In 2016 I had an idea to create a city-based family tourism app. I first thought of it when trying to find an innovative way to engage my children with their local city, Cambridge, and all the exciting sights it has to offer. I thought ‘how can I get the kids off their phones and interested in their surroundings?’, and it occurred to me that, instead of taking away the technology, I could instead create something that would use the technology effectively for family adventures in Cambridge.
I wasn’t aware of a city guide or app that was tailored towards parents and children, and so with a background in software and having been on a number of writing courses, I set out to research the local area and to write stories for a guide that would appeal to families – making sure to use a friendly tone, to tell jokes, and to put activities in such as challenging children to find particular things on the way, or when they reached a destination.
I also wanted to provide really useful information, such as restaurants or cafés that are really geared to welcoming families; where parents can go to find baby changing facilities; and which outdoor adventures would suit little legs, and so on.
It was fairly straight forward to put together an initial app. I developed the structure, then worked alongside graphic designers to develop the look and feel, before launching an early version of the app – named YoYo Let’s Go – on the app store in February 2017.
In the first six months the app was downloaded 200 times which was really fantastic and I received such positive feedback, such as how there was nothing else like this for children that focuses on local heritage. However, having estimated that there was a potential 450,000 users annually, I wasn’t sure beyond the thousands of flyers I had been distributing around Cambridge how to take the app to this bigger ‘waiting’ audience.
It was at this point I came across Signpost2grow, which provided with me 12 hours of consultancy around growing the business, through which I developed the business model, realised the need to register with Companies House and HMRC, and attended bookkeeping courses. I learnt about some of the essential steps I would need to take that I hadn’t previously thought of, and the experience was really helpful in formalising my business approach and formulating a marketing plan.
In July 2017 Signpost2grow put me in touch with the team at REACTOR, and I attended one of the Concept Development Workshops, which provided opportunities to develop and practise intense three-minute pitching; to refine the business model canvas; and to consider for the first time whether applying games theory would enhance the app. This was really interesting as I recognised that there was an opportunity not only to include a game as an add-on to the app, but to actually incorporate elements of reward, challenge, and levelling up into the core app – to encourage return visits, to influence behavioural change and so on. I also applied for REACTOR funding – which is available jointly from the European Regional Development Fund (ERDF) and Anglia Ruskin University. The process of applying for funding was useful in itself – I needed to get quotes from multiple organisations to work with me on implementing game mechanics into the product - this also enhanced the look and feel of the product in order to make it more professional, and progressed the product to the second stage of development with improved navigation and structure.
The team at REACTOR is always happy for people to go along to events to chat about ideas and offer advice, and the tips that the team was able to provide and the networks that grew were also invaluable – in terms of identifying who locally might be available to offer help and advice on the app’s development and, essentially, to consult on developing the gamified element of the app. Unlike the usual video games the designers had worked on, where the game element is the entire basis of playing, we had to find a way of incorporating game elements into the app that would encourage engagement with physical surroundings, not just with the app itself (which is how most traditional games boost the time players spend gaming).
The funding was approved, which gave me the ability to pay the team at Polygon Treehouse to develop the app and, by July 2018, we had a Minimum Viable Product. The most valuable element of REACTOR’s support has to be the help in defining my product through gamification. Furthermore, the reputation of the REACTOR project and its team gives projects like mine a real stamp of approval, which has been incredibly helpful.
From this point I was doing a lot of pitching events to try to secure funding to take the app to the next stage. The business model had been to give the app away for free, but I was receiving feedback from funders that this might not be the right approach. I was still in touch with REACTOR and in September 2018 the team directed me to Innovate2Succeed, part of Innovate UK and delivered by Exemplas, which offers support in taking existing businesses onto a mentoring scheme if they are perceived to have the capacity to grow. The first piece of advice I received was that the app could remain free, but that in-app purchases would offer a stronger business model. I also further developed my IP, and worked on increasing access to markets and scaling the app up from a focus on Cambridge, to a focus on other cities.
REACTOR also introduced me to academic support from Anglia Ruskin University. I was able to work with travel and tourism academics in an advisory capacity who helped me to develop the concept of the app from something that works for families, to more broadly being something that can help tackle nationwide issues of over-tourism in cities like Cambridge. Through this academic support, I discovered that there was little research data about the behaviours of city visitors; quite a surprising fact bearing in mind that cities like Cambridge receive a huge portion of their income from tourists and tourism. So we are now considering how to use gamification to ‘level out’ visitors to attractions across the city and encourage visitors to make trips to attractions that are off the beaten track by looking at visitor behaviours and incentivising particular behaviours through the app – for instance, identifying not only the more well-known destinations like the Sedgwick Museum, but also the graffiti on Mill Road, which also forms an integral part of our city’s personality.
I am now going through a number of rounds of funding applications with Innovate UK, applying for Heritage grants and Research & Development grants, and the support received from all of these business catalysts has been really helpful and encouraging. The next steps for YoYo Let’s Go, once I have secured additional funding, will be to create different user profiles within the app and to add more elements of gamification; prompting children to look around, or giving adults items that they have to remember, or making the screen go off so that everyone has to collaborate to find the next destination. I also hope to establish new trails with different themes – for example environmental trails, or seasonal trails, or topical trails such as an ‘Eddie Redmayne’ trail or a ‘Science’ trail.
I’m incredibly grateful to have received all the support I have from REACTOR and the other business catalysts. It’s only through the provision of expertise and advice in these ways that people like me can have an idea one day and, in just a couple of years, have developed an MVP ready to pitch to business investors.
Twitter Handle @PlayPhysio
With a background as a product and web designer I was, by 2007, freelancing as a result of the substantial amount of time I spend caring for my daughter, who was diagnosed with Cystic Fibrosis (CF) at 18 months. Prior to this diagnosis our family was unfamiliar with CF, but we quickly learnt about living with the condition and now, 12 years later, I have developed a solution that I believe will improve the lives of CF sufferers and their families. CF causes abnormally thick mucus to build up in sufferers’ lungs, which can lead to blockages of the pancreatic ducts, intestines, and bronchi – which can in turn cause irreparable damage. In order to dislodge much of the mucus that has built up, and to keep lungs especially healthy in the longer-term, CF sufferers complete daily physiotherapy. For very young children, this can mean parents spending time each day positioning their child, trying to gently encourage mucus to be dislodged from their lungs with various techniques. As sufferers grow up, they will begin twice-daily respiratory (blowing) physiotherapy, in which they blow into a device with a particular level of force, for a specified number of times, again in a bid to dislodge the mucus that builds up.
It was this particular element of my daughter’s daily routine that inspired me to want to make physiotherapy more fun. Families struggle to ensure that the twice-daily physiotherapy has been completed properly; there is far too much room for debate about whether each blow has been forceful enough and, without sitting and watching every single blow (which most people can understand teenagers don’t warm to); there’s plenty of debate around whether enough blows have been completed, too.
One particular morning during 2013, I remember that my daughter didn’t want to complete her physiotherapy at all. Of course, living with CF can be difficult for anyone, let alone a young person. It is a lot of responsibility to put on the shoulders of someone who is not yet 10 but, for each missed or incomplete session of physiotherapy, parents are acutely aware of the potential long-term repercussions. Each round can therefore be incredibly highly charged, with parents often taking the exercises much more seriously than their children might.
My idea to solve this was to harness the power of games to make physiotherapy more enjoyable for my daughter and, therefore, less of an opportunity for family arguments. As an electronics hobbyist, I initially began using little light bulbs to simply track whether an individual blow had been completed correctly. My daughter’s attitude to treatment changed immediately, but it didn’t take too long before the attraction of these little lights wore off. I realised quite quickly that I would need to come up with innovative ideas to keep any new developments exciting.
By 2015 I had worked out how to link the standard physiotherapy device to a smart phone, and the proof of concept was established. Registering each perfect blow (not too strong, nor too weak), users would be able to use the ‘power’ of each blow to drive an element of a game through the smartphone app. Think space invaders, where you can only shoot down the invaders if your shots travel far enough and quickly enough to hit your target before it moves. Most importantly, the app also keeps a tally of the number of successful blows completed, meaning that parents don’t need to be so closely involved in monitoring the process. The child can be left to their own devices and parents can check whether the physiotherapy has been completed by checking the status of the app.
I presented this concept to the CF team at Addenbrooke’s Hospital and, with their early support, headed to the CF Trust in London just two weeks later. The Chief Executive and Head of Research ‘got it’ straight away, but the Trust couldn’t simply give money away, so I then realised that I would need to source some initial investment, because the CF Trust would only be able to support my concept through match-funding.
I won a place at Cambridge Social Ventures Incubator (at Judge Business School, University of Cambridge), and later that year I was one of the winners of the Big Venture Challenge (unLtd). Through these programmes I benefitted from support to build a social venture. Although I hadn’t known what ‘social ventures’ were beforehand, I discovered this was a fantastic fit for me because I felt it appropriate, that grant income secured from charities would directly benefit families managing chronic diseases. The time spent around other like-minded individuals was invaluable, especially in learning about sources of funding and support only available to a social venture.
In 2017 having graduated from Cambridge Social Ventures incubator I founded Playphysio®, as I realised I would need to develop a sustainable business plan and get started on fundraising. This was supported by Allia’s Cambridge based ‘Serious Impact’ incubator. By this point my daughter, now a teenager, was less interested in the arcade style games but increasingly receptive to treatment tracking. There is a dangerous trend in teenagers living with CF that as they get older they do tend to become more laid back in their approach to physiotherapy. However, pretending that everything is fine, sadly results in serious irreparable lung damage. So it’s imperative that Playphysio® continues to develop solutions to suit CF sufferers of all ages – ensuring there is always another style, or level, of solution to keep patients engaged with their physiotherapy treatment.
It was this realisation that led me to approach REACTOR – while I had managed to develop one game, I realised that to keep the ‘solution’ working day after day, month after month, year after year, I would need truly enjoyable and engaging games to be incorporated into the app. Whether this would be achieved by asking existing game studios to create a version of their game to work with the app, or by working with game developers to create new games, I wasn’t yet sure. But REACTOR’s network was really helpful, introducing me to game developers and existing studios, but also helping me to better understand the different elements of gaming that would be essential to keep CF sufferers engaged in their physiotherapy. I applied for one of the European Regional Development Fund (ERDF) REACTOR grants, which was awarded to me for the specific project of enhancing the gamified elements of my app, through creating code to link existing games to work with the app’s software. I initially had one game and, as a result of the support provided to me by REACTOR, I was able to develop the first game and an additional three games along with a code framework to enable existing games to easily work with the app.
With more games available to play, I was ready to support Addenbrooke’s Hospital in writing a grant application to Addenbrooke’s Charitable Trust, with a view to running a clinical trial into the safety and acceptance of gamifying physiotherapy for children with CF. The application was successful and enabled a match-funded grant from the CF Trust, and the trial kicked off in December 2018. It is on a rolling recruitment programme to May 2019 with space for up to 30 participants aged eight to 16 to take part. At the end of 2018 we were thrilled to be awarded some additional funding from Comic Relief’s Tech for Good fund, to build an online ‘clinical dashboard’ which care teams can use to view patient data remotely.
Today there are more than 4,000 children in the UK living with CF, and more than 10,000 people of all ages – and encouraging all patients to commit to daily physiotherapy has the potential to save the health service millions of pounds by helping to prevent some of the irreparable lung damage caused by repeat infections. Our mission remains to reduce the burden of care for families; to collect data to inform medical research; and to save on costs of care.
My ambition once the trial is complete is to transform the daily experience of physiotherapy for as many CF sufferers, and their families, as possible. From there, the technology could easily be developed to support patients who manage other respiratory diseases with similar daily physiotherapy. And in the same way that fitness apps use gamification to keep people active, or to track their diet, Playphysio® can provide a similarly usable, engaging and rewarding – yet bespoke – service to CF sufferers, and make a world of difference to their lives.