Video games: Health-care tool of the future? Possibly

With or without insurance reimbursement, the notion of using technology to help patients with chronic diseases stay in closer touch with health providers is gaining new momentum.

At the University of Washington, Dr. Harold Goldberg has just received a grant from the Robert Wood Johnson Foundation to bring together academic and business leaders to develop computer "environments" for home-based co-management of chronic diseases.

The twist: They'll be looking at using multiple types of hardware, including Nintendo's GameCubes and Microsoft's Smartphones, along with teen "alpha testers" to see if these popular devices can provide useful platforms for establishing regular interaction between patients and their health-care providers.

"It occurred to us that we need to move beyond the PC alone, to include the game systems with televisions and cellphones that young people prefer," Goldberg said.

Melding medicine and technology to entice a diabetic adolescent, for example, to regularly test blood-sugar levels, might entail a pop-up reminder or text message to the patient. Or, it could give teens an easy, convenient way to regularly report glucose levels, encouraging them to test themselves more often.

"Why should patients carefully record their glucose readings or dietary intake if they next hear about it when they go to a physician, three months from now?" Goldberg asked. "Many of my patients don't adequately monitor themselves except the week before they see me, because they don't want to disappoint me."

If it proves possible to use these popular "screens" to engage and encourage young chronically ill patients, Goldberg believes, the benefits could be huge.

"It changes the paradigm from chronic-disease management being something that occurs once every four months for 15 minutes inside an examining room, dictated by a provider, to something that potentially goes on every day, with the patient taking more responsibility for health every day, and the provider providing feedback that is timely and customized."

A just-completed clinical trial using personal computers and adult diabetic patients yielded "rewarding clinical results," Goldberg says, doubling the result of drug therapy alone in lowering blood-sugar levels.

Although diabetes is epidemic — and expected to be more so, with an American child born in 2000 having a 1-in-3 chance of developing the disease in his or her lifetime — only a small percentage receive recommended care. "Our current office-based chronic-disease-care system is really failing us," Goldberg says.

Goldberg's job is to test whether such communication can work to improve health. Then, the business case will have to be made.

He takes heart in this statistic: By the year 2030, fully half of the American public will be both chronically diseased and wired.

"We here at the UW hope to take advantage of that inevitability."