Exploring Gamification of the Incentive Spirometry Tracker Device: A Survey of Patients, Providers, and Healthcare Employees

Background: Incentive spirometry (IS) is used after surgery to reduce pulmonary complications; however, adherence remains low, and objective measurement is lacking. This study evaluated the feasibility of ISTracker, a gamified, sensor-enabled IS module, and assessed the perceptions, usability, and engagement of the device. Materials and Methods: This exploratory study recruited 105 adult participants (patients, anesthesiology clinicians, staff) at a single large academic center. Participants sequentially used IS alone, ISTracker, and ISTracker plus gamification. After each configuration, participants completed a survey evaluating ease of use, design, navigation, and overall enjoyment. Open-ended feedback and administrator observations were also collected. Results: Most participants (90.5%) rated the ISTracker easy to use and gave the add-on five stars rating for shape (66.7%), stability (70.5%), and color (71.4%). Most (81.0%) reported willingness to use the gamified version, with 62.9% preferring it over standard IS. Younger participants were more in favor of gamification (p<0.0001) and reported greater enjoyment (p=0.0166). Inspiratory volume significantly varied by gender and BMI (p<0.0001), showing performance-engagement difference. Participant feedback highlighted the need for real-time utility, effort-gameplay linkage, and age-appropriate design. Conclusion: ISTracker was created to attempt to enhance engagement with IS across diverse groups. Combining gamification with data capture, features unavailable with standard spirometers, is a promising approach for improving perioperative care and guiding future research.