When Apple first announced the Apple Watch, I couldn’t help but think that the product was somewhat underwhelming on the health front. But that’s to be expected; we are only at the beginning of the nascent world of personal health tracking. The data that wearable smart devices and smartphones collect right now can be useful for helping us get more active, but the system isn’t particularly inspiring. Sure, getting notifications that I’ve been sitting for too long certainly helps keep activity salient, which in turn makes me more likely to find an opportunity to move around. But what I find is that I’m rather adept at ignoring notifications that I, for whatever reason, can’t or don’t want to act on. Which means all those clever notifications simply fade into a distant background constructed by my brain.

Motivation is a tough nut to crack. Rewards systems can be difficult to perfect. But there’s one industry that understands these things better than almost anyone else: video games. It’s tough to motivate someone to spend 5 hours of a weekend walking around a gorgeous nature trail. But put them in front of a screen and load up Skyrim, and you’ll have to scrape them out of their chair 12 hours later. Good game developers, through simple practice over the decades have built up an incomparable understanding of what motivates us to do things. Armed with our health and fitness data, they could really motivate us to improve our health.

So…what if we could connect the health & fitness data with games? Could we get healthier gamers?

Imagine an RPG game that gave your in-game avatar small boosts in stats or even small bonuses based on your real world activities. For example, if you walked a certain number of steps, burned a certain number of calories, or even increased your activity level by a certain percentage, your in-game character would gain a little more acrobatic skill, or maybe some special items. We could further blur the line between the real world and the virtual world and introduce an interesting and potentially useful dimension to game design.

From a design perspective, using real-world activity information to build an in-game avatar poses an interesting challenge. Many of us play video games as an escape. Would someone who can’t run very far or very fast because of a medical issue enjoy being haunted by their real-world problems in a virtual world? Probably not. But that doesn’t mean there isn’t a way to design and balance a game with health data as a gameplay dimension whilst still retaining escapism. And whether we like it or not, our real-world physical and mental abilities play a role in our virtual worlds. Using health data would simply formalize one aspect of those abilities. The key will be careful balance. How health data affects gameplay will vary from game to game, and not all games will or should integrate things like activity data.

There are a number of other issues that would need to be worked out. Privacy immediately springs to mind. Turning over our health data is unnerving, and depending on the nature of the data and legal jurisdiction, it could place new regulatory burdens on video game developers and publishers. In the United States, for example, things like pedometer data or even calories burned generally do not fall under HIPAA regulation, but as we start collecting newer forms of data things might not stay so simple. Though one might ask, if data about a users’ physical activity ever became regulated medical information, wouldn’t physical inactivity as measured and collected through existing video game telemetry also need to be regulated?

I could also see some players exercising themselves to injury or death to collect in-game bonuses. And given the variations in physical health from person to person, it’d be a good idea to design a system that accounts for these differences. Luckily, we live in a world where we can increasingly personalize our products and services, so even that may not be impossible to solve with clever thinking.

OK, so then what’s preventing someone from just shaking their phone for an hour to simulate taking some steps? Good question, but cheating isn’t a new problem.

I don’t think that these issues are intractable, just challenges that would have to be dealt with. We can’t just slap some “If/Then” health-data based gameplay mechanics in the game and call it a day. It would have to be carefully thought out. If done well, it could introduce new dynamics in video games, all while helping motivate people to increase their level of physical activity, which in general seems to help us live healthier and happier lives.

So who knows, maybe in the near future, as you take a brisk walk around your neighborhood, your sneaky, thieving Khajiit can get a boost in her skills, just like your heart.