If you’re a health or gamification professional looking to elevate your projects, Series 3 Episode 8 of the Health Points podcast is a goldmine of insight. This episode features Luca Contato, founder of Rising Pixel, a creative studio that has developed over 200 games with millions of plays worldwide. This isn’t just about flashy numbers, it's about meaningful impact.
🧠 From Kindergarten Sketches to Global Impact
Luca’s journey into game design began in kindergarten, sketching imaginary video game levels while others drew houses and cars. That early passion evolved into a career focused on solving real-world problems through games. His studio, Rising Pixel, now based in the Canary Islands, specializes in serious games, advergames, and gamified experiences that educate, engage, and empower.
💡 What You’ll Learn in This Episode
Here’s why this episode is essential listening for anyone working in health gamification:
1. Designing for Impact, Not Just Clicks
Luca emphasizes that the most successful games aren’t always the most played, they’re the ones that create real change. Whether it’s improving digital skills for adults with disabilities or helping blind players reconnect with gaming, the goal is always meaningful engagement.
2. Accessibility as a Design Philosophy
Accessibility isn’t just about disability, it’s about making experiences better for everyone. Luca shares powerful stories, including a blind gamer who was able to play alongside his sighted girlfriend, thanks to thoughtful audio design. His advice? “Add a UI scale option to your game - please!”
3. Prototyping on a Budget
No budget? No problem. Luca shares how one hospital prototyped a gamified training experience using PowerPoint and internal resources. It wasn’t flashy, but it worked... and it laid the groundwork for a more robust game later. This is a must-hear for teams working with limited resources.
4. Game Mechanics That Work
From tactile interactions to creative leaderboard design, Luca reveals which mechanics deliver the most bang for your buck. One standout? A Morse code mini-game that players couldn’t stop talking about. It was simple, physical, and unforgettable.
5. Cultural Sensitivity and Subject Matter Experts
Designing for global audiences? Luca stresses the importance of working with subject matter experts who understand the cultural and contextual nuances of your target users. It’s not just about language, it’s about values, expectations, and lived experience.
6. The Future of Serious Games in Health
Luca predicts that serious games will become as common in healthcare as PowerPoint is today. With younger, game-literate medical professionals entering the field, the appetite for interactive, engaging training tools is only growing.
🎯 Key Takeaways for Health Gamification Professionals
- Start small: Use low-cost tools to prototype and test ideas.
- Design for everyone: Accessibility benefits all users, not just those with disabilities.
- Focus on engagement: A game’s success lies in how deeply it connects with its audience.
- Measure impact, not just metrics: True success is about behavior change, not just play counts.
- Collaborate wisely: Partner with experts who understand your audience’s context.
Whether you're designing a mindfulness app, a training tool for clinicians, or a public health campaign, Luca’s insights will help you build games that don’t just entertain—they educate, empower, and transform.
🎧 Tune in to Series 3 Episode 8 of Health Points now and get inspired to level up your next health gamification project.
You can listen to this episode below:
Episode Transcript:
Ben
Hi everyone and welcome to another episode of Health Points where we talk about anything and everything. Gamification. Health. I'm Ben and here with me, as always, is my co-host Pete.
Pete
Hi everyone.
Ben
And today we have with us Luca Contato. Who is the founder of rising pixel in 2012, where he and his team have since created over 200 games with cumulatively millions of plays. For the week, there's some big. Stats to start with, Luca, it's great to have you on health points.
Luca
Well, thank you. Thank you very much for the invitation. Yeah, in Long story short of my, my job title is solve problems with games. And that's what I do.
Ben
Well, then, let's talk about that. Let's start from the beginning. How did you get into serious games, games developments or games more broadly?
Luca
Well, the story is long story, but my story with games start very early, like in kindergarten. While most kids were drawing like houses, cars and sketching things, I was sketching my imaginary video games, video games, level on paper. So that's something that my teacher thought sometime was something was wrong with me, or maybe I was just a little, a little unconventional. But yeah, I was already designed. So that's obsession becomes like my my passion, my, my lifelong passion, passion, and and eventually my profession. So I discovered the concept of gamification years later and it perfectly describes what I've been doing all this year, so using game mechanics to engage people. And drive change in their life. So that's my definition of communication so. Some years after so Fast forward I run this company. Now I run rising pixel. This creative studio we are based on Canary Island. We build series, game, advert game gamified experience which will help people to create, connect, grow. That's because I believe. That playing games playing is the most powerful tools to make a creative impact. And as and this is also my my way to contribute to build a better world.
Pete
Things there you mentioned the Canary Islands. Perhaps you could tell us a bit about the size of your team, who you've got, because that stat was over 200 games. So let's get a bit of insight into the.
Luca
Rising pixel. Yeah, we started 10 years ago. We are a team. Of now 15. So yeah, that's is a vocation, but it's not a charity. So we are a private company, not an NGO. And to create also meaningful. Will measurable impact? I rely on my team that is a professional and so to build also this sustainable business, we choose to move. I choose to move to Canary to Gran Canaria, to Canary Island because well, climate helps. And not having winter is nice for a quality of life, but mostly for well, lower taxes, lower cost of life. So I can build video games at reasonable cost and do more for less. That's my trick.
Pete
It's a good little trick so.
Ben
Over 200 games is an impressive number. What sorts of games have you created? What problems have you been solving through games?
Luca
So yeah, we build games to solve problems, and our free slogan motto is we make games to innovate. So we Co create with our clients. The games they they need to solve their problems, so we make games for help people because we care about impact and not just clicks. And we create experience for everyone. That's another thing about accessibility and inclusivity, always part of our. Line and of course there are a lot of games, so don't expect we build like 200 console games. We have been building mostly serious games, so games for learning things that helps company to train employer on safety, on stress management. The shorter game is called playable ads or sometimes advert game, and for that we have done games for Nissan South Park. Kim Kardashian so where gameplay drives marketing engagement. Awareness game. So games that like we have done for Canary Island government Tap Tap Platino so games that teaching kids about where the banana came from and is farmlands not supermarket. And different museum games, forest keeper, Ocean keeper. So we're also we try to make museum game more interactive. So we turn your phone as a controller and the museum is like your playground. So you play with all the people together in this museum games and. All the games we have done is made. Mostly in HTML5, so that's is because it's the game made in web games open instantly. No download, no installation. Click play so. The game can run in a browser on your phone in a trade show during a training session, or even in a plane in a fridge. We we have done a game that runs on Samsung smart fridge years ago, so that's the advantages of doing games with HTML5. So long the the resume of all of this is we do games because it's the best way to get into people's mind. So entertain them and sometimes without even realising their learning something. I don't know if you ever played that game and then realised that you are learning something without knowing it.
Ben
Yeah. First of all, the breadth that you've been able to achieve also South Park, Kim Kardashian, I wasn't expecting those to. Come. But it shows the breadth of where you've been able to support and develop games, and I just want to do a bit deeper on some of the health games or health related games that. You've created around training doctors. But also games with visually impaired people as well. So it'd be great to go a bit deeper into those, but my overarching question. Is. What makes a successful game? We interviewed so many people, so many game ideas, concepts and different as a gameplay. The biggest challenge when we interview people is its scale and spread. So what makes a successful games in terms of one that people want to play? What makes it successful game in terms of? Big scale, big spread.
Luca
Well, a lot of questions. Well, first of all, the the gaming of health sector, we've started like recently doing games in the health sector. One of the most recent projects I'm working with is mission antibiotics is a game made? For the University Hospital of Lausanne in Switzerland. And so this is again, this game is a serious game for mix of adventure game Diagnostic Simulator simulator. Our current reference is mini games for Kingdom come deliverance, but we mix and match a lot of things from real games, so the game is you play as a young medical intern and 1st week of the job, so patients walk in and you have to figure out what's going on. So history understand data. But most importantly, decide what to do and the game is not only about diagnosis, but we want to make a game that you feel it doesn't. It doesn't feel like a text box with buttons it. We added layers of humanity, so it's not about training the medical logic, but empathy with the patients. That they are human being and the pressure that comes with the real world decision. So about the successful very. Of course we have done 200 game, not every game was successful game. Sometimes the impact of the game is financial. Sometimes the impact of the game is about the number of game plays. Sometimes the impact is about. The change you've made, I think one one of the most recent project about that had a strong in. And it's a good example of also to explain why I think it works. Is a project we have made for is our European Union project and it's called project. The project ended month ago, but they in fact you you measure the impact you got later of course. So there was an initiative to aiming to announce the digital skill of adults with physical disabilities. Through an educational games so quite complex research things so the project demonstrate how the accessible gaming can significantly improve the employability of those individuals. And I don't have my data, I don't have all the data of the game now, but you can check also on the website. And it was recognised as a best practise by the European Commission, so which was a proud moment of. For us, because we demonstrate with some university paper that games can actually help this type of people. And for me this is the most meaningful impact we have made, games that maybe have been played millions of time. We have made games that get. Good return value for our clients for the click the sales, but this type of impact is what I'm looking the most and how to do that. There is not a magic formula there. There is not a a golden rule I think is a mix of well, of course making a game that is engaging first of all make a game that work well with the topic you are doing. So a game that works very well. With their clients, they meet their mission, their meaning, so the player must feel the meaning of what they are. And a good partnership, because the game is not only a the game is not only a good game to be played, but it's a good game where reach a lot of people, so you need partner and other companies that help you to spread out the game.
Ben
I think that's a challenge that a lot of our guests have had is is not very creating a great and engaging game. But it's not the best game. It's the most visible game in terms of social media marketing, whatever the channels are, often there's difference between scale and mass adoption versus what can be a nice project, but doesn't get into the hands of many people. Yeah, in that case, do you support? The games to go and get that spread or usually do your clients and partners already have another partner for that visibility, that scale, that spread.
Luca
We don't do everything, so we rely on the partners. Sometimes the game is not so. The success of the game is not only the number of players, but is the impact the game mix. So we have done games that have millions of game plays but made little impact. This embedded game has been played. By few thousand of players, another game we have done for blind players have been played for have been both like 1000 in total sold 1000 total units. So it's not about the numbers, but sometimes it's it's about reach the. Right, people at the right moment.
Ben
In that case, you talked a lot about impact and what what are the changes that these games are having in people's life, what what is that impact that's being measured?
Luca
Well. The impact isn't always measured in revenue, and for us the, for me, the best impact I I received is when we with the games for blind people, so we have done accessible games and when we. During development and also during the release of this game, the feedback for the Blind gaming community was incredible. Incredible positive, and also set us on this path to explore more in the realm of accessible game design. For example, we we have received a lot of emails, long emotional message for blind players and one story that I report time to time that I really like is this guy David. He's an Italian guy who lost his sight during fireworks. President and before he was a console player. Until PlayStation one, I think, and afterwards he thought that's part of his life. Was. Over because he can see the console, the game on screen. So then he found our game, actually another game for the audio game. Audiogames.net is a community of audio games games. Or. Mine. And he wrote something like for the first time since I went blind, I felt like I was back in front of my console and he can play a game with his sighted girlfriend. So playing the exact same level only by sound so they can compete at the same level. That's. For me was the best impact I could ever expect.
Ben
Just an incredible example, particularly around how do you calibrate for different accessibility of different players which have diverse needs, whether sighted or blind or whatever restrictions someone may have. That is, that's a real challenge.
Luca
Accessibility is not just about disability, so it's about making things easier for everyone. Uh human is lazy, so we all ate cognitive overload, so that's why we tried to design with accessibility in mind. So clean interface, readable text, clear feedback. We are not only helping people with this specific need, we are making the experience. Mood for? For every. Player and of course, because doing games for blind is something more complex. There are a lot of rules that you can find online. There is this guy called Ian Hamilton and he's like advocate on. Accessibility in games. He followed the development of a lot of commercial games like also FIFA football game, and he spoke a lot about this in part. So and another thing that I like also I take from his talks is accessibility is a big thing that often overlooked because it's not about doing the right things for the better world, but it's about make game that. More people can play because. Those when more people can play more people can enjoy what you have created and that's that's the goal because the next person that needs visual impairment accessibility option is me. You everyone in senior years. So I already avoid game with no UI scale option for example. And dismal change can affect you. Your you and your players in in an incredible way.
Ben
What would be great to talk through now is that you've got a team of 15 people. How is it you approach that game design which the narrative, the storyline, which game mechanics, how the gameplay will work? Do you have a process or a protocol that you work through as a team, or is it often led by the? The clients you're working with.
Luca
The main. The main the the main things for me is always engagement. Well, this is also gamification podcast, so you have heard already, heard a lot of definition of gamification and my take in the also the main difference between commercial video games and serious. Name is the video games are made for. To entertain you and serious game are built to engage you, so that's about using game mechanics to make people care, learn, act or sometimes just not to be bored. So we use gamification famous gamification frameworks like. Is to map human core drives. And depending on the project also we try to use I like to use multi personal profiles like the Bartle taxonomy. The race motivational profiles and understand what make your audience tick but. To be honest. Theories are often far, far from reality, so every project is different. Budget, time, goals, audience, all they all shape the final experience. So there is not perfect project only. The best possible solution for the context I encounter, and that's also why I like my doing job as we do so it's not like, OK, this is our portfolio of game, choose one and put on your website. So that's this communication. Now we try to build something that is meaningful for the reality. Of this situation and the limit comes from the user mostly of the time comes from the budget, so you have to fit all to make the best solution ever. Of course you don't never have the optimal solution, but you can get something that works for what you have.
Pete
That's very true. One of the things that interests me about what you've just said as well and your audience is you've got the frameworks such as octalysis. But you're dealing with audiences in many different countries. So do you see much in the way of cultural differences when applying any of the frameworks?
Luca
Yes. Well, we do games worldwide, but we also need someone that is an expert. So the subject matter expert is a role very important for our project and usually is not internal. It comes from the. The company, the clients company, because the subject matter expert usually is someone inside the context because it's not only the difference between Italy, Spain or UK is the difference between. And micro word inside every country, a company that works with iron casting is very different from a company who works in pharmaceutical company. So it's very important to have someone who give you the context. And the culture of the of the. Environment and is not working always, so sometimes it's difficult to reach that. So we try to use some general rule to create some sort of engagement. But when there is a collaboration between the part so we and the. Client or the subject matter expert. In that case, the game can be more impactful and I'm not have a lot of experience. For example, with the Asian market, because when we have done something with them we noticed. That. For something, that's something that works for us. It doesn't work the same for. For them a lot of different cultural perception of a lot of small things makes these psychological tricks we use sometimes not very effective.
Pete
Yeah, I mean that, that would be fun to dive into. Further, if we if we had access to the knowledge and I'm interested in some of the things you said there around. I'm going to say like rewards and game mechanics, so in terms of gamification, what we often have is an issue with the amount of budget available, so that potentially limits what game elements we can use and build into the games. Have you found there's any particular game elements that are like? Shall we say more expensive to implement, but not that impactful and like and on the other side of things, what's the what's the quickest win?
Luca
The quickest win? Well, I think the the case of shoe hospital is very interesting because we have building. We are building this game because they were already testing the gamification in their company. So they contacted me. To do game, but of course the making gamification was expensive, complex, not very. A lot of sceptical mostly. And So what they've done is they use. PowerPoint or, well, Google Drive. I I think that they mean PowerPoint. A story about a narrative story about a daily ad day of a of a doctor. So they did this simulation in directly in PowerPoint and they they took themselves a lot of photos doing different things. So they build the game with their own resource of. They need time and they did that in a period where, like, there weren't so many workload on the on the hospital. And also they asked time from the hospital to do the things and they weren't technical they invented. So they know the basic things they told. Each other to see what they can do the best so you can arrange a sort of gamification experience to test to test grounds, of course. It can give you the same results, so this game doesn't have analytics or can is to change something is very complex and the story is pretty linear, non animation or close to known. So is the limitation. There are a lot of limitations but it helped them to test. What is the ramification and when they conduct a company like us to do the the real game? Is a very useful tool because we have we can start from something that is already tested on the ground. So the story we are following exactly the same story, expanding a little bit to add more humanity, but it's something that we can start from so. There are a lot of tools outside. Right. Microsoft PowerPoint is easier to build story, but also there is like tools to make engaging engagement activities like hoot that can help you to build quits very easily with people mentimeter to make interactive presentation. So there are a lot of tools out there. Free or very very low effort. And you can start using that for make first step into communication. Of course is not the same as building a game that engage your audience, your people, and can get more data, more analytics, more. A lot of things, but it's something that you can use to start.
Pete
That's great. I mean those are quick wins which are like really useful tips for listeners. I actually kind of meant like what game elements have you put into your own games that you think are like cost effective and impactful, what works really well for you? Obviously, you mentioned narrative in that PowerPoint. It's that one of them. What are the others?
Luca
I personally like do something with hands, so in general it's very interesting making action that require movement. So for example we have done games where you have to physically move an object. From one part to the other of the. Scream not because it's necessary, but it reminds the real move, and increasing the physical movement of your player increase also the possibility to create new neural connection, so this is the trick that I've seen a lot of good results with very low effort. And things that a lot of players reminds, the more the most. So I remember I've I've done a game for Guillermo Marconi, the inventor of the radio, and one of the mini game of the IT was like sending message with them.
Pete
Morse code.
Luca
Yeah. Morse code. Yeah. Yeah. Yeah. So you have to Morse code as fast as possible. And. Players get mad on on this mini game so, and it's only press fast to send more signals. And yeah, talking to people, a lot of of of players say, yeah, yeah. Remember. Yeah. Sending the signals. I I've been playing with my friends and everyone touching the screen to touch as fast as possible. So that things I like the most. Even though it's not always doable, I think the easiest mechanics I use of course, is leaderboards, but you can play a lot with leaderboards, so you can make some storytelling around your leaderboard. You can make leaderboard. More competitive trying to build cluster that is meaningful for your player. There are a lot of things that you can do. Around the concept of leaderboard.
Pete
That's very good. I think that's a great tip about the physical movement because, yeah, a physical experience is going to be more engaging and more memorable than just looking at the screen. So those were things that work really well. What have you tried that didn't work?
Luca
Oh, I can't say the project, but for. There are a lot of moments of not doing anything in a lot of games. Educational games, because sometimes they need or the client won't. Now we have to put a player in front of this long text or 10 minutes video because they have to and they have to listen it. So we have to force them to lie. Then. So they can skip the video. So this is the best way to lose interest on on your player. And so long time of no interaction is the worst. So it's engagement killer. And I know the game is not a book, so we can't. Deliver as much content as you can deliver with. The book. But you have to balance between the amount of content and micro learning experience that remains. And because it's engaging, it's small tips and then of course to get more into that topic, you have to read books or see some video tutorial or whatever. But. The game is not a substitute of a book.
Pete
The next question that actually occurs to me from what you've been talking about is with this wide range of games wide range of clients and audiences. Can you give us a bit of insight into your prototyping and testing process to make sure games stay engaging and get the impact they want?
Luca
Is not always possible, because sometimes we don't have budget to do testing, so we do basic things and hope for the best. Sometimes we rely on mechanics that are really worked on similar. Community, but I think is very important not only to make the game but iterate. With the game, so you have to change adapt the game depending on your audience, your, the, the reaction, the content, maybe the content change after so iteration is very important. There are some platform that allows you to do it and some we are trying new. Some creative. Approach on that, so we are. There. Also testing game mechanics, which web game platform and then implement that in serious games. So sometimes we mask a serious game as a real game and see how the game goes with the with the players and then. Use that mechanics in the serious games.
Pete
I think that's. That's excellent, sort of, because you're what you're saying is you're gonna be able to get more results and tests back with a wider audience than our more niche audience for the gamification, the serious game. So in, in terms of that, like, what sort of games are you working on now?
Luca
A lot. If I check my. Platform of project management. Well of course, the issue of antibiotic games we were talking about, we are doing a game for USA Museum about American Dream. So different interactivities to explore how. Hope migration and pop culture shape modern America. We are doing another game for Spanish Government EP Strasserite Sikla is a game for Canary Island that is school game that turn like. Start trashing into our competitive team sports for kids.
Speaker
MHM.
Luca
A VR detective game prototype for Oculus Quest, I can say more. We are following some health and safety training expansion for games we already made for energy sector. Them. Many prototypes for like low pressure field, good games that mix mental health prompts with gentle gamification and. Project that is quite super secret. I can talk about yet, but they involve cool things.
Pete
Great real insight into that last project there. We obviously this podcast is very much around health, mental health, gamification. The accessibility is also I think very interesting. What issues have you seen or do you foresee with the role of gamification across health delivery?
Luca
So. The opportunity is huge. Met adoption. The adoption is still quite slow. I think in my opinion, because of sceptical so many. Clinicians, doctors still here, like game and think, oh, it's not serious. So convincing them that this medium can deliver measurable outcomes. Takes time and I think. Diplomacy. Uh, and also regulatory things, so anything that smells smells like a medical device lands in this territory of yeah, we have to check a lot of things. So stretch budgets and timelines a lot and scares the. The the client. So that's the the the bad things, but. Also, good things not just not to say to to to say this, everything is going bad. Things are changing, at least for the the sceptical because new generation. So a new wave of game, literally.
Speaker
Mm-hmm.
Luca
Literate medical students are starting working, so for them interactivity is in training. Is normal. Is expected. So in five years the serious game. Could be like common as the PowerPoint is today, so that's my hope. And also the health sector is more and more related to mental health and self tracking. That's that the the stigma of mental health is fading. Fast and so patients actively patients and also students or also people in companies start asking for playful app that nudge, mindfulness or their mood. So that's that's the true bad and two good things for for me.
Pete
I like that. I think my favourite quote so far is that. You think there's a possibility serious games will be as common in the future as PowerPoint is tonight? Today. So that's quite a hope. I like that a lot. Are there any games or gamification examples you've seen recently that you really liked or really didn't like?
Luca
K Love and Hate for gamification well. I love the the rise of the cosy game mechanics, so games that rewards creativity and reflection instead of only points. So gamification, that's. Slow you down in the in the best way, so like a cure for the information overload we we have not right now. And for example the first example is. Town, Scaper town town, scaper. Yeah, is a game on Steam and no scores scores. No objective. So toy box building. Big success on Steam. Big numbers. And also I've experienced that. In first person in with our game Tree, House maker is a web game we published on hockey platform and it's a game where you only have to decorate a tree house and is one of the most successful game in terms of game plays. I wasn't expecting that. So the the cosy game mechanics is something that I looking forward. So it's something that games is not only pull Pew and and and stuff like that but it's only sit down, relax and enjoy. And that that's the good things. The things that I always no. Well, the things that I hating gamification is that the the OR actually is more points unification. Is gamification gone wrong? So like lootbox dark pattern for free to play loops that blurs into gambling sometimes. So we have a great power and I hate when they use this gamification power to. Hack the psychology for retention, but strip away all the real fun or meaning of the game. So I hope to make game that make positive impact and not dopamine mining.
Pete
Does I mean that's a really good point. I actually just before we started recording this podcast, I downloaded another health gamification mental out and I installed it, started playing and then the first thing that popped up loop boxes and I was like, this is not going to help. Your mental health. This is. Not. Look, this has been absolutely. Brilliant chat so far. Is there a question you'd like to have been asked that we haven't, that we've missed, that we haven't?
Ben
Asked yet?
Luca
Well, there are a lot of things we can talk about, of course across this project. And I I don't want to transform this podcast in three hours long discussion of everything in general, the topic that I've been most involved into recently. Is of course in games for health, is mental health. That is something that don't forget about this in gamification and accessibility is always something that returns a lot in. You are in our world, but I think I already say the most important thing. So accessibility is are big things often overlook, but it's very important. And yeah, don't reinvent anything. Don't prevent everything, so start small and listen to your players. And add the UA scale option to your game please.
Pete
Brilliant. That's absolutely fantastic. I think this episode has been packed with tips and handy insights into how to design better games and gamification across the board.
Ben
It's been great to have you on the show today, Luca, to talk through your learnings from developing over 200 games with millions of plays each week and your insights on the important elements when developing gamified health, education and accessible games, and that for games to be effective. That players must feel the meaning in the game and be motivated by games purpose. And that a good game is one that has strong channels to reach its intended audience of players, because it's not just about developing the most effective game is about having the most visible game to the greatest number of players, because that delivers the greatest number of players who use the game, and hopefully the greatest impact. It's been brilliant to have you on the show today.
Pete
Luca, this has been an absolutely fascinating conversation. Thank you so much for sparing some time for us today.
Luca
Thank you. Thank you very much.