The impact of gamification on the patient's engagement in the online health community
| DOI | https://doi.org/10.1108/AJIM-10-2021-0314 |
| Published date | 15 April 2022 |
| Date | 15 April 2022 |
| Pages | 1196-1213 |
| Subject Matter | Library & information science,Information behaviour & retrieval,Information & knowledge management,Information management & governance,Information management |
| Author | Peng Ouyang,Jian-Jun Wang,Usman Ali |
The impact of gamification on the
patient’s engagement in the online
health community
Peng Ouyang
School of Economics and Management, Harbin Institute of Technology,
Harbin, China, and
Jian-Jun Wang and Usman Ali
School of Economics and Management, Dalian University of Technology,
Dalian, China
Abstract
Purpose –Gamification has been widely implemented to improve user engagement in the online health
community (OHC). While its effect on the physicians’engagement has recently been documented, whether and
how gamification influences the patients’engagement in the OHC remains an untapped research area. The
purpose of this study is to fill this dearth by encompassing the gamification strategy of Haodf.com, which
awards the “Annual Physician”badges to the physicians, to analyze how this gamification approach motivates
patients’engagement in the OHC.
Design/methodology/approach –Real-world data are leveraged from the OHC. The Tobit model is
employed for modeling the gamification-patient’s engagement nexus in an OHC. Robust findings are obtained
by incorporating different measures of a dependent variable, a set of control variables about the physician’s
characteristics and hospital’s features, and alternative estimation techniques.
Findings –The results reveal that a patient’s engagement in the OHC in the form of appointments and review-
posting behavior is enhanced by the gamification strategy. Besides, the positive influence of gamification on
the patient’s engagement is further strengthened by the physician’s professional capital. It is basically obtained
that the gamification is an efficacious tool to accelerate not only the physicians’engagement but also of the
patients in the OHC platform.
Originality/value –The study provides both theoretical a nd empirical discussion to enr ich the
understanding on how OHCs enhance patients’engagement by developing gamification techniques. The
findings guide the practitioners of OHC to better understand the implications of their gamification design to
optimize user engagement.
Keywords Gamification, User engagement, Online review, The online health community, Patients’
engagement, Professional capital
Paper type Research paper
1. Introduction
Over the last few years, the online health community (OHC), such as Haodf.com,Guahao.com
and Practo.com, has gained widespread popularity and brought tremendous changes in
people’s health-seeking behavior, such as obtaining healthcare services and knowledge. The
OHC is being seen as a valuable channel of mitigating health disparity and the looming
shortage of healthcare services (Goh et al., 2016;Cao and Wang, 2018). On the one hand, the
OHC provides the patients with the opportunity to access the physicians to receive
AJIM
74,6
1196
The authors thank the editor, Professor Dan Wu, for her precious time, the associate editor, and two
anonymous reviewers for their valuable comments and suggestions.
Funding: This research was supported by the National Natural Science Foundation of China
(71903020), The Ministry of education of Humanities and Social Science project (19YJC790174), the
Fundamental Research Funds for the Central Universities (DUT19RW212).
Declaration of interests: None.
The current issue and full text archive of this journal is available on Emerald Insight at:
https://www.emerald.com/insight/2050-3806.htm
Received 7 December 2021
Revised 4 January 2022
20 March 2022
Accepted 27 March 2022
Aslib Journal of Information
Management
Vol. 74 No. 6, 2022
pp. 1196-1213
© Emerald Publishing Limited
2050-3806
DOI 10.1108/AJIM-10-2021-0314
consultations services, and scheduling appointments with the medical practitioners without
time and space restrictions (Cao and Wang, 2018). On the other hand, the OHC offers a variety
of ways for the physicians to gain social and economic returns (Guo et al., 2017). In addition to
the patient–physician interaction, users in the OHC may also engage in health information
sharing (for physicians) and seeking (for patients). Therefore, the OHC serves the purpose of
not only providing healthcare services but also improving health awareness.
The proliferation and development of the OHC rely heavily on the user’s active
engagement in the online platform (Wang et al., 2017). In fact, user engagement is the
mainstay for the smooth functioning of the OHC. However, like other online platforms, the
OHC also faces the challenge of increasing users’active engagement. It is reported that more
than 90% of users in the OHC are only short-term observers (Van Mierlo, 2014). Only a small
minority of members in the OHC are active contributors (Matzat and Rooks, 2014). The lack of
users’active engagement is detrimental to the sustained development and the continued
operations of the community (Ren et al., 2007) as the success of the OHC is contingent on the
users’active engagement (Wang et al., 2017). Therefore, to motivate users to engage in the
OHC, the managers set up various strategies, such as reputation (Liu et al., 2016), income (Guo
et al., 2017) and channel (Luo et al., 2018).
Gamification has recently been advocated as an effective strategy to engage users on the
OHC (Liu et al., 2020a).The definition of gamification is using game-design element in
nongaming contexts (Deterding et al., 2011). Generally, in the context of OHC, gamification is
designed for the physicians since physicians are the main knowledge contributors.
A common practice in OHC is that the physicians are rewarded with honorary badges or
higher status based on their contributions. For example, Haodf.com uses a unique badge, the
“Annual Physician”, designed for the physicians. Physicians must make long-term (usually
one year) contributions, in the OHC, such as respond quickly to their patients, to earn this
badge, which results in higher status among the physicians in the OHC. Therefore, this
unique gamification aims to motivate engaging healthcare service providers. Thus, it is
different from other previous gamification studies.
The “Annual Physician”qualification is evaluated every year based on the following
criteria: (a) physicians provided enough online consultations in the last year; (b) physicians
respondto their patients quickly;(c) physicians satisfy mostof their patients and (d) the levelof
patients’onlinereview-posting forthe physicians. It implies thatthe physicians must consume
more time and energy to their listings to earn this badge. For example, they must carefully
screen their patients to avoid unnecessary negative reviews from them, as wellas to improve
their professional competency to satisfy the patients. Previous research discussed the direct
effect of this gamification of badge on physicians’engagement in the OHC (Liu et al.,2020a).
This paperdiffers from existing studiesabout the direct gamificationin the OHC. We aim to
investigate its indirect effects that whether it can increase patients’engagement. This is an
important issue because user engagement in the OHC is a two-side engagement, which
necessitates engaging not only the physicians but also the patients on the online platform.
Patients’engagement in the communitythrough their appointment behavior and consultation
experience also attracts other patients looking for quality online health information
(Gopalsamy et al.,2017), which is therefore an indicator of success and sustainable growth
of the onlinecommunity. Theoretically,physicians makemuch effort to earn this badge; in turn,
patients viewthese badges and use them to formtheir attitudes and perform theirsubsequent
behaviorssuch as making appointmentand posting reviews.In such a case, the gamificationof
“Annual Physician”badge should have indirect effects on patients’engagement. However,
whether such type of gamification can help enhance patients’engagement remains unclear.
Therefore, it is necessary to explore theimpact of gamification on patients’engagement.
The possible indirect effects of gamification on patients’engagement may vary due to the
diversity of physicians. The effect of some physicians’features, such as professional capital,
The impact of
gamification
and the OHC
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