Amazon's ultra-marathon to conquer healthcare

How does tomorrow’s health world look like? 

A mix of lots of services and products and a variety of distribution channels. Monitoring - based on a variety of wearable sensors in a client's home, and in the clinic or hospital, data management - both in the patient's historical information, real-time information and comparative information for other patients, data analysis - both by a human specialist and by algorithms. Patient management and the medical procedure - both self-management, telemedicine (remote medicine), a doctor's visit to the patient's home, and a patient's visit to the doctor's clinic, laboratory or hospital. 

There are expensive and complex equipment for operations, patient management based on preventive, chronic, or emergency medicine, and drugs - both generic and custom, both for collection at the pharmacy and transport to the client's home, and finally - the cost - how to manage the cost of all of the above?

Amazon is very different from its competitors, although it plays in the Cloud computing world is also present in the worlds of electronics (mobile phones and a variety of accessories), unlike the others it has a large physical presence. If Microsoft has 166,000 employees, Apple 137,000, Google 114,000, Amazon has 1.2 million employees. The strength of the distribution channels of its physical products are also several orders of magnitude larger and more efficient than its competitors.

A few comments on the US health system (a deeper analysis is for another article): (a) The entity who typically bears health insurance is the employer, competing with each other employers for the medical insurance offer, not less than competing with each other on salary. (b) Hospitals are not focused on patient well-being, but on charging the medical insurance company for the services provided. It sounds awful, but hospitals will not invest a cent more in patient welfare, if the insurance company does not pay a cent or more for the improvement in patient welfare.  (c) COVID19 is economically obliterating the American health care system. These systems made a living from milking health insurance companies, but since the beginning of the pandemic, patients do not come to the hospitals except in emergencies, so there are fewer additional services to provide.

So what is Amazon going to do to capture a share of the healthcare market? Amazon touches on almost every component of tomorrow's healthcare market: monitoring, data management, surgery, patient management and the medical procedure, medications, and cost.

The vision - two years ago Amazon announced, together with Buffett's Berkshire and JP Morgan that together they will rebuild the American healthcare system. The initiative was named Haven and promised to build a simple, high quality, transparent and affordable healthcare system. The appointed CEO (who in the meantime left), and since then - crickets. But in the meantime, without waiting for a partnership, Amazon is advancing.

Monitoring - everyone has been waiting anxiously for Halo, which was launched to experimenters in June and is now available to purchase. Initial reactions to the product are quite chilling. For example, when you install his app, hit asks you to take pictures without clothes, and then it calculates how much fat it sees on you (without offering a fitness plan to burn it, yet). It also has a microphone that listens to everything you say during the day tagging your mood according to your voice analysis, so there are already some users being offended by an algorithm tagging them as aggressive and opinionated. Of course, everyone is worried about what Amazon will do with all this personal data it collects on you, maybe it will offer pants just the right size?

Amazon has made a wonderful move that will help strengthen contact and save lives. They allow, with consent, to set up the Alexa Care Hub For support (elderly, and chronically ill). For example the duration of use of Amazon products, the start time of use where the data is processed and sent to the caregiver or a family member, so that changes in the patient's condition can be monitored, even remotely. When a patient is in distress and says - "Alexa - Save" she will call to call for help. The same service in a centralized manner is also offered to the staff of sheltered housing in order to help support the tenants. It is precisely such things that can help improve the quality of life and save lives.

Data management - Amazon already has a slew of cloud services, medicine and especially monitoring products with infinite information, so what's the problem? The problem is that every medical or academic research institution keeps its data in a different format and many are afraid to upload the information to the cloud. So Amazon's AWS started offering the "Medical Analytics Platform" that meets HIPPA standards (the Insurance and Health Data Protection Act). The platform offers a variety of configurations for storing medical information, even one that is not built as images and free text. Amazon intends to build HealthLake on a huge medical database, in which they hope to identify trends and health effects, and with its help recruit the right experimenters for clinical trials.

Drugs - Two years ago it acquired PillPAck for $800M. Then in November Amazon launched Amazon Pharmacy. How long it will take to grab a share of the $312B drug market in the US? If they can offer it to 118M Amazon Prime subscribers today (about a third of Americans), guaranteeing them free "home-to-home" delivery within 48 hours of ordering?

Patient management and treatment process - with 1.2M employees, it is cheaper to give some health services yourself instead of buying the services from a third party. So Amazon has opened Amazon Care which started from a telemedicine services hub that opened in February, targeting to care for 115,000 of its employees. In July, a deal was signed with Crossover Health that offers Amazon employees neighbourhood health centers that also offer vaccines, preventative medicine, and psychological services, and this service is currently being offered in Dallas Texas. Since June, about 2,200 employees (and their families) have signed up for the program and about 800 have already received services. Amazon has announced that it intends to open the program in 4 more cities, and even reach about 20 clinics dedicated to Amazon employees only. Rumour has it that there is an intention to start selling these services to other companies, and in fact, compete with traditional health insurance services.

So Bezos marked the target and started moving in the direction, this is not a sprint, rather a marathon. It will take 5-10 years but they will get there. They have all the ingredients to become leaders in the healthcare world of tomorrow. I would not be surprised if in the first half of 2021 we see Amazon buying a nationwide network of healthcare services, and making a move in the healthcare market that is reminiscent of what it did with Wholefoods in the physical supermarket space. 

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Sources:

https: //www.businessinsider.com/amazons-top-5-health ...

https: //www.mobihealthnews.com /.../ amazon-dives-deeper ...

https://medcitynews.com/.../amazon-opens-4-more-primary.../

https://medcitynews.com/.../paging-dr-amazon-company.../

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