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We are currently witnessing rapid changes in health services in general due to the coronavirus pandemic. In the light of the ongoing crisis, new needs continue to arise both from the perspective of patients and clinicians, paving the way for truly novel services and technologies. With that said, digital health and especially digital therapeutics are in the center of attention. So it is right about the time to elaborate on one of the boldest approaches in the field of digital health: using a game environment to deliver therapy.
Digital therapeutics (DTx) are defined as evidence-based, clinically evaluated therapeutic interventions delivered through software. At the same time, the intervention could be delivered in various ways, as such, it could be delivered through a game environment. For example, Akili has developed a game for children with attention problems that works in a way that children steer an avatar through a course dotted with obstacles, collecting targets to earn rewards. For children, it is a fun game experience, yet the tasks in the game help children by improving their attention skills. The developers claim that EndeavorRx is different from other action video games that a child might play. The treatment programmed into the game was scientifically designed to challenge a child's brain during treatment requiring the child’s attention and focus on multiple tasks at the same time.
The game is now on the market and can be prescribed as a digital medicine. That said, Akili has truly made history: for the first time ever, a game has received the approval from the FDA. Of course, they needed to conduct a lot of research to receive the approval. However, it is not by chance that the creators of the EndeavorRx game have been able to show that the game is effective (and has minimal side effects) and here is why.
Prevously, researchers have suggested that our brains are not shaped by merely our physical environment but also the virtual environment. This hold a great promise for utilizing game environment to positively influence brain development. Techology usage influences how our brain processes information and with that being said, gamers tend to outperform non-gamers – they have faster response time, improved visual acuity, improved attention switching abilities etc. Furthermore, games are training the brain without it being the primary aim (although it could be as Akili team has shown). Moreover, not only expert gaming is associated with cognitive benefits of gaming. Research shows that those who report more gaming, make less errors and have faster response times during cognitive tasks. To sum up, the extent of gaming in daily life in moderate amounts is associated with enhanced working memory functioning.
Thus, as shown here, gaming is not all bad. These findings are of great importance, since it is vital to understand how the increasing amount of on-screen time might affect or interact with the cognitive and brain functioning of the youth.
Previous research findings show that gaming in general improves cognitive skills and Akili's health game is now approved by the FDA. Is the Triumf game any different from action games or EndavorRx? Quick answer is yes but let me explain this further.
Like Akili, we utilize game environment to deliver digital therapeutics. But in addition to various tasks that challenge users and evaluate their motoric and cognitive skills, the gameplay evolves around taming the Disease Monster and all the missions and features fit together with the underlying aim to provide psychological support to children under heightened (or toxic to be more accurate) stress. Toxic stress might be experienced as a result of their health situation, home environment or societal situation such as the ongoing coronavirus crisis. In developmental psychology, it is argued that this kind of instability caused by toxic stress in childhood is the strongest predictor of long-term chronic health problems, a reduction in earning potential in adulthood and of chronic psychosocial distress.
To tame the Disease Monster, the player needs to be smart (this means that the player needs to continuously learn from the game that features an extensive educational module) and take care of him/herself (to achieve that, daily tips and tricks based on player's strenghts and difficulties and progress in the game are received from the sidekick through the psychological support module).
So how does this sidekick deliver psychological support? Our team involves various psychologists with different backgrounds; we have had the proper training, have been using validated methodology in traditional therapeutic setting, and have been working side by side with the rest of the care team in hospitals. Now, our situation as psychologists has changed as our knowledge and expertise is poured in the game. Instead of us, the virtual sidekick is delivering psychological support. Having several psychologists in the team has allowed us to use various validated methodology in a game, way beyond what I could, for example, achieve as a single psychologist with my knowledge basis. The content has been revised with care teams as well as families, and we are working side by side with many health institutions and professionals.
All personalized and absolutely necessary for inducing behavioral change.