References on the Website

Problem page

• Footnote 1: Journalist Dan Weissmann said, "If you were to design a health system that did the worst job of serving people and immiserates people the most, you'd have a hard time coming up with something that was more effective than what we've got.”
  KHN's ‘What the Health?’: Boosting Confusion
• Footnote 2: According to the Commonwealth Fund, the US ranks dead last among developed nations on health outcomes; last on access to care; last on administrative efficiency; and last on health equity.
  Mirror, Mirror 2021: Reflecting Poorly. Health Care in the U.S. Compared to Other High-Income Countries
• Footnote 3: According the American Journal of Public Health, healthcare is by far the leading cause of personal bankruptcy in the United States.
  Medical Bankruptcy: Still Common Despite the Affordable Care Act
• Footnote 4: Other innovators are rethinking our teetering health system.
  ReThink Health
• Footnote 5: Our health system may be broken beyond compare or repair, yet its most under-utilized, under-performing human capital is not providers, payers, or the supply chain. It’s the embattled patients.
  Warner Slack, the visionary physician who wrote that the patient is the “largest and least utilised resource in healthcare” -- BMJ 2018;362:k3194

Contacts page

Becker links

robert.becker@humaginarium.com

https://www.linkedin.com/in/beckermultimedia/

Walker links

dave.walker@humaginarium.com

https://www.linkedin.com/in/walkerdh/

Peterson links

david.peterson@humaginarium.com

Halpren-Ruder links

daniel.halpren-ruder@humaginarium.com

https://www.linkedin.com/in/drdanhr/

Company page

• Footnote 1: All ways considered, the best by far was with video games.
  According to clinical research physicians with the Pediatric IBD Consortium, the lack of patient and caregiver engagement impeded patient-centered outcomes. The art and entertainment of video games were likely to counterbalance cognitive overload and dread caused by disease, whereas health information per se tended to increase it.

Technology page

• Footnote 1: We are practitioners of system dynamics, a computational approach to modeling nonlinear behavior of complex systems over time.
  Our cofounder and Chief Modeling Officer, David Peterson, is the Chairman of Ventana Systems and a pioneer of applied system dynamics. Three of our senior leaders are active members of the System Dynamics Society.
• Footnote 2: The systems we model are determinants of health i.e. the risks, causes and consequences of disease.
  Determinants of health are a complex, nonlinear system of intersecting causal loops whose stocks and flows change over time. Our health and healthcare simulations allow patients and other folks to investigate and experiment with the system in order to optimize its behavior in particular scenarios.
• Footnote 3: We construct rich, mathematical models with Vensim software.
  Vensim
• Footnote 4: Our models power high-fidelity simulations that reframe illness as a curious puzzle that may be seized and solved by patients and other folks.
  Our scientific, evidence-based, mathematical models power accurate, realistic simulations of causes and drivers of disease. These are two of the product types that Humaginarium makes. A third type is video games that infuse our simulations with fantasy and address the cravings of players for escapism. 
• Footnote 5: The simulations are mediated by virtual physicians, who embody myriad human factors in our use-case scenarios.
  Standardized patients and now virtual patients are critically important techniques in medical education.Virtual physicians have not existed for patient education, but are now being introduced into our health and healthcare simulations. 
• Footnote 6: Scenarios are drawn from our evidence-based patient journey maps.
  Patient journey maps are typically limited to what we call institutional determinants of health in clinical environments. Our integrated patient journey maps include all five determinants of health for a more authentic picture of patient experience.
• Footnote 7: the untutored and unmotivated who own the lion’s charge of health disparities and inequities.
  The untutored lack science and health literacy; the unmotivated lack self-determination and grit. Our scientific simulations provide these affordances, including to marginalized communities, and thus attack the symbiosis of health inequities and health disparities where they are easiest to find and hardest to eradicate.
• Footnote 8: we create video games that render scientific simulations as adventures, role-plays, and mind-bending puzzles.
  Our video games are “hybrid simulations” that blend mechanics and aesthetics of five popular video game genres: simulation, adventure, role-play, strategy, and puzzle.
• Footnote 9: together, they may improve the lives of millions.
  We estimate that over 100 million American adults, who play video games, also have at least one serious chronic illness that is poorly controlled.

Impact page

• Footnote 1: medical self-efficacy
  Medical self-efficacy is our term for any individual’s ability to control and improve their health, alone and in collaboration with a care team. The pillars of medical self-efficacy are science literacy, health literacy, and health acumen: competencies that players build in our simulations.
• Footnote 2: constructive health competence
  Constructive health competence is our term for any person’s ability to apply medical self-efficacy dynamically, creatively, spontaneously, and bravely. It is a problem-solving capacity that is key to patient empowerment.
• Footnote 3: science literacy in tandem with health literacy
  According to the CDC, “Personal health literacy is the degree to which individuals have the ability to find, understand, and use information and services to inform health-related decisions and actions for themselves and others.” According to the The OECD PISA Framework (2015), science literacy is "the ability to engage with science-related issues, and with the ideas of science, as a reflective citizen." Though it is impossible to make informed health-related decisions without understanding the science that justifies them, it is a fact that science and health literacy are never paired, as we have paired them, in a unified construct of medical self-efficacy. The apparent reason: science is hard. We make it fun.
• Footnote 4: patient competency model
  According to SHRM, “A competency model refers to a collection of competencies that are needed for effective job performance.” Avoiding, preventing, and mitigating chronic illness amounts to a full-time, self-employed job for millions of people, but no competency model exists for it. As though patients do not require competence to achieve their health outcomes. This of course is nonsense, and we are correcting it with the dynamic concept of constructive health competence.
• Footnote 5: patient-centered outcomes
  Patient-centered outcomes are usually assumed to be the sole responsibility of healthcare providers. In our simulations, they are the fruits of collaboration between providers and patients, with patients exercising considerable thought leadership.
• Footnote 6: virtual physicians
  Our invention of virtual physicians is conceptually and functionally analogous to extant virtual patients.
• Footnote 7: healthcare simulation for patient skills development
  The well established industry of medical and healthcare simulation provides services to providers only, for their training and development. It does not address the needs of patients.
• Footnote 8: mathematical modeling of  to power health and healthcare simulations
  Our mathematical models of determinants of health are not unprecedented. Scientists have modeled somatic and social determinants of health for medical and industrial applications. What is unprecedented in our work is mathematical modeling of determinants of health for the general population. 
• Footnote 9: video games to engage folks with determinants of their health
  Our video games are not educational or “serious”; nor are them gamification. They are art and entertainment that engage consumers with subject matter for the purpose of amusing them. The subject matter happens to be determinants of their health, but that is not intrinsically fun or even interesting to most people. Mechanics and aesthetics are.
• Footnote 10: transform healthcare, health education, and health promotion
  Our simulations enhance patient experience and outcomes (healthcare); how well patients understand determinants of their health (health education); and the degree to which patients control and improve a chronic illness (health promotion). This triple play is transformative.
• Footnote 11: increase the size and scope of the video game industry
  At present, despite the gargantuan size of the video game industry, not a single AAA game concerns itself with personal or public health; or for that matter edifies players about any aspects of life. Popular video games are pure fantasy and escapism. We do not undercut fantasy and escapism, but we make them more personally meaningful.

Content page

• Footnote 1: people facing serious chronic disease. That’s well over half the US population.
  According to the CDC, six in 10 adults in the US have a least one chronic disease; four in 10 have more than one. Chronic diseases are the leading causes of death and disability and the leading drivers of the nation’s $3.8 trillion in annual health care costs.

Promotion page

• Footnote 1: The World Health Organization (WHO) and the US Centers for Disease Control and Prevention (CDC) say health promotion is a process of enabling people to increase control over, and to improve, their health.
  World Health Organization and Centers for Disease Control and Prevention
• Footnote 2: We see health promotion as a call for patient empowerment, though others may believe it’s a way to improve healthcare.
  High-level definitions of health promotion allow for both interpretations; the latter is preferred by stakeholders in health systems that assume responsibility for health outcomes. Unfortunately, those health systems are failing across every dimension except for revenue generation. We believe that the only health promotion that matters is the kind that empowers individuals to take better care of themselves.
• Footnote 3: US health system is ineffective and unlikely to change until its financial incentives change; that is, not soon.
  Mirror, Mirror 2021: Reflecting Poorly. Health Care in the U.S. Compared to Other High-Income Countries
• Footnote 4: we view empowerment as a cognitive more than a behavioral intervention.
  Humaginarium takes the unusual position that patients are not stupid; that they want to understand and solve problems; moreover that they resist solutions that they don’t understand. We offer ways for them to figure things out, on their own terms, as a prerequisite for taking action. This contrasts with digital health technology that eclipses cognitive problem-solving and decision-making with conditioned behavioral response. 
• Footnote 5: Ground zero for empowerment is learning, not nudging.
  We believe nudge theory is a high-falutin reframing of the commercial truism: “don’t make me think.”
• Footnote 6: resistance to learning that is too strong to overcome.
  “The expression learning resistance … refers to situations in which one or more individuals directly or indirectly, consciously or unconsciously reject any engagement in a learning possibility.” Illeris K. (2012) Learning Resistance. In: Seel N.M. (eds) Encyclopedia of the Sciences of Learning. Springer,

Pitch - Advisors

Gilbert link

https://www.linkedin.com/in/sean-gilbert-76342826/

Huey link

https://www.linkedin.com/in/erik-v-huey-6b384a58/

Macfarlane link

https://www.linkedin.com/in/charles-macfarlane-9629a33/