For the better part of a decade, one doctor He has been my primary care provider. It’s convenient, with locations around the Bay Area, and I like being able to schedule a same-day physical or get a quick referral to a specialist.
One Medical knows a lot about me. In addition to many years of clinic visits and virtual chats, I use the mobile app to record my resting blood pressure and heart rate, check my lab results, and refill prescriptions as needed. That’s why I pay a membership $199 fee per year.
But I never considered the possibility that Amazon may one day own One Medical.
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The same company that ships me countless boxes every week, peppers my Kindle with book recommendations, and my smart TV with movie suggestions, he tells me kids the weather forecast when they call Alexa, and offers Prime discounts when I store at Whole Foods is about to provide my medical services and own the portals that contain my most sensitive information.
I’m not the only person who had this deeply troubling thought on Thursday after waking up to the news that Amazon had agreed to buy One Medical for around $3.9 billion. At $18 a share, Amazon is paying a 77% premium compared to the value of the primary care company a day earlier.
As one member wrote on Twitter, “After a largely positive experience with One Medical, I canceled membership today. I don’t trust Amazon to act in good faith with my health data.”
The law and customer trust
Founded in 2007 and headquartered in San Francisco, One Medical offers clinical services in 16 US markets, with three more to follow, according to its website. At the end of last year, the company had 736,000 members.
Amazon did little to calm my fears with its acquisition ad. The company said nothing to reassure One Medical customers, and there was no conference call to discuss the acquisition, as is customary for many major transactions. Closing of the deal will require regulatory approvals.
In response to a query for this story, Amazon offered the minimum level of assurance that it will comply with government regulations, under the Health Insurance Portability and Accountability Act. (HIPAA), which limit how the company can use protected health information, or PHI. That includes all personally identifiable information, as well as medical history, lab test results, and other health data.
“As required by law, Amazon will never share One Medical customers’ personal health information outside of One Medical for purposes of advertising or marketing other Amazon products and services without clear customer permission,” a spokesperson for Amazon said. Amazon in an email. “If the deal closes, One Medical customers’ HIPAA-protected health information will be handled separately from all other Amazon companies, as required by law.”
In other words, everything One Medical knows about me is supposed to stay in that protected silo. Any profiles Amazon has created about me and my family, from our shopping habits and travel preferences to the shows we watch together on weekends, won’t be mixed with my health data.
Despite the laws, Amazon will have to work hard to convince consumers, and likely politicians, that its intentions are pure and its main goal is to help “dramatically improve the healthcare experience for years to come.” as Amazon Health Services leader Neil Lindsay said. he said in the press release that he was announcing the deal.
After all, along with its giant cloud and retail divisions, Amazon has built a highly profitable business. advertising business which generated more than $31 billion in revenue last year and grew 58%. Most of that money comes from brands that pay top dollar to promote their products on Amazon properties, where competing for eyes is getting more expensive.
Amazon controls approximately 13% of the US online advertising market. Google Y Facebookaccording to internal intelligence.
“I don’t think Amazon can do anything to get people to trust the company with their health care information,” said Caitlin Seeley George, campaign manager for Amazon. fight for the futurean advocacy group focused on technology and digital rights.
Seeley George said in an email that the health privacy issue is particularly important after the Supreme Court overturned Roe v. Wade, which ended the constitutional right to abortion. Certain decisions related to reproductive health that, until very recently, were protected by law may now be considered illegal.
Amazon has already limited sales of emergency contraceptive pills after demand skyrocketed following the Supreme Court ruling. And Google said it will work for quickly delete location history for people who go to abortion sites.
“Advancing health care raises some serious red flags, especially in the mail-Roe reality where people’s data can be used to criminalize their reproductive health decisions,” said Seeley George.
Seeley George also wonders if, outside of HIPAA regulations, Amazon could implement a mental health or fertility tracking app and collect information that “could be used to create assumptions about an individual that could be used against them.”
Amazon already has a health tracker called aura which collects information such as body fat percentage, activity levels and sleep.
‘Not his first rodeo’
Techno-optimists will likely scoff at such cynicism. The status quo in health care is miserable. Systems are old and don’t talk to each other, billing is notoriously opaque and complicated, and healthcare is ridiculously expensive.
Amazon has been pushing the healthcare space for years, acknowledging the system’s many flaws and inefficiencies and trying to offer better care to its massive employee base, which jumped to 1.6 million last year from 1.3 million. in 2020.
Amazon bought online pharmacy PillPack in 2018 for $750 million and launched Amazon Pharmacy two years later. The company has been investing in a telehealth service called amazon carewhich was launched as a pilot for some employees in 2019 and is now available for other employers to offer as a service to their staff.
deena shakirA partner at venture firm Lux Capital and an investor in numerous health technology startups, he noted that for Amazon, this is “not its first rodeo in health care.”
“Amazon is well aware of how to handle HIPAA considerations and has experience across multiple products with this,” Shakir wrote in an email. This type of agreement “should encourage further partnership between the largest companies and the major players in health technology,” he wrote.
Shakir’s firm is an investor in carbon health, which offers primary and urgent care centers in 16 states. The company serves around 1.1 million patients and, compared to One Medical, typically targets a less affluent demographic.
Analysts say that Amazon is about to disrupt the $934.8 billion global pharmaceutical industry.
Carbon Health CEO Eren Bali agrees with Shakir that Amazon is deeply restricted in how it can use data. Compared to other big tech companies like Facebook Y Googlesays that Amazon receives a fair amount of trust from consumers.
But Bali understands why there may be concern. Health care companies have vast amounts of personal data, including Social Security numbers, driver’s license numbers, and insurance cards, in addition to all other health information in their systems. Patients are much more willing to give personal information to doctors and nurses than to other types of service providers.
And while there are strict regulations on how that data can be used, consumers may reasonably wonder what happens if a company like Amazon breaks the rules.
“Unfortunately, there are no strong technical solutions to enforce data access, which is a huge weakness,” Bali said in an interview. Whether patients should worry about that is a “personal decision,” she said.
Bali is generally optimistic about Amazon’s jump into space. When Amazon makes a splashy announcement signaling its arrival in an old market with big headlines, existing players are forced to act to avoid being wiped out, Bali said.
quoted amazon purchase of PillPack as an example. While Amazon has struggled to gain a foothold in the drugstore business, entering the market pushed companies like Walgreen’s Y walmart to beef up its digital offerings in ways that are beneficial to consumers, Bali said. The One Medical deal could lead to improved products and services in the world of primary care.
“Large companies don’t usually feel threatened by small startups,” Bali said. “But they are really threatened by Amazon.”
— CNBCAnnie Palmer’s contributed to this report.
CLOCK: Amazon’s deal with One Medical is part of a ‘package of options’