Finite vs. Infinite: Learning Gameplay at MGMA18

October 16, 2018 |  Industry Leaders, C-level, Healthcare IT

Old chess clock

Over the past year, we’ve seen the term ‘gameplay’ popping up in more and more places. People seem to be quite taken with the notion that the logistics and patterns surrounding games and their rules can be applied to business, politics, and everyday obstacles. As I would discover at the 2018 MGMA Annual Conference, gameplay can tell us a lot about how to succeed in healthcare today.

The value of applying gameplay to healthcare’s transformative landscape was explored in a fascinating keynote speech from renowned motivational speaker and organizational consultant Simon Sinek, the mind behind some of TED Talks' most popular segments. Mr. Sinek began his speech by breaking down the basic principles of his latest work, “The Infinite Game”:

  • There are two types of games: finite games, and infinite games.
  • A finite game consists of known players, fixed rules, and a final, agreed-upon objective. A finite game concludes when one player beats another player.
  • An infinite game consists of both known and unknown players, and rules that change. The objective is to perpetuate the game, or stay in the game as long as possible. In an infinite game, the players play until the second-to-last player drops out because they lack the resources or the will to continue playing.

When we match a finite player against a finite player, the situation is stable. Tennis is a finite game: there are two players, they know the rules, and they agree on when and how the game will conclude.

When an infinite player opposes an infinite player, the situation is also stable. Mr. Sinek cited the Cold War as an example: players dropped in and out of the game, there were no agreed-upon rules, and there could be no true winner. The Soviet Union played until they lost the will and resources to continue playing, and dropped out. The game continued without them.

Problems arise, however, when you pit a finite player against an infinite player. The finite player is playing to win, but the infinite player is answering to a higher calling — they are playing to survive. Eventually, the finite player will find themselves in a quagmire; they will deplete their own will and resources in an attempt to win a game that is unwinnable, and will be forced to drop out. Only then do they realize that they were playing the wrong game.

Healthcare’s Quagmire

Today, many healthcare organizations find themselves in a similar quandary, as players continue to dedicate all their resources to winning the finite game of fee-for-service care. They talk about being the best, about beating the competition, about being #1. Unfortunately, they’re playing an old game.

As healthcare has undergone a paradigm shift and transitioned from volume-based care to value-based care, the game itself has transformed from a finite game to an infinite game. The goal is to survive… survive and thrive.

So, how does an organization survive (and thrive) within the confines of an infinite game? There are a variety of strategies to explore, but Sinek suggests that one of the biggest assets is establishing and pursuing a just cause: a higher calling, a raison d’etre, a vision of the future that does not yet exist.

A Just Cause

The just cause of healthcare organizations seems evident: help people to be healthier. But Sinek says that this just cause belongs to the healthcare industry at large, and that too many organizations mistakenly assume that it is also their just cause. We are looking at our objective through the wrong lens.

“The job of the leaders of healthcare organizations is not to make people healthy. Their just cause is taking care of those who deliver care to patients.”

This insight resonated with me. It strikes at the core of what we strive to do every day at MEDITECH: provide organizations with tools that empower providers to deliver better patient care, and increase their satisfaction. Our goal is to continue to grow and get better at what we do, so that our customers can do the same, and their patients can do the same. We’re not playing a finite game — nobody is going to “win” healthcare. We’re in this for the long run.

How will we do it? Well, there’s no secret blueprint. But the topics we discussed in the education sessions that peppered the rest of the MGMA Conference may hold the answers. We need to embrace patients as consumers, engage them, and deliver a superior care experience. We need to better understand social determinants, and establish a clear vision for managing patient populations. We need to promote innovation and increase interoperability. And while the game we’re all playing may be infinite, there’s no time to wait. Our just cause requires our immediate attention and resources.

There are few industries that have experienced a paradigm shift as expansive and transformative as healthcare’s shift from volume to value. There’s no denying that we find ourselves at a collective crossroads. But rather than shy away from change and attempt to do the same thing over and over, we should embrace change, and look at this moment as an opportunity for self-assessment and growth.

It’s time for us to stop and ask ourselves the big question: what game are we playing?


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Written by Carol Labadini, Vice President, MEDITECH

With over 28 years of experience at MEDITECH, Carol brings a depth of knowledge of healthcare operations and regulations to her role as Vice President. As the leader of MEDITECH’s implementation division, Carol’s expertise helps healthcare organizations everywhere leverage technology to improve care and communication across the continuum. Carol developed a passion for healthcare at a young age, and her drive to improve the experience for both patients and providers led her to earning a degree in Healthcare Management from Northeastern University, and managing a physician practice.
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