Games for Health 2010

Bruce Milligan - DesignerBill Becker - Lead Programmer

Simulation and Training Environment Lab

Code OrangeA Multiplayer 3-D Game

for Hospital Mass Casualty Incident Training

Who are we?

Division of MedStar Health

SiTEL offers professional training, including:

• On-line education• Live hands-on training with mannequins• Clinical medical simulation, virtual apparatus, and other

devices• 3-D multimedia including serious games• More than 70 employees • Headquartered in Washington, DC

• A $3.8 billion, not-for-profit organization• The largest health care system in the greater

Baltimore-Washington corridor• 9 hospitals and 20 other health-related businesses • Over 29,000 employees and 5,300 affiliated

physicians• Serves a half-million patients annually• Committed to the use of new technologies for training.

Who is MedStar Health?

Traditional MCI Training

• Classroom lectures and exercises• Tabletop exercises in HCC• Live training events

Liabilities of Traditional Training Methods

• Unrealistic

• Too short

• Too small-scale

• Too disruptiveTraditional training exercises take valuable people and equipment offline. They also consume vital space from hospitals that often have a 90% daily occupancy rate.

• Too expensive!It can cost up to $50,000-$250,000 for a one-day exercise

Code Orange - Game Vitals

Our audience: Hospital management and staff

• First-person, 3-D virtual hospital• Up to 12 human players• Approximately 2 hours of playing

time per session• First Scenario – Conventional terror

bombing• Editable scenarios• Integrated into SiTEL’s Learning

Management System • Full event capture for AAR and

offline post-session analysis.

More Benefits: 3-D Games as a Serious Choice

• 3-D environments are compelling

• 3-D training is less expensive

• Mistakes can be made

• Training areas are there when needed

• “Volunteers” are always available

Immersive and realistic

Training costs can be reduced

Better to kill NPCs than your patients

A 3-D hospital is always available

Orange includes over 400 patient and staff NPCs.

The Mission

• To create a credible virtual hospital Simulate the sights, sounds, and pressure of a real hospital during a crisis

• To make a game that is both compelling and realistic If it isn’t compelling, they won’t play If it isn’t realistic, they won’t learn what they need to know Create an MCI situation – something hospital employees may encounter only

once in their careers Effectively teach that all the normal rules change during an MCI – real triaging

occurs (some patients will die), time and space become luxuries, and that working with and trusting unknown people and organizations is a must

• To make a game that is useful for two players or for a dozen Meets requirements for always available training Requires credible AI for all player positions

Code Orange: Strategic Goals• Teaching staff how to handle a surge of patients into a hospital that

is already almost full and how to handle patient flow throughout the hospital

• Teaching the structure and procedures of HICS (the Hospital Incident Command System)

• Helping staff to focus on four key resources during a disaster: People (staff and patients) Supplies Space (hospital bays and other areas) Time (the one resource that is always fixed)

• Teaching the importance of communication

The Code Orange Virtual Hospital

Triage Area

Emergency Department

Hospital Command Center

The Triage Area

The Emergency Department

The Hospital Command Center

Code Orange – Short Video Tour

Teamwork is a must!

The Job Action Sheet

The heart of the HICS system:

Players will use them as personal “scorecards” in the game, so they can keep track of whether or not they are accomplishing key tasks at the right time

Communications are the Key

• If you don’t communicate with your colleagues during an MCI, people will die

• Code Orange puts a premium on communications between players Chat (same room) Telephone (i.e., private chat) & voicemail Written messages using HICS forms.

• Technical challenges arise in the capture and analysis of game data as a result of permitting “free-form” chat during gameplay

Part of an Integrated System

Data Repository

SiTELMS

Code Orange

Credentials and Session information

Asse

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ent &

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Offline Analysis Tools

Assessment data

Ref

ine

asse

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ent

Refine Game Model

A Unique Partnership

Partners in the development of Code Orange include:

• MedStar Health physicians, nurses, and administrators

• Incident Commanders and staff from hospitals in D.C. and elsewhere

• In-house subject matter experts

• Code Orange Advisory Board (with members located around the U.S. and abroad)

Challenges!

Don’t Forget who the Real Experts are• By the time we finish a commercial product, we

typically know far more than the average user will ever know.

• By the time we finish a serious game, we know a fraction of what our end users have known for years.

Serious Challenges

Looking Ahead…

“The Incident Commander has declared the Incident is over.”

Questions?

Contact: Bruce Milligan

Bruce.Milligan@email.sitel.org

202-364-5180, ext. 131