Amazon’s Big Push Into Telehealth Could Shake Up Health Care Delivery

Amazon may be trying to do for health care what it did for shopping online. In September 2019, the world’s largest online retailer quietly launched a Seattle-area pilot program offering its employees health care through an app. The service, called Amazon Care, lets patients use an app to schedule appointments and connect with a medical professional within a minute. They can chat with a doctor or nurse about their symptoms via messages or a video call. If needed, a doctor can follow up with a house call. Medical providers can also stop by for routine exams and care, such as blood draws and vaccinations. The service also delivers prescriptions to people’s doorsteps.

More than 18 months after the pilot program launched, Amazon said it’s expanding Amazon Care beyond its Washington state employees and family members and will be available to Washington-based companies. Amazon plans to take the virtual, app-based portion of the program nationwide this summer, offering it to both its employees as well to other companies in all 50 states. Also this summer, Amazon will offer Amazon Care’s in-person service in Washington, D.C., Baltimore and eventually other cities.

A focus on speed and convenience

Amazon Care isn’t the company’s first foray into health care. Three years ago, the retailer partnered with Berkshire Hathaway and JPMorgan Chase to create a health care partnership called Haven, which was expected to present a new model for health care. But Haven’s ambitions were vague and it was never quite clear what exactly the partnership was trying to accomplish. Haven announced earlier this year that it was shutting down. Erin Brodwin, a correspondent for the medical news site Stat News, told NPR that Amazon may have emerged a winner from the failed effort. The company, she said, is surely to have studied closely what did and didn’t work at Haven and absorbed those learnings into Amazon Care.

amazon care

Case in point: Amazon has been very clear about how its other health care offerings benefit consumers. In November, the company launched Amazon Pharmacy, which lets customers manage their prescriptions through Amazon and have medications shipped free in two days using their Prime subscriptions. Amazon has a history of diving into new markets and inventing new technologies that reshape customer expectations, especially when it comes to speed and convenience. It did it with online shopping and cloud computing, and has been trying to do the same with groceries.

In an indication of how seriously investors and the pharmaceutical industry took Amazon’s foray into prescriptions, stock in Rite Aid, CVS and Walgreens closed down between 8% and 16% the day Amazon announced its pharmacy service. By offering its health care services to third-party companies, Amazon appears to be trying to reinvent health care, no small feat when you consider doctors’ offices have been operating largely the same for decades, said Nathan Ray, director of the health care and life sciences practice at West Monroe, a consulting firm with offices in Seattle.

“Obviously, their dominance in home delivery … is a model everyone’s had to adopt,” Ray said. “I think they’re going to present an understanding of what convenience and simplicity (in health care) should look like. A post about Amazon Care on the company’s corporate website includes 20 references to saving time, including phrases like, “less than 60 seconds,” “instant,” “speed,” “same day” and “quickly.” Edit out the mentions of Amazon Care and medical terminology and might think you were reading about Amazon’s package delivery service. Ray noted that Amazon has had plenty of opportunity to test its Amazon Care technologies and procedures during the pandemic and scale up the service.

“The pandemic theater has led them to see this as something that opens doors to a number of different things that are growth angles,” said Ray, who works out of West Monroe’s Chicago offices. “It doesn’t surprise me that, as we’re coming out of this, they have an offering they’re at least telegraphing that they’re going to take to a wider audience.”

Using the cloud to collect patient data

Telehealth may also provide new ways to collect and work with patient data, both for the purposes of individual care and broader research. Although Amazon hasn’t mentioned tying Amazon Care into data collected from wearable devices, an increasing array of consumer gadgets, most notably Apple’s Watch, can collect health data and provide alerts about patient’s health condition. Should consumers opt in, some of that data is already being used for medical research purposes and to create a personal record of an individual’s evolving condition.

On Monday, AWS published a white paper illustrating how Amazon’s cloud can be used to help researchers use voice recognition to collect patient data. Clarence Choi, the paper’s author and an AWS solution architect, noted that smartphones have been a popular way for researchers to gather data from patients, but some patients may find it difficult to enter the data to their phones because of limited vision or, in the case of conditions like amyotrophic lateral sclerosis, motor control.

One solution, Choi said, is to allow patients to update researchers on their condition using their voices. It’s not a stretch to imagine how the cloud-based voice recognition technology could be used to help Amazon Care patients communicate with their doctors.

An expanding global market

Grand View Research said in a report published in February that North American companies dominated the telehealth market as money poured into the online health care technologies to stem the spread of Covid-19. Health care segments that expanded markedly online during the past year include dermatology, psychiatry, intensive care units, emergency care, ophthalmology and radiology, Grand View said. The global telemedicine market is expected to grow to nearly $300 billion by 2028, the research firm said, with a compounded annual growth rate of 22.4%. In an indication of how important the nexus of health care and cloud computing is to Amazon and Microsoft, the world’s two biggest cloud providers, Microsoft announced Monday that it was spending close to $20 billion to acquire Nuance Communications Inc., an AI and cloud voice recognition company whose products are used by a majority of U.S. doctors and hospitals.

Amazon has been positioning itself in the health care sector in recent years through a series of acquisitions and partnerships. In 2018, the company bought online pharmacy PillPack for just less than $1 billion and eventually rolled that technology into Amazon Care. The following year, Amazon snatched up Health Navigator, which had about a dozen employees and was founded just three years earlier by emergency physician David Thompson. The startup, which has worked with Microsoft, provided technology for checking a patient’s symptoms online and provides tools for triaging patients. Amazon quickly folded Health Navigator’s technology into its nascent Amazon Care program.

Challenges ahead

Despite its capacity for invention and endless capital to buy its way into the health care space, Amazon faces significant challenges in scaling Amazon Care to serve the broader population. For one, it may be difficult to find enough doctors and nurse practitioners available to make house calls, Ray said, adding that he wouldn’t be surprised if Amazon launched a significant nationwide recruiting campaign. Another challenge is ensuring a high standard of care across the program, especially if it were to grow at the dizzying speed Amazon is accustomed to. There’s also the question of Amazon’s AWS customers that are already in the telehealth space and relying on Amazon’s cloud. How will they react when Amazon becomes a direct competitor, Ray wondered. It’s possible, he said, that Amazon Care will become a software-as-a-service platform offered through AWS to every telehealth provider, similar to Amazon’s online retail marketplace.

“You know,” he said, “that’s one way they’ve succeeded before.”

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