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Learning from the Video Game Experience

by Jonathan Bush, President & CEO

I spent some time in Aspen in late July to attend Fortune magazine’s tech brainstorm. I joined a panel on innovation and when it was over there was a really interesting discussion all about video games.

It made me think about a recent piece in the NY Times on the friction between innovation and standardization in EHR design. But have you ever played the incredibly popular game Angry Birds? No? How about any of the games from the developers at Naughty Dog?

Who knew that millions and millions of people cannot help but take every spare minute they have to throw digital chickens up at digital, edifice-dwelling pigs? Who knew that millions would be made in sales of stuffed animal versions of said chickens?

If you think about what essentially is happening on the platform for our cloud-based services known as athenaNet, it seems to me that it doesn't have to feel all that different. athenaNet users often get very excited about their online tasks that have a gaming sense of accomplishment. For example, we hold an annual user conference attended by hundreds of clients and it’s instructive to listen to the “super-users” talk when they talk about “my buckets.”

As in:

“Now that my buckets are clean, what’s the next most important thing for me to focus on?”


“The kids were so excited about Harry Potter…and yellin’ at me to get in the car, and I’m like ‘Okay, just let me get this last thing out of my bucket!’.”

If you compare that with the snippets I got from these video game successes during the session in Aspen, you get the notion that perhaps we could push the concept further.

Here are some tidbits from the panel discussion that I tweeted from Colorado:

  • Games. They connote emotion: joy or frustration.
  • "It is important that games are fun"
  • Many social games these days are not fun because they take too much time and investment before the “hit”---they need to feel a lot like smoking!
  • Casual games started leading the pack. Now we are seeing more involved games following on…but only after a huge following gets hooked at the easy level. It’s crazy to try to push people to complex levels before they are hooked on the easy stuff. Only then can you build animated movies and sell them stuffed animals and bring them to the higher levels of complexity.
  • The Naughty Dogs games. Very focused on synthesis of game and story.
  • Angry Birds -- huge back story. They bought an animation studio.
  • They don’t think of themselves as a game company, but the next entertainment brand.

This all sounds like advice for us. It seems like we already have a lot of this intuition in place. Perhaps we just need to go with it more.

What if we built more of a formal storyline for a character to develop in athenaNet? (For non-users, there’s some athenaNet terminology coming up here.) What if the ‘back-end holds’ were the bad guys, the ‘scrubs’ were the hostages and the user was the very human hero placed in unusual circumstances…like Nathan Drake in the game Uncharted?

To be totally clear here, I am talking about encouraging people to become expert users of athenaNet and this has nothing to do with people getting rewarded to submit claims, drive our bottom line, refer others, etc. Not the case. But what if there was no training, only LEVELS that you get to. A super-user becomes someone who can stay at Level 6 or above in athenaNet and a Jedi is someone who can stay at Level 10. A super-user gets free admission to the User Conference and a Jedi gets their own conference and a $1,000 gift card every year they keep their status (oh, and a glowing green light saber).

What if you got a gift for each level you reached, like an athenaNet cookbook for Level 3? athenaNet toys?

What if you knew exactly where you were in your current level and how far you have to go to get to the next level?

“You are 60 scrubs into Level 2… You need 100 to clear this level.”


“This is your third bank statement reconciliation. When you close, you will be at Level 18.”

What if Jedi were available on the athenaStore as consultants and your practice could pay them after-hours to coach your own super-users?

What if there were team prizes too?

In the video games I learned about in Aspen, there is a pyramid of users at the bottom doing just fine and a tiny elite of Jedis at the top who are essentially going toe-to-toe with the game makers as they develop new levels. They are in essence the mother-of-all elite focus groups. Wouldn’t that work for us too?

 SO you may be asking yourselves:

“What happens when Angry Birds fades (as fads do)?”

Ask yourself why video games will fade.

Could it be that they will fade because life will actually emulate them in such a way that fantasy versions just don’t measure up any more?

Maybe they will fade because we will make them fade by moving real life and fantasy a tiny bit closer together.

What about the seriousness factor?

Would we be making light of it?

I assume you don’t need to have this be so transparent. We don’t need athenaChickens. But one attraction of the game world is the notion of 'all world' transparency. That is, you know where you are on this level versus the next and you know where the other players are. There is an instant gratification/feedback that we don’t get once we enter adulthood and that many of us miss from childhood. I think this kind of accomplishment might bring more clarity to the value of the work that folks on athenaNet do.

Or maybe a little tongue-in-cheek (chicken?) is exactly what we all need.

Jonathan Bush is the President and CEO of athenahealth.

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