Reflections on a social game for health innovation

In a previous post, I described The Foresight Engine, an interesting game designed to encourage divergent thinking about a complex  health problem in an alternative reality. To recap, players involved in the game are invited to imagine a future scenario in 2020 where a neurological disease is expected to infect as many as 100 million in the US.  Players are part of a panel investigating ways to speed up the progress of research and  are asked to assume that they can:

  • get any resource needed
  • remove any obstacle
  • change any practice
  • collaborate across any boundary

The Rules

Players are prompted with broad questions such as “how can we safely accelerate clinical trials?”  and “what will the next generation non-profit organization look like?”  Players respond to these questions by playing “cards.” These can either be new cards or cards that build upon the ideas of others.

New cards include  “positive imagination” cards where you answer a “how would you….?”  question and “dark imagination” cards where you answer the question “what would make this impossible?” If you work from already played cards,  you have a variety of interaction options:

  • Play a momentum card: If that happens, what happens next?
  • Play an antagonism card: I disagree; here’s what might happen instead.
  • Play an adaptation card: How might this play out differently?
  • Play an investigation card: Ask or answer a follow-up question.

While new cards and momentum cards generally support divergent thinking, the remaining cards provide the opportunity for convergent thinking as well.

How points are earned

Merely posting won’t earn points;  your idea has to have some value, as measured by crowdsourcing. For example, you get one point when someone responds to one of your ideas and you earn  20 points when one of your  cards  is deemed “Super interesting” by one of the Foresight guides.  Points allow you to “level” through a number of different positions until you reach legend status. (I managed this, so it’s not that hard.)

There are also special awards  for “achievement” given out by the guides.  For example, there’s the “Venter” award for “Micro-forecast that makes the biggest paradigm shift.”  No stated points are awarded for an achievement award (at least, that I could tell from the rules), but you’re mentioned in the site’s blog, so there’s the “cool” factor to winning this and you get a spiffy “achievement” logo in your profile section. However, winners of the award mentioned getting a boost in points as well.

The dashboard

The game has a “Twitter-like” feel in that your responses are limited to 140 characters  and you see streams of cards. The dashboard is a bit clunky when it comes to viewing conversations represented as card “builds.”

When more players are involved, this can result in repeating earlier played cards and hanging conversation threads and as the game goes on in time, questions are repeated and people may go over old ground without building on previously played cards. Additionally, rather than being able to view a thread of responses on a single web page you have to click through multiple pages, so if you’re following someone else’s build you have to click through quite a few pages to get to the original card. A differently designed interface might have ameliorated some of these issues.

Why it’s a good game

I’m not a  game designer, but I did enjoy playing the game and it got me thinking about why it was rewarding for me personally.  I did a bit of reading on the attributes of good games and found this description by Mark Oehlert (e-Clippings) of “must-haves” and “nice-to-haves” in a game.


  • Action
  • Goal
  • Points/Feedback


  • Competition
  • Countdown timer
  • Social

The action
The action to this game resides entirely in social interactions and viewing posted responses to different questions being proposed at timed intervals. So needless to say, there’s more action when there are more players involved. The game had a slow start when it opened, but ramped up as new players joined in.  Overall, the question intervals were long enough to allow some dynamic brainstorming, but short enough not to let participants flounder or start repeating themselves too much. Unlike most brainstorming games, opportunities for divergent thinking and convergent thinking were not separated in time, which took a bit of refocusing (not entirely efficient) as you switched from one mode to another.

The goal
The goal is to be as creative a thinker as possible when faced with different game questions. The different game questions are all part of the overarching question/problem of how to speed up medical research when faced with the alternative reality of this devastating neurological disease. I really liked that questions all had serious real-world implications and were relevant to my interests in health care. For me, the relevance and interest factor trumped any frustration the goal’s fuzziness might have evoked.

There’s a scoreboard, so you can see your overall points. You also see the builds on your dashboard, which indicate when other players have responded to your cards. You have to toggle to a different view to see when you’ve been awarded points for having super interesting ideas, so feedback’s a bit delayed when it comes to your really good ideas.  I received a respectable number of super interesting points but I was never really sure about what piqued a guide’s interest.  Special awards received banner headlines and accessing a link gave you some explanation of why it was granted.  The somewhat arbitrary (and mysterious) point system made it a bit hard for me at least to care all that much about gaining points.

In addition to viewing points and awards, you can also view your “personal strengths” which are measured by the types of cards you play and  can change throughout the course of the game. Looking at your strengths throughout the game, can allow you to monitor your overall strategy. When I exited the game, my strengths looked like this:


You can see who has higher points than you have and so that creates incentives to come up with more innovative ideas to rise up the ranks.  Being mentioned in the site’s blog as a winner of an achievement award is also pretty cool.

Countdown timer
The game is played in real-time but it’s asynchronous in the sense that you can leave and return to the game area and you have quite a lengthy countdown— the game runs with a break over two days.   There’s no real sense of urgency and players who can afford to play the game for all two days are certain to get the highest scores (some sour grapes here, of course).  But for what it’s worth, I think the advantage of being able to hear from the maximum number of globally distributed voices really diminishes this weakness.

This game is all about being social, but with caveats. You’re awarded points for providing ideas that prompt discussion and the biggest rewards are handed out for divergent thinking (i.e., having super interesting ideas, winning achievement awards), but there are no apparent rewards for convergent thinking and of course both divergent and convergent thinking are required for innovation. Also, because the game had this “Twitter-like” feel, there is the sense of sending ideas out into the void and that luck also plays a part in being listened to.

Overall, however, the social dynamics of the game were very positive, and people were generally open-minded to what others were saying and worked together on builds. As in any social situation, some seemed to be better “listeners” and “explorers” than others.

Success  in a game like this is likely to mean different things to different people.   At the one end of the spectrum, you can imagine the player for whom the idea of competition is subsumed by the idea of doing some social good. For this player, it’s  less important to get points than to come up with solutions that might have the potential to lead to real change, though this player can be quite good at garnering points if he/she’s inherently creative.  At the other end of the spectrum, you can  imagine a player interested in the game purely as a challenge to win the most points.  This person’s more interested in creating some focus on himself/herself, since ultimately that creates more potential to gain rewards. Social interactions, therefore, have some element of manipulation to them. However, this person’s efforts may be hampered if he/she’s not that creative a thinker.  This mix of game intentions  can lead to some “interesting”  social dynamics.

So who wins a game like this? I do think it’s the social good that wins. The game lives on in the questions raised, which many of the players will continue to think about and work together on, in some way, in their own different social networks that exist outside of the game. In this particular game, I think most of the players were on the social good end of the spectrum and genuinely wanted to answer the questions raised during the game.

Playing this game has made me more interested in the idea of social games in general and I need to do more research on how social games create unique paradigms. I’ll share more about this in a later post.


One response to “Reflections on a social game for health innovation

  1. Nice, thanks for posting…

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