Roblox and Healthcare's Metaverse

As neither a gamer nor the parent of a gamer, I’ve been proud that I’ve stayed even mildly in touch with the cultural phenomenon that gaming is.  I’ve written about, for example, the Metaverse, Fortnight, and e-sports.  Still, I somehow managed to be completely oblivious to the existence of Roblox, until they went public this week and was valued at $45b, larger than Electronic Arts (which I had heard of). 

Once again, I think there are lessons for healthcare.

Credit: Roblox

P.J. McNealy, CEO of Digital World Research, described Roblox to NPR as: “Minecraft meets Nintendo, which meets Lego and mobile phones enable a whole bunch of it.”  Whatever the metaphor, Roblox is booming.  It was valued at $4b a year ago, but the pandemic was very, very good for it. 

Credit: Quartz

Half of America children use Roblox.  Two thirds of its users are 16 and younger, and most of them were spending lots of time at home last year.  It is now estimated to have 37 million unique daily users, spending some 30 billion hours on the site last year.  It is available in 180 countries, in 11 languages.

What makes Roblox particularly unique is that it is not a game developer; it is a platform where users develop the “experiences”.  Roblox describes its mission thusly:

Roblox’s mission is to bring the world together through play.  We enable anyone to imagine, create, and have fun with friends as they explore millions of immersive 3D experiences, all built by a global community of developers.

It claims 8 million developers have created 20 million experiences -- and that it paid over $300 million to them.  The games are free but users can buy and spend an in-game virtual currency (Robux), which can be exchanged for actual money (Roblox shares 30% of the revenue with developers).  At least one developer made over $1 million in a single year; over 1200 made at least $10,000, with over 300 making over $100,000. 

Mr.  McNealy believes the IPO will allow Roblox significant expansion:

This money will either give them an opportunity to build more content for the for the platform or to go to adjacent platforms like music or partnering with Spotify or movie service.  That's where this is going to go.

CEO and co-founder David Baszucki isn’t content with the younger market, wondering: “So how do we make it possible for Roblox to connect with everyone in the world?”  Alex Hicks, cofounder of Roblox studio Red Manta, sees such potential, telling Polygon: “Lots of kids already know what Roblox is, but they’re just scratching the surface with the older audience.” 

In a February company blog post, Mr. Baszucki outlined some of the vision:

We see a future where tens of thousands of people can gather in a single instance to join a virtual business conference, attend a movie premier, or watch their favorite artists perform live.  We are working to make this vision a reality, innovating towards new technologies such as spatial audio and high-fidelity avatars with lifelike facial expressions.

Microsoft (Teams), Google (YouTube), and Facebook (Live) should all be looking over their figurative shoulders.  

Mr. Baszucki told Wired last year:

We will see a shift in the way people play, work, learn or simply hang out in 2021. Some of these connections will move into the Metaverse, a digital place where people seamlessly get together and interact in millions of 3D virtual experiences...[it is] arguably as big a shift in online communications as the telephone or the internet.

 Ah, the metaverse again. 

Credit: Roblox

To recap: a platform that relies on -- and rewards -- on user-generated content, thrives on shared immersive experiences, appeals to young people, and is fun.   Let’s see, which of those also apply to our healthcare system?  That’s right: none.

Healthcare is at least talking about platforms (e.g., Mayo Clinic Platform), but the closest thing the U.S. healthcare system has to a platform is probably Epic, which is renowned for poor usability and lack of interoperability.  Companies like AmWell would love to be the new platform, but are only slowly moving out from telehealth roots.  Optum is many things to many people, but not anywhere near being a platform.

Peer-to-peer support/advice is becoming more important in healthcare, but usually despite the healthcare professionals and institutions, not because of them.  Professional advice and treatment is still considered the “gold standard.”  Paying for patient-created “experiences” is unheard of. 

As for fun, well, when people use “Hunger Games” to describe what it is like to score COVID-19 vaccination appointments, it isn’t intended to convey any fun.  Healthcare may be allowing some games/gamification, but it is much too serious to take the importance of fun seriously.

Where is the healthcare platform that is built upon user-created content, paying those creators for how they engage other users in immersive 3D experiences?  “Participatory medicine” means simply allowing patients a say in their own care, which is a low bar Roblox wouldn’t even recognize.

Online gaming is a new industry compared to healthcare, but we’re already seeing the battle of its old guard and newer models.  In Venture Beat, Dean Takahaski contrasts Roblox’s IPO with Microsoft’s blockbuster acquisition of video game publisher Bethesda:

I see it as a contest between a promising part of the industry, as represented by the potential of the user-generated content of Roblox, and the old part of the industry, where Microsoft’s purchase of Bethesda is a new step in consolidation.

The way Techcrunch’s Luke Matney sees it:

The gaming industry has entered a very democratic stride as cross-play tears down some of the walls of gaming’s platform dynamics…While massive publishers have tapped cloud gaming as the trend that will string their blockbuster franchises together, they all wish they were in Roblox’s position.

Healthcare needs a Roblox.  It needs a platform that user created content and tools, among other things, can be built upon.  It needs a platform that engages users, using the latest technologies.  It needs a healthcare Metaverse. 

Such a company probably won’t come from within healthcare; e.g., Epic Games is more likely to create a healthcare Metaverse than Epic. 

I don’t know what a healthcare Roblox would look like; to be honest, I don’t really even know what Roblox looks like.  But I hope that there are some younger, smarter, more gaming-oriented people who can imagine what it might be, and that they make it happen.