Design can be described as how things work and look. More than that, design has the power to craft a user experience. In an increasingly online consumer experience, companies are aware of the value design brings to their market presence. A product may be stellar, but without good design, it turns consumers away and casts doubt on the brand altogether. Done well, design crafts a compelling and delightful experience while building brand loyalty. Take Slack for example: its designers understood that traditional email can be cognitively overwhelming. The email inbox requires us to jump from one message to another and change subjects repeatedly. Designers at Slack have organized messages into "channels" preventing us from cognitive switches - an exhausting and counter-productive exercise. Slack has re-invented the way we send and receive messages - and arguably for the better. Slack has become an industry standard and boasts an army of fans.

Design influences human behavior. That is, a delightful experience draws a user to engage with a product. By engaging with a product, the user is more likely to commit to a journey with it. For example, Noom encourages a user to achieve their ideal weight over a period of time. Fitbit accompanies a user with notifications and reports, as they progressively become more physically active. Good ethical behavior design has the power to encourage a user as they strive towards a personal goal. 

Gamification rewards progress. Designers use gamification to insert gameplay elements in non-gaming settings with the goal of building engagement and reaching a personal goal - all in a delightful way. Common motivational drivers associated with gamification are points, badges, stickers, leaderboards, challenges and community sharing.

Moreover, gamification triggers a deeper motivation - a personal reward. Research has shown that gamification builds on intrinsic rewards. In other words, rewards that are personally fulfilling, instill a sense of pride, and ultimately motivate a person to continue towards their goal. Gamification does this in two ways:
a) by engaging a user on a journey and
b) creating a feedback loop that builds user momentum. We'll explore how gamification can be applied to concussion recovery next.

Gamification as a catalyst for concussion recovery

Concussion affects cognition and can cause headaches, and brain fog. Nausea, tinnitus, and fatigue are common too. A patient in early post-concussion often struggles to understand and manage their symptoms. Clinicians may recommend documenting these symptoms because it helps reveal trends and identify cause and effect. When a patient consistently journals their post-concussion experience, it provides the clinician with a more accurate and complete picture of the patient's state. Ultimately, journaling provides the clinician with invaluable data that helps with both assessment and treatment. But often patients perceive journaling as tedious and even irritating.  And so, it falls by the wayside, leaving both the patient and the clinician without the data they need to progress.

Gamification can fill the gap between a great product and lackluster user engagement. Gamification, as we said above, inserts game-play elements into a non-game environment to add an element of pleasure and engagement. Gamification encourages the patient in performing necessary or even challenging tasks. One form of gamification is the gamified journey, sometimes described as a student - teacher relationship. The app progressively and gently guides the user along a leveled experience, safeguarding them from excessive challenge. The user learns at a personalized, leveled pace. This journey has also been described as "keeping the user in a state of productive bliss as they level up, so that the pain associated with new learnings is not a deterrent to using the product". Otherwise said, a gamified experience makes a task easy for the user and their progress is more likely assured.

Gamification as a clinician's assistant

Clinicians are limited in their influence over the patient's behaviors as they recover. While clinicians can provide guidance during clinic visits, they can't accompany their patient during the daily ups and downs of recovery. A health app, on the other hand, is in a patient's pocket as their constant companion. Here, gamification is especially useful. Feedback loops - a gamification technique - can step in to assist the clinician in motivating their patient. This loop establishes a cause and effect mechanism between the patient and the clinician. For instance, a physiotherapist starts a concussion patient off with 10 minutes of biking. This goal is noted in the app, which then sends reminders to the patient. Ideally, the patient heeds the reminder, logs their 10 minutes biking sessions into the app, which then informs the clinician. In this way, a feedback loop establishes a stronger relationship of reciprocity between the clinician's prescription and the patient's engagement.

Feedback loops are instrumental for data generation. Because phones are like a fifth limb to many, they accompany us in everyday moments. Health apps like Apple or Fitbit record heart-rate and sleep cycles. When this data is shared with a clinician, who specializes in data  analysis, it offers a deeper, richer portrait of a patient's condition. The clinician can make a more precise assessment and a more targeted treatment plan. 

A clinician does more than simply prescribe and monitor data inputs, however - they often take on the role of a coach. When patients see their overall capacities diminish, it can take a toll on their mental health. Often, when in the thick of symptoms, a patient can't recognize progress and feels unmotivated to continue. This in turn can lead to depression and anxiety. Gamification and in particular, the feedback loop, offers personalized data on the patient's progress. A feedback loop identifies positive trends, underscoring efforts that are bearing fruit after all. In this way, gamification supports the clinician as they coach a patient through recovery. 

IN SUM

Design is valuable to digital prescription therapy because it supports the concussion recovery journey in powerful ways. For instance, for patients, design draws on techniques that drive human behavior towards improved health. Gamification, in particular, acts as a catalyst for concussion recovery. It builds a patient's desire to engage with their own health and rewards them for taking steps in their own recovery.

Clinicians also benefit from design's ability to shape an experience for the good. Done well, design reinforces the clinician's assessment and treatment via notifications, challenges, and data visualization. What's more, a health app accompanies the patient and keeps them on track in times when the clinician can't be with them. Design for digital prescription therapy collaborates with the clinician while coaching patients. Taken together, digital prescription therapy and design go hand in hand to create impactful health outcomes.

ADDITIONAL RESOURCES:

• Feedback Loops
• Intrinsic Rewards: What They Are and Why They're Important
• Three Ways Gamification Is Being Used In Medical Apps