Pokémon GO as a health tool

THOUSANDS of Australians have been walking the streets, parks and beaches of their cities with eyes glued to their smartphones following the recent release of a game called Pokémon GO.

Pokémon GO is a new, free, smartphone game that augments reality and requires users to walk around in the physical world to progress through the game. The smartphone’s camera captures the surrounding environment and integrates Pokémon characters into the scene.

Players are rewarded for exploring their environment and walking between certain landmarks, or “PokéStops”, which tend to be places of cultural significance, museums, scenic lookouts or even government buildings.

Walking is an integral part of the game – allowing players to capture more Pokémon, hatch eggs or obtain useful tools, such as health potions.

It’s the walking part of the game that may just make Pokémon GO an exciting tool that health care professionals should be aware of, and one that highlights the need for further discussion about the use of video gaming in health care.

An in-game feature, called a “lure”, can be used to create a location abundant in Pokémon. Now, imagine how the ability to attract people to locations could be used for health. If particular demographics could be targeted, potential uses might be a rare Pokémon appearing near a health careers booth in a rural area, near a dietitian’s stall or appearing at a mental health awareness event.

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These are things health care providers should be thinking about, talking about and be familiar with for our patients. 

Gaming is prevalent in the patients we see, simply because so many people play. The Bond University Digital Australia Survey 2016 showed that 98% of homes with children have video games, the average age of video game players is now 33 years old, 47% of video game players are female, and approximately 68% of the population plays. This is a huge percentage of patient demographics from school age through to our oldest citizens.

While many doctors are familiar with using a game to distract a crying child in the emergency department, there is a much broader potential in paediatrics.

Twenty years ago, the use of video games at school was limited to crunching numbers on Math Blaster. Health care professionals might now be required to discuss Pokémon GO as a weight-loss tool or know to ask if a teenager is experiencing cyber bullying via a game.

In America, in 2010, the state of West Virginia committed to installing the active video game DanceDance Revolution in all 765 of its public schools to encourage students to exercise.

In the same way we learn about Peppa Pig so we can interact with our younger patients, we should understand gaming in order to better connect with our patients who are gamers.

Health care professionals can often name the Ninja Turtles but must now also differentiate between MOBA (multiplayer online battle arena), MMORPG (massively multiplayer online role-playing games) and LARPing (live action role-playing).

In older patients, gaming is being explored in many areas, including physical therapy, pain control, health education and disease self-management.

Carers of patients with dementia can use the Virtual Dementia Experience, an immersive virtual reality experience using gaming technology developed in Melbourne for better understanding of Alzheimer’s. In Australia, there is ongoing research into exergames (think DanceDance Revolution for the elderly) and their potential benefits in falls prevention.

However, one case of Pokémon GO actually causing a fall has highlighted some unintended negative consequences of the latest craze. 

A commenter on the Pokémon GO subreddit stated: “Not even 30 minutes after the release last night, I slipped and fell down a ditch. Fractured the fifth metatarsal bone in my foot, 6–8 weeks for recovery. I told all the doctors I was walking my dog lol … Watch where you’re going, folks!”

The in-game rewards for walking to set locations on a map can also be misused. One Northern Territory police station was disrupted by large numbers of players walking in after it became a PokéStop. Missouri Police reported a robbery involving Pokémon GO recently. Police suspect that a lure was used to bring game players into a secluded area where they could be easily robbed.

In terms of mental health, the negative effects of gaming have been much debated, and there is a need for further guidelines.

Internet gaming disorder is listed as a “condition for further study” in the DSM-5. Some literature reviews have highlighted associations with increased aggressiveness and gaming, particularly with adolescents.

However, gaming may also be able to assist with mental health.

In Australia, a game called ReachOut Orb is being launched into high schools to help teenagers improve their mental wellbeing in a serious yet fun way.

People with conditions such as agoraphobia, social anxiety and depression have posted on social media about how Pokémon GO has helped them to be active.

Like most of our tools, Pokémon GO is one we may have to counsel our patients about the risks, benefits and responsible use, including avoidance of spending money on “in-app” purchases.

In an innovative Australia, Pokémon is now an active game, many of our patients are gamers and gaming is a multibillion-dollar industry that fills stadiums to watch “e-sports”.

Just as health professionals must be at the centre of health care policy formation, they must be involved in driving positive gaming.

Dr Christopher Timms is a GP registrar based in Port Macquarie, NSW.

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