Admittedly, I enjoy my fair share of video games. Whether an amusing distraction on my smart phone or playing through a console attached to my television, I have spent a good amount of time enjoying some alternate reality where I’m tasked with any number of goals I don’t typically strive to achieve in my typical daily activities. I don’t recall, however, ever performing complex medical procedures within a game.
 
That, however, is exactly what Eric Gantwerker, MD, MS, MMSc (MedEd), FACS, vice president and medical director at Level Ex, enabled me to do through his video game offerings. I took on a few levels of Cardio Ex, one of Level Ex’s four apps and performed a number of cardiovascular procedures via a quite realistic-looking interface. In just a few minutes, I was able to insert a catheter and navigate it to the proper location, inflate a balloon, and initiate the correct therapy to resolve the “patient’s” medical issue. Of course, as an untrained layman, I had no idea what I was really doing, and it didn’t take very long before the learning curve was well beyond my (lack of) medical training. The interface, however, was quite intuitive and could easily be adapted by someone who had the necessary medical experience, but may not be a gamer like myself.
 
Afterwards, I was able to have a discussion with Dr. Gantwerker about Level Ex’s products and how the company is helping to keep healthcare professionals on top of their game when it comes to being ready to perform similar procedures for real.
 
Sean Fenske: What is Level Ex and what are the games the company offers?
Dr. Eric Gantwerker: Level Ex is a Chicago-based medical mobile video game company that creates industry-leading medical video games for more than 500,000 healthcare professionals across the United States. Level Ex games provide healthcare professionals with an array of challenging, rare cases within four specialty areas including cardiology (Cardio Ex), anesthesiology (Airway Ex), gastroenterology (Gastro Ex), and pulmonology (Pulm Ex). Our games are available to download free from the App Store or Google Play.
 
Fenske: How did you become involved with the company?
Dr. Gantwerker: During my pediatric fellowship, I earned a master’s degree in Medical Science in Medical Education with a focus on educational technology and innovation. I started consulting and advising for several companies from the medical education and technology standpoint, and focused on Level Ex because of its tremendous potential and my wholehearted belief in its mission. I became the full-time medical director at Level Ex in March 2018 and continue in that capacity while also operating as a pediatric ENT surgeon at a nearby academic institution.
 
Fenske: Beyond entertainment, what are the benefits of surgeons playing the games?
Dr. Gantwerker: The games are more than just entertainment. The benefits for physicians playing Level Ex games include practicing on actual physician-submitted rare and challenging cases and the ability to earn CME credits. Doctors are able to experiment in a risk-free environment to see what potential consequences may arise from their decisions and actions.
 
Because the games are interactive, users are able to glean nuances in the cases that will prepare them for real-life challenging situations with patients in a way that textbooks don’t. Another major benefit is that completion of certain levels earns the physician user valuable CME credits that are required to maintain their medical license. Spending time engaging with the games while at home or between cases at the hospital—and earning CME credit while doing so—is a popular choice among our users, as 118,000 CME cases were played in 2018.
 
Fenske: What’s been the feedback from physicians and surgeons who have played the game?
Dr. Gantwerker: Feedback on the games has been very positive. Universally everyone has been amazed by the graphics and the realistic experiences the games provide. Physicians who play these medical video games in their downtime or between cases enjoy the access to the latest medical devices and drug therapies, learning new techniques, engaging in the rare and challenging cases the games present, and the competition that exists within the games.
 
Fenske: Is it unusual for a video game to be qualified to issue CME credits to physicians for playing?
Dr. Gantwerker: We’re creating another universe of continued medical education that truly provides value to these physicians’ lives, and in turn, to patients’ lives. We only offer CME for select cases in our games. Playing a mobile video game and earning CME is way more satisfying and rewarding than having to take extra hours out to attend a conference or read journal articles.
 
Fenske: How do partner companies get involved with Level Ex?
Dr. Gantwerker: We are always looking for new opportunities to work with pharmaceutical and medical device companies, as well as medical societies and associations. We collaborate on cases and incorporate innovative strategies to engage physicians for advanced learning. Our relationships include Pfizer, Merck, Baxter, Medtronic, the American Heart Association, the American Society of Anesthesiologists, and several others. For example, we collaborated with Baxter to create a dosing mini-game inside our Airway Ex game. The objective of the game was to educate healthcare professionals and build their confidence in dosing Suprane, an inhalational anesthetic by Baxter. In the first three months of the program, the case was played more than 7,000 times by physicians.
 
Fenske: What are corporate partners commonly seeking to achieve in working with Level Ex?
Dr. Gantwerker: Organizations we work with want to expose their therapy or device to medical professionals who use the games. When a pharmaceutical or medical device company has a case with us, medical professionals are able to practice using the therapy or device via their mobile device rather than on a patient, providing valuable experience in a simulated environment. Additionally, the ability to practice new devices and therapies from their phone frees up their already hectic schedule—much more appealing than spending hours with a sales rep. Plus, physicians can play Level Ex’s games wherever they are and whenever they have downtime, which ultimately results in better outcomes for patients and more visibility for therapies and devices. For example, within our Airway Ex game, we worked with Medtronic to develop an augmented reality unit that allows medical professionals to better understand the benefits of the McGRATH MAC video laryngoscope over the more commonly used Macintosh Laryngoscope.
 
Fenske: What’s the reaction from companies when they see their technologies recreated in the virtual space of the game?
Dr. Gantwerker: Our collaborators love seeing their technologies recreated in our games. They know that their product is being noticed and used by hundreds of thousands of healthcare professionals, and they like that. Our ongoing and expanded relationships are a testament to our mutual goal of enhancing physicians’ training opportunities.
 
Fenske: Can you share what other clinical areas are on the horizon? Any preview of what’s coming?
Dr. Gantwerker: Aside from our four current medical apps, we are developing games for dermatology and neurology. Each game we create is tailored to that specific specialty. With Level Ex and the games that we’re able to develop, our expansion is endless.
 
Fenske: What’s in store for Level Ex? Where do you see the company in five years?
Dr. Gantwerker: We are always looking toward the future and areas of medicine we can apply our solutions to. We are extremely proud of the work that goes into creating our games and are excited to see so much receptivity toward them.
 
In five years, our goal is to be a go-to game on every provider’s phone because, in turn, the additional training and education received through Level Ex will translate to improved quality of care for the thousands of patients.
 
Fenske: Do you have any other comments or insights you’d like to share?
Dr. Gantwerker: Level Ex brings together top talent from the medical world and the video game industry to develop medical video games that can ultimately help patient outcomes. Physicians learn from our games and take that knowledge into the clinical setting, where outcomes really matter.
 
With the momentum we have drummed up in 2019, the impressive team we have built over the past three years including bringing on Todd Shallbetter and Jason Rubenstein to our leadership bench, and the endless possibilities of where we can take Level Ex games, we’re excited about what’s to come for Level Ex.