Purpose Gamification introduces game-like properties into routine service processes to make them more engaging for service employees and users alike. The purpose of this paper is to investigate the effects of gamification mechanics, or game design principles, on user engagement in gamified healthcare services. Design/methodology/approach Through observations, interviews and the study of desk materials, two cases of gamified healthcare services, each using different game mechanics, are analyzed. Findings Gamification mechanics produce four distinct experiential outcomes in patients: challenge, entertainment, social dynamics, and escapism. Patient engagement can be stimulated through these outcomes. However, to fully enjoy the benefits of gamified services, users are often expected to acquire and use new skills. The relative absence of these skills (or difficulties in acquiring them), depending on users’ medical predispositions and age, may defer or negatively moderate the positive effects of gamification on engagement. In the case of progressively decreasing capabilities (e.g. in the case of aging users or users with degenerative diseases, whose physical or mental disabilities may be emphasized by the mechanics), it is recommended that health professionals adapt the mechanics accordingly or search for alternative options to increase patient well-being. Research limitations/implications The study was conducted in healthcare, and caution must be exercised in generalizing the findings to other domains. However, the finding that gamified service users’ disabilities - or the lack of required abilities – may negatively impact the encouraging or engaging effects of the use of gamification appears to be relatively universal. Originality/value This study contributes to service research, specifically in the healthcare domain, by providing insight into employees’ and users’ motivations for using gamified service processes, the experiential impact of gamification mechanics, the individual factors that influence users’ gamified experience and multiple forms of cognitive, emotional and behavioral engagement outcomes. A research agenda is developed.
