By David Lazarus, Los Angeles Times | September 27, 2019

When Amazon joined Berkshire Hathaway and JPMorgan Chase last year in establishing a joint venture aimed at overhauling the U.S. healthcare system, people could only guess as to what the three corporate behemoths had in mind.

The picture is now clearer, or at least it seems to be.

While the joint venture, dubbed Haven, remains largely shrouded in mystery, Amazon’s announcement this week that it will test an app-based approach to treatment on a limited number of employees is an indication of where Haven may be heading.

Amazon unveiled what it calls Amazon Care on a website. It describes the service as “a mobile application that allows you to access virtual and in-person healthcare services.”

Those services are provided at the moment not by Amazon but by a Seattle clinic called Oasis Medical Group, which brings medical professionals to the equation and shields Amazon from privacy concerns about an employer prying into workers’ health status.

Amazon Care includes video conferences with doctors, nurse practitioners and nurses, online prescriptions being written and drugs being delivered by courier.

If in-person treatment is required, Amazon Care “will send a Mobile Care nurse to your home, a designated room on the Amazon campus, or any other location in our service area that you request.”

An Amazon spokesman, asking that his name be withheld, told me that Amazon Care will be tested at first on a relatively small number of workers in the Seattle area.

He declined to comment on whether the program will be expanded to other Amazon offices nationwide or if Amazon Care eventually will become available to the company’s customers — as a benefit of Prime membership, say.

“We’re as curious as anyone else about how this will work,” the spokesman said. “We’re looking forward to seeing if it’s successful.”

I asked how Amazon Care plays into Haven’s plans. The spokesman also declined to go there.

But he did acknowledge that “Haven is very much aware of this and is completely supportive of it.”

Healthcare might be the last big mountain for Amazon to climb. The company already accounts for about half of all online sales. It’s into original TV programming, clothing, even groceries via its Whole Foods acquisition.

Applying its data-driven mojo to the $3.5-trillion U.S. healthcare market seems almost too big an opportunity for Amazon to ignore.

Healthcare experts have been predicting for years that telemedicine would play a role in Americans’ lives. But those predictions have remained largely speculative, aside from relatively small-scale forays into the field by some medical providers.

Amazon’s size, technical expertise and laser focus on using data to expand its business opportunities could change everything.

“It makes a difference when a firm like Amazon, with its scale and reach, does something like this,” said David Asch, executive director of the University of Pennsylvania’s Center for Health Care Innovation.

“It’s hard not to think that pretty soon Amazon will be doing this for everyone,” he said.

Brad Doebbeling, a professor of science of healthcare delivery and biomedical informatics at Arizona State University, was similarly impressed by the possibilities of what Amazon is attempting.

“I think it’s the future of healthcare,” he said, describing himself as “very interested and engaged.”

But he sounded a cautionary note.

“There will obviously be challenges and barriers, including willingness to adopt by providers and patients, concerns about confidentiality, reimbursement concerns and need to evaluate whether it is helping or hurting,” Doebbeling said.

He added: “I’m not sure I want my personal information shared with Amazon. But it’s time for innovation and disruption.”

Another aspect of this is that Amazon is simultaneously learning how to dispense and deliver drugs online by testing an online pharmacy on its employees.

The company last year purchased a San Francisco-based online pharmacy called PillPack. Since then, PillPack’s mail-order facilities nationwide have obtained licenses to sell in most states.

Wall Street analysts have speculated that Amazon aims to gain experience with online drug sales by first meeting the needs of the company’s hundreds of thousands of workers. Then it could start filling prescriptions for its millions of U.S. customers.

Amazon’s spokesman declined to comment on how PillPack might play into Amazon’s broader healthcare initiatives.

He did say, though, that “Amazon is a customer-obsessed company.”

It may be premature to connect all the dots. But stir these developments together and you get a strong sense of Amazon being on the cusp of far-reaching healthcare services.

“It’s sort of a no-brainer,” said James Robinson, director of UC Berkeley’s Center for Health Technology. “This is a company that already owns a good part of the internet.”

There is much that’s unknown: How ambitious are Amazon’s plans? Does it see Amazon Care becoming a sort of online CVS MinuteClinic, or will it offer more comprehensive treatment?

Will it work with all insurance companies? Will Amazon offer its own insurance?

What are the consequences of telemedicine to some extent replacing in-person visits with medical professionals? Will care suffer as a result?

How much do we really want the world’s largest online retailer knowing about our personal well-being (beyond what it already knows)?

“Amazon’s move into healthcare in general signals an approach that may seem more patient-centered because Amazon is good at customer service,” said Kirsten Ostherr, director of Rice University’s Medical Futures Lab.

“But it is actually less about people and more about data mining as a means to cut costs,” she warned. “This general approach, which Google and Facebook and Microsoft and others are all pursuing, points in the opposite direction of person-centered care, and it raises serious concerns about digital profiling and the harms that may result.”

It will be up to state and federal officials to ensure that medical regulations keep pace with these technological changes.

But it seems fair to say that the U.S. healthcare system is ripe for disruption — and no company excels at disruption like Amazon.

Color me optimistic. Cautiously optimistic.

Original Article