The Misalignment Between “Incentives” and “Purpose”

Posted on May 28, 2014 I Written By

John Lynn is the Founder of the blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of and John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I’m often left puzzled when I read some of the tweets and blog posts out there that talk about the “purpose” of a certain product. It might be the “purpose for the EHR” or the “purpose of meaningful use” or the “purpose of HIE.” It doesn’t really matter which product, initiative or program we’re talking about. Their comment assumes a certain “purpose” is why something is being done.

I’ve always hated when people say this unless they include plenty of modifiers (which is often not possible on things like Twitter). The problem is that the purpose for something changes completely based upon who you’re talking about. Plus, even if we’re on the same page about who we’re talking about, I often ask myself the question, “Is that the purpose of that product?”

The real purpose of any business is to make more money for its shareholders. This focus doesn’t mean that a company can’t do a tremendous amount of good along the way. This focus doesn’t mean that a higher purpose for a product might make a lot of business sense as well.

My favorite is when people say things like “meaningful use is suppose to improve patient engagement.” Is it really? This might be the purpose of meaningful use for some, but I don’t know a single doctor who looks at meaningful use and thinks “Wow, that’s a great program that I want to do because it will improve patient engagement.” For most doctors, they see the purpose of meaningful use as a way to justify the distribution of billions of dollars towards EHR software. Certainly many doctors will twist this idea a lot of ways (ie. Meaningful use is a way to get more data and pay us less.). Perspective matters when we talk about purpose.

HIE is another great example. What’s the purpose of HIE? Is it to lower costs of healthcare? Is it to provide amazing continuity of care? Is it to lock in a hospital’s relationship with outside doctors? Is it a way to do population health? I could go on, but hopefully you get the point. It depends on who you’re talking to and what they’re trying to achieve. Perspective matters when talking about purpose.

Understanding people’s true motivations or purposes is important to making sure you’re providing the proper incentive. If there’s a misaligment between the incentives and people’s true purpose, then you’re not going to see the action and results that you desire.