcare tasks required.
The group demonstrated a three-minute "code" emergency. Amusingly, the game crashed, but while it lasted the demo effectively displayed the time-sensitive collaboration required in the game.
Evaluation of Virtual Learning Environments for Emergency Medicine
Patricia Youngblood of Stanford University collaborated with the university to create a sim-tech game, a virtual emergency education simulator. Together, they also created a first responder training system, both built in Forterra, owned by the company that used to run There.com (Forterra uses the There technology). Like the last demo, this is a multiplayer emergency medicine crisis resource-management training tool, adapted from standard research and training practices.
Because There is a virtual world with voice support, the scenario can be played out with users distributed around the world. Next, Youngblood and Stanford University hope to debrief first responders online to support both training and summary in the virtual world, since physically distributed teams can often benefit from training together remotely.