A HEALTHY APPROACH TO GAME DEVELOPMENT

Dr. Bruce Jarrell, a transplant surgeon, has created a virtual patient that simulates all the characteristics of a human with a disease. But, right now, it's just a piece of software that, without the appropriate leading-edge graphics, is useless as a training aid for physicians. What Dr. Jarrell needs, he says, is funding to bring in a talented video game developer to create those graphics.

Meanwhile, kids stricken with cancer are learning about what is going on in their bodies by playing "Re-Mission," a first-person shooter that's being distributed free to treatment centers and over the Web by Palo Alto, CA-based HopeLab. In the game, players steer a nanobot character named Roxxi through missions inside the bodies of people suffering from cancer, blasting away at bad cells and in the process learning about different aspects of the disease.

In Atlanta , the Centers for Disease Control and Prevention (CDC) is funding an effort to provide developers with the information they need to accurately depict health messages in video games.

Video games for health? Conventional wisdom links video games with increased aggression, childhood obesity, repetitive stress syndrome and seemingly everything but promoting good health. But that may change, especially if Ben Sawyer has anything to say about it.

Besides being the president of Portland, Maine-based game developer Digital Mill, Sawyer is the co-director of the Games for Health Project whose second annual conference takes place in Baltimore next month. It's being funded to the tune of $250,000 by the Robert Wood Johnson Foundation in order to "apply the power of video games to find solutions to health and health care challenges."

"This has absolutely nothing to do with the games industry needing to stand up and be apologetic about anything," insists Sawyer. "We are not doing this because game developers have a little PR problem that needs fixing. My goal is to get the industry to do this because it makes sense and it's a smart, cool thing to do, period."

While examples of health messages in commercial video games are few and far between, Sawyer recalls that in Microsoft's 2004 Xbox game "Fable," the main character has a choice of foods to consume and, depending on which ones he eats -- high-fat or low-fat -- it changes his appearance accordingly.

"There's a very subtle, simple message embedded there," says Sawyer, "that what you eat affects your health. Clearly you can see the potential for teaching gamers about childhood obesity."

Sawyer's game plan for Games for Health calls for getting developers excited about non-entertainment projects, for playing match-maker between game makers and philanthropic causes that need their skills and for getting the word out that games are an effective tool for promoting health. For instance not only can games like "Re-Mission" be built for a disease-specific purpose, but "health messages" can be inserted into commercial games just as they are in TV shows and movies.

"Hollywood has a long history of embedding social messages about health care into story lines," says Sawyer. For example, in order to get the word out about AIDS prevention, CDC officials persuaded producers of NBC's "ER" to place a condom poster on the set as a roundabout way of getting the health message to TV viewers. Over time, the agency's collaborations with Hollywood worked out so well that, three years ago, it provided the University of Southern California with a $300,000 grant for the Norman Lear Center's Hollywood, Health & Society program, an amount that nearly doubled this year with additional funding from the National Cancer Institute (NCI) and two other Federal agencies.

"We've focused on being a resource for TV writers who call us all the time," says Vicki Beck, director of the Beverly Hills, CA-based program. "They've got an idea, they want, say, a certain character to suffer from a specific disease, and they need to talk to an expert on that topic to see, in fact, whether that makes sense. We then put them in touch with whomever can best help them, whether that person is with the CDC or UCLA or NCI or NIH [National Institutes of Health], wherever."

This year alone, Beck's organization has handled over 250 requests from writers of "ER," "Grey's Anatomy," "House," the various "Law & Order" and "CSI" shows, "Bones," "Numb3rs," "24" and dozens of other shows.

"We worked with '24' quite a lot when they did their bioterrorism storyline, for instance, and we still get calls from them from time to time," says Beck.

But now Beck is looking to branch out to what she calls "new emerging media" -- such as video games -- especially since the TV networks are moving towards more interactive technologies on their Web sites.

"For example, NBC currently has over a dozen games on its Web sites, including 'Wheelchair Challenge' on its 'ER' Web page, and we want to be a resource for the game makers, to assist them when, say, they need to know how a wheelchair needs to be used," she says. "We can put them in touch with the experts who the game developers' writers need for that sort of information."

Beck's immediate plans are to begin reaching out to game developers who have an interest in health issues, who may be developing games for the Web pages of TV shows and who may not be aware of the services her organization provides gratis.

"We're very early in the research process and it's difficult to say who we'll be targeting. But, for instance, a likely target would be [Los Angeles-based] Legacy Interactive, the developer of the wheelchair game," she explains. "They don't know us yet but they will soon enough. I intend to let them know that we're available as a reliable resource anytime they may be interested in some of the bigger health issues and need someone to turn to."

Don Daglow plans to do all he can to support the Games for Health effort -- and that included being the keynote speaker at the Games for Health Day preceding this year's E3 show in May. Daglow is president and CEO of San Rafael, Ca.-based Stormfront Studios, a developer well known for big-budget triple-A titles such as "The Lord of the Rings the Two Towers" for Electronic Arts. Stormfront is putting the finishing touches on "Eragon" for Vivendi Universal Games, which will be released day-and-date with the 20th Century Fox film in December.

"We're used to spending millions and millions and millions of dollars on grand, sweeping spectacles that require those sorts of budgets to create jaw-dropping experiences that have the potential to sell millions of copies globally," he explains. "But there are some slow cycles in between making those games, and one of the things I'm looking for is an opportunity to use those slow times and put them to good use. Other developers -- like Quicksilver Software and Breakaway Games -- have made games for health a core part of their business and I think they are going to do some great things with that. I'm looking for a way to make those kinds of games a secondary part of our business and, hopefully, do some great things too. While we haven't worked on one yet, I believe the opportunities to help people with our team's creative skills will come up more and more."

Daglow adds that while the industry should be able to point at such efforts proudly, he denies that it's being done for publicity's sake.

"All of us who are interested in this space ... if you gave each one of us a letter from God saying that there'd never be any good publicity from these efforts ... we'd all get up the next morning and do the same exact things," he says. "Because all of us are doing it for the good it does."

However, he adds, altruism isn't the only motive for developing games for health.

"The software business isn't a high-margin business, so I don't think you're going to find guys in this space who are looking for the next big high-profit-motive thing," he explains. "That said, a good software developer can run a business and make money doing this ... and then feel good about themselves when they go home at night."

He likened the scope of the games to the currently popular "casual games," which tend to have tight budgets.

"Casual games are a great parallel," he explains. "We're talking about budgets that may not be appropriate for blockbuster games, but they're big enough to allow you to produce something of quality."

Daglow says he encourages other game developers to be aware of this field, which he describes as "new and utterly fertile. I don't think there's any downside whatsoever, and there's all sorts of upside. I mean, it won't appeal to every game developer. But for those who are interested, there are many non-profit-type people who are starting to reach out to the game business. And our upcoming conference will be a good place to meet some of them."

Which brings us back to Dr. Jarrell who, besides being a transplant surgeon, is also the vice dean for academic affairs at the University of Maryland School of Medicine in Baltimore which is hosting the Games for Health conference for the second year in a row.

"We expect some of the attendees to be people who may have an interest in funding some of these projects," he says. "For instance, we had quite a turnout from the Defense Department last year, which might seem odd. But the Armed Forces have plenty of people who need to learn medicine. And remember that more people in the military get sick from appendicitis than they do from gunshot wounds."

While it might seem like quite a stretch from what Dr. Jarrell does in his profession to video games, he says that's absolutely not true: "I've been involved in education my whole medical career, and I'm always interested in better ways to teach our students or improve the skills of our physicians or inform patients about their disease or to help them regain their health. And, to me, video games offer a new avenue to learn things in a different way. What the conference does is to raise the level of consciousness about this whole area and its potential."

Sawyer concurs: "The reason agencies like the CDC are interested in gaming is that they know that it's one of the best ways to reach the young core gaming audience, which is of huge importance to them. But they also know that casual games, like Bejeweled, are very popular with an older audience, mothers over 30, for instance.

"Can you think of a better way to reach mothers about their kids than with, say, the 'Bejeweled' equivalent of how to talk to your kids about drugs ... or not to smoke ... or to practice safe sex? That's the goal here. That's the Holy Grail."