Digital games have the ability to engage both children and adults alike. We are exploring the use of games for children with long term treatment regimes, where motivation for compliance is a key factor in the success of the treatment. In this paper, we describe the game framework we are building for this purpose. This framework is meant to support the long term use of a gaming world for children with three main goals: (a) provide easy and continual gaming access on a range of computing appliances including small screen devices; (b) offer games that can be personalized and are adaptable based on the child's interests or specific illness; and (c) maintain novelty and interest in the treatment over time. This framework not only provides a benefit to the children involved, but also provides user data to the coaches, clinicians, and health researchers involved in the child's treatment regime.