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Plastic Bags

September 10, 2010
by Bobbie Byrne
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What is the key to motivating physician EMR adoption?

I am preparing to do a series of education sessions for our private physicians on ARRA and Meaningful Use. I would like our docs, and more importantly, their office managers, to know what is available for them and how we can assist them with their plans. Since their time is valuable and their attention span is limited, I started to delve into what would really motivate them to adopt EMRs. If I could determine that, I could do a better presentation.

Motivation, of course, is a complicated thing. There are over 18,000 books on Amazon somehow related to motivation. (Of course, if you look for “motivation: teenagers,” the number falls to less than 50. Perhaps motivation and teenagers is an oxymoron.) But motivation under ARRA is pretty simple: carrots and sticks. I believe ARRA will have limited impact on adoption for the innovators and early adopters. They are just cashing a check for functions they implemented years ago. For the early majority adopters, ARRA just got them off the dime. They were intending to implement anyway and needed a shove.

Motivating the reluctant adopters (later majority and laggards on the adoption scale) is the more interesting to me. Prying the paper out of their clenched fists will be a challenge, and ARRA may or may not have an impact. They will be balancing between a very small carrot and a very small stick. I cannot predict which will be more powerful or whether either will work at all.

Without a crystal ball and without much published here, I was at a loss. However, two stores I frequent have their own stimulus efforts going on; they are trying to stimulate the elimination of the plastic bag. A recent bout of errands gave me some perspective on my conundrum that area.

Target credits the customer 5 cents for every reusable bag used. On my last trip, I saw shopping carts full of white and red plastic bags, but nary a reusable bag in sight. I even saw someone put a new tote bag into a plastic bag. The carrot was not working.

The next stop was Ikea. Ikea charges the customer 5 cents for every plastic bag used. Absolutely nobody was walking out with plastic bags. I saw people balancing candles, bags of frozen Swedish meatballs, and picture frames in their arms. One man bobbled, then dropped, a whole stack of plastic children’s cups, on the way out the door. The penalty, even a nickel, will cause grown men to look like juggling clowns. The stick was definitely working, but definitely ridiculous.

My highly scientific study was consistent with what all those Amazon books on motivation were saying. Sticks and carrots work well for the simple behavior choices. Even small penalties can have a bigger impact on behavior than larger incentives.

So if we fast forward to 2015, I believe that we will still have a whole lot of paper in physician offices and a whole lot of Target plastic bags in landfills.

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