Howard Degenholtz thought he had a good idea.
He wanted to make a video game to encourage people to donate their organs if they died, something too few Americans do to keep up with the growing list -- now 112,000 -- of people awaiting some type of life-saving transplantation.
But Mr. Degenholtz, associate professor of health policy and management at the University of Pittsburgh's Graduate School of Public Health, knew from experience that private investors weren't going to be enthusiastic.
"When you go to investment capital people with ideas like this, they sit back and scratch their heads," he said. "They'll say, 'Wait a minute, you're trying to save lives here? Because, if so, we're not interested. We want to make money.' "
Fortunately for him, the federal government had other goals. Mr. Degenholtz and a team of colleagues at Pitt and the Center for Organ Recovery & Education, the agency that oversees organ procurement and allocation in our region of the country, applied for and in 2010 won a $700,000 federal grant to fund their idea.
After hiring local social media company MogiMe to help design it, they've spent the last two years building and refining it, overcoming more than a couple of concept-versus-reality issues.
The end result is "Doctor Transplant," a resource management game that the team will publicly debut this week in San Francisco at the Game Developers Conference, billed as the world's largest professionals-only game industry gathering.
"Doctor Transplant" will go live and be available as a free download on the Apple App store in April. It will be available on Facebook shortly thereafter.
It plays like many other popular resource management games like "FarmVille," a wildly popular game on Facebook.
But instead of running a farm, "Doctor Transplant" players will run a transplant hospital and have to buy the right equipment, hire enough doctors, nurses and janitors, and ultimately take care of a continuous stream of patients well enough, and long enough, for them to get a transplant, with the shortage of available organs the controlling factor.
"We wanted a game where the message is integrated into the game," Mr. Degenholtz said.
The team debated the tightrope issue of how to make the game fun while driving home the concept that the fatal shortage of organs is a serious issue that the players could help with by donating.
"We talked about how it can be like those reality shows that have a socially conscious message," said Helen Bollinger, the research, grants and legislative specialist for CORE, who was part of the team. "As long as you lead with entertainment in there, we think it can still have a message."
They will try to drive that message home both through the "Doctor Transplant" website, its Twitter account and Facebook page, all with the goal that players will find their way to a state registry link on them where they can sign up to donate their organs.
Though there have been a number of video games set up to let players run a regular hospital, such as "Hospital Tycoon" or "Hospital Hustle," and even simple games that put you in charge of transplantations, a complex resource management game that puts players in charge of a transplant hospital is unusual, experts say.
"I don't see games targeting this," said Asi Burak, co-president of Games for Change, a nonprofit organization that encourages the creation of such games. "I've seen games developed around disease and cancer and different health aspects, but not promoting donation in this way."
Though socially conscious games have had a tough time gaining traction, and often rely on donor or grant funding to support them, "there are games that show you can make a difference," Mr. Burak said.
Mr. Burak, for example, was a co-creator of the game "PeaceMaker," which won rave reviews and had some initial success getting players to try to figure out how to create peace between Israelis and Palestinians. But the company, Impact Games, eventually closed its doors for lack of funding, though "PeaceMaker" continues on with another local company, Hybrid Learning.
He cites three other leading examples:
The company iCivics, founded by former Supreme Court Justice Sandra Day O'Connor, has gotten 1.2 million players to learn more about civics, with studies showing 78 percent of the players know more after playing the games.
The game "Foldit" was created to get the public to help scientists find new ways to fold proteins to help with treatment of diseases, a riddle the public eventually did solve.
The game "Re-Mission" was designed to help young cancer patients learn the importance of adhering to treatment and take their medication, and studies showed patients who played it were more likely to do so than those who did not.
"Doctor Transplant" could become a similar success, said Jan Plass, co-director of the Games for Learning Institute at New York University, "because organ donation is something that could actually benefit from game playing."
Issues that benefit from socially conscious games "are especially things like organ donation that are riddled with peoples' misconceptions and apprehensions about what they are," he said. "If you ask people about organ donation, they may not want to deal with it. But if you show them a game, they might play it."
Still, the team -- made up of Mr. Degenholtz and Abby Resnick of Pitt, Ms. Bollinger and Misty Enos of CORE, and game designer Geraldine Yong, co-founder of MogiMe, a mobile social network company in Pittsburgh -- struggled with how to get people to play the game.
Initially, they thought the most obvious way was to create a game that would show people what patients go through while they wait for organs to become available for transplantation.
So, for example, they decided that the game player would help a patient awaiting a kidney transplant. When the patient entered the dialysis room, the player would swipe his finger on the smartphone screen directly on the patient's blood line, which would react by turning the patients' sickly green blood to healthy red blood.
Because it was funded by the U.S. Health Resources and Services Administration grant program that likes feedback, the team used a focus group to test the idea in June 2011.
"It was a good thing we did a focus group, because that first version didn't go well," Ms. Bollinger said.
"It would have been a total flop" if they had put that version out, Mr. Degenholtz said.
It turns out the focus group, made up of Pittsburgh-area game players between 18 and 60 years old, thought having a direct hand -- or finger -- in a patient's health "was icky," Ms. Resnick said.
That stunned the concept team, Mr. Degenholtz said, because many in the focus group played blood-and-gore shoot-em-up games like "Call of Duty."
That result drove home a powerful point: "It wasn't pretend enough," he said.
"They said, 'When we play the games we know it's an escape. But when you show me this game it makes me think about real life too much,' " he said.
So last summer they spent two months revamping the game, changing it from having the players have a direct role in patient health to managing the hospital. Part of the tightrope debate was what to do about patients who don't get a transplant in time.
"Again, we took a light touch," Mr. Degenholtz said, "because a game where all the little characters die would not be fun." Instead, if a patient runs out of time before he gets an organ, he just leaves the hospital.
The new version won rave reviews from a second focus group in August.
"This game makes you realize it's happening now. Lives are saved and lost every minute," one of the focus group testers wrote after trying the second version.
This week, Mr. Degenholtz, Ms. Bollinger and Ms. Yong will be at the conference in San Francisco dressed in scrubs with the Doctor Transplant logo on them, handing out pretend First-Aid kits with information about the game in them, hoping to build buzz behind the game and see if their vision takes hold.
"The one thing I wanted to do is create something that would have an impact on its own," Mr. Degenholtz said. "Hopefully more people will register because of it."
Sean D. Hamill: firstname.lastname@example.org or 412-263-2579. First Published March 4, 2012 5:00 AM