The (In)Effectiveness of Incentives: A Field Experiment on the Adoption of Personal Electronic Health Records

Gabel M, Foege J N, Nüesch S

Abstract
Medication errors are the third-leading cause of death in the US; however, a large number of these cases could be prevented through better medication management. The aging population and the associated high number of individuals taking multiple medications regularly makes medication management even more important. Personal electronic health records (PHRs) can improve medication management significantly and thus increase patient safety. Despite unequivocal benefits for individuals, healthcare professionals, governments, insurers, and employers, the adoption rate of PHRs remains low. Therefore, we seek to identify measures that motivate individuals to adopt PHRs. Drawing on justice theory, we show that incentives in terms of personalization, as well as the signal of fair information practices, increase the adoption rate of PHRs. These effects are mediated by perceived benefits and privacy concerns, respectively. Based on counterintuitive findings on the effects of monetary compensation we start a discussion on the complexity and context-dependency of different incentives.

Keywords
Personal electronic health records (PHRs); financial incentives; personalization; fair information practices; justice theory