In 1994, Jeff Bezos moved Seattle, known at that time for its tech talent and Grunge music. He didn't start a band, but he did start selling books online though his new company Amazon. Now he is arguably one of the biggest rockstars in tech, and he is making a mark in a new genre, healthcare.
The growth of Amazon's business from a bookseller into the largest tech company in the world has transformed the way we shop for everything from electronics to groceries through their easy to use, fast delivery service. Amazon also has its cloud computing division, AWS, which has a dominant share of the market and provides computing for many business sectors, including healthcare. They bring a diverse toolkit with them into healthcare. In this post, we will take look at the different endeavors they are pursuing.
Amazon's experience selling products online and delivering them to consumers gave them a good foundation to enter the pharmacy business. Amazon bought pharmacy delivery company PillPack in 2018, thus entering the $500 billion pharmaceutical industry. They are looking to disrupt the model of going to a physical pharmacy and waiting on a prescription. Their last-mile delivery process that brings products to consumers quickly at a low cost is a great advantage over retail pharmacies. They have also launched a pharmacy system that helps patients and pharmacists streamline management of multiple prescriptions. This extension of Amazon's sprawling e-commerce business threatens the past industry model by removing layers of pharmaceutical middlemen. Could this benefit patients by reducing the high price of prescriptions?
Amazon doesn't just want to deliver prescriptions, they want to deliver health information. Alexa, their cloud-based voice service has become HIPAA compliant and is now able to send and receive information between patient and patient record. Alexa users will be able to make appointments at some health systems. Some patients will also be able to check blood sugar levels through the Livongo app that can now be accessed through Alexa. Development of healthcare apps for Alexa is currently by invite-only, but their website says there are plans to allow more developers to build Alexa's healthcare "skills".
They are also going "big picture" with their healthcare aspirations. Amazon has partnered with JPMorgan and Berkshire Hathaway to create a non-profit called Haven Healthcare. They hired esteemed surgeon and author, Dr. Atul Gawande, to be CEO of the partnership. Their stated goal is to lower costs and improve access to healthcare. Their first effort is to offer transparent and easy to understand health plans to employees of the partnered companies. They will invest surplus from the health plans to "improve health outcomes, patient satisfaction, and lower costs for individuals and families.” It is not clear what is in the future for Haven beyond health plans at the moment, but Dr. Gawande states, "[W]e will ensure our work has high impact and is sustainable… We are committed to do this work for the long-term."
Their web services division, AWS, has become the dominant cloud computing company with 41.5 % of the cloud application workload. AWS provides a range of services some of which include computing, storage, and analytics. It is utilized by healthcare entities for serverless storage as data generation grows and on-site storage becomes more expensive. EHR vendor Cerner recently announced that it would use the services to provide better interoperability and data portability for its EHRs. They will use AWS's artificial intelligence and machine learning to lower costs and provide better value to their customers through better analytics of patient data. For example, Cerner built its HealtheDataLab which uses de-identified patient data to build datasets, models and algorithms to assist physicians in decision making.
AWS also has a medical language processing service called Comprehend Medical. It uses machine learning to organize unstructured medical data into relevant information. The relationships between different parts of the data can be linked, for instance, medical conditions and medications, and transmitted between different medical languages with less risk of error. AWS claims this will be useful for clinical decision support (e.g., getting a historical snapshot of a patient’s medical history), revenue cycle management (e.g., simplifying the time-intensive manual process of data entry), clinical trial management (e.g., by identifying and recruiting patients with certain attributes into clinical trials), building population health platforms, and helping address (PHI) requirements (e.g., for privacy and security assurance.)
Amazon has a diverse offering of services for both consumers and healthcare entities that allows them to offer a better connection between the two. They also have the money to invest to move their initiatives forward. But can they maintain innovation as one giant company? We have seen in the past where companies are dominant that innovation suffers. The Amazon-Cerner partnership could be good for interoperability, but how much of the consumer-provider relationship should they be able to control? On the one hand, it could be quick and seamless to accomplish, but it other, better solutions could be shut out.
Healthcare is a rapidly changing industry, and Amazon is quickly developing the solutions for it, becoming a major force in healthcare. What will be their next move?