Alexa: Tell me about Amazon's ambitions in healthcare

Over the last two years Amazon’s healthcare plans have gone from being a closely guarded secret to underpinning a series of very public deals and product launches, with 2018 proving to be the tipping point.

The year before, all the chatter was focused on the company’s secret healthcare team and the disruptive potential of this, as-yet-unknown, unit. Then all the behind-the-scenes work started paying off.

Twelve months later and the company had made a series of high-profile healthcare appointments, moved into the medical retail sector, made further moves in digital health and established a joint venture with a blue-sky mission.

Keeping up this pace in 2019 would have been surprising, and the company looks to be letting last year’s deals and launches bed-in, but it did make one very interesting, voice-activated move this month.

Its smart-speaker Alexa significantly ramped up its healthcare potential after it gained the ability to transmit and receive health information in line with the US Health Insurance Portability and Accountability Act (HIPAA) and its data privacy and security provisions.

To showcase the new functionality, Amazon signed up a number of healthcare providers, payers, pharmacy benefit managers and digital health coaching companies to launch six new Alexa healthcare skills.

They allow certain users of the device to do things like ask Alexa when their prescription delivery will arrive, to schedule a doctor’s appointment and even check their last blood sugar reading and provide trend information on their blood sugar measurements.

Amazon’s first partners for this new type of Alexa healthcare skill are pharmacy services organisation Express Scripts, health service company Cigna, healthcare networks Providence St. Joseph Health and Atrium Health, digital health company Livongo (see video below) and Boston Children's Hospital.

John Brownstein is chief innovation officer at Boston Children’s Hospital, whose My Children’s Enhanced Recovery After Surgery (ERAS) skill allows patients and caregivers to easily share recovery progress with their care team post-surgery.

“Boston Children’s Hospital has long believed that voice technology has the potential to substantially improve the healthcare experience for both consumers and clinicians," he said. "We began this journey with one of the first Amazon Alexa skills from a hospital four years ago and are thrilled to participate in the initial launch of Amazon Alexa’s HIPAA-eligible service for developers."

The hospital’s new Alexa healthcare skill was, he added, “just one example of how voice technology can extend the care and support of our patients beyond the four walls of the hospital”.

As a US-only, invite-only programme, it’s yet to fully hit the mainstream, but the direction of travel is clear to see, with Boston Children’s Hospital not the only organisation to have launched Alexa healthcare projects in recent years.

Others include a first aid skill from the Mayo Clinic and an information skill from WebMD in 2017 and a healthcare information skill from Cigna that arrived last year. The Answers by Cigna skill provides brief answers to more than 250 of the most commonly-asked healthcare questions and aims to improve the public’s health literacy.

With over 20% of Americans owning a voice-activated smart speaker, of which Amazon’s Echo is currently the most popular, there’s a good chance it could help with this, given that one third of adults in the US have either basic or below basic abilities to deal with health information, according to the Department of Health and Human Services.

Amazon’s healthcare plans and projects

The development of Alexa as a source for health information and tools is just one strand of Amazon’s efforts in healthcare and looking at its achievements in 2018 that I briefly mentioned above gives a sense of the scale at which it wants to operate within healthcare - and perhaps pharma.

The tech giant’s commerce roots were evident in its $1 billion acquisition of US online pharmacy PillPack last summer. The deal with PillPack could disrupt the traditional pharmacy market by delivering pre-sorted medicines and refills to customers’ doors and Amazon also showed interest last year in India’s second-largest pharmacy MedPlus.

It followed those activities with the October launch of an exclusive range of diabetes and hypertension devices. The Choice devices, produced by healthcare consultancy the Arcadia Group, included blood glucose monitors, blood pressure monitors and test strips to help people manage their conditions at home.

Amazon also began selling an exclusive line of Perrigo OTC products as part of its Basic Care range in a move that, as Business Insider suggested, could help strengthen the company’s association with healthcare in consumers’ minds.

The company already sells a huge variety of professional medical supplies, offering everything from scalpels to sample containers and even a hospital room, and its Amazon Business unit aims to be a major supplier to hospitals.

On the digital front in 2018, Amazon’s Web Services unit joined a cloud computing initiative from the US National Institutes of Health (NIH) that aims to harness the power of commercial cloud computing for NIH biomedical researchers. And there was also the November launch of machine learning tool Comprehend Medical, which mines doctors’ notes and patient health records for data about a patient’s diagnoses and medications.

Last year also saw Amazon make a trio of headline-grabbing appointments, as it signed up the FDA’s former chief health informatics officer Taha Kass-Hout, cardiologist Maulik Majmudar and Atul Gawande, a surgeon and writer.

The latter was picked to head-up Amazon’s non-profit joint venture with Berkshire Hathaway and JPMorgan Chase, known for now as Haven, that launched with a mission to provide their employees with a better health plan.

When talking about the ‘GAFA’ (Google, Apple, Facebook and Amazon) bloc of technology companies and their efforts in healthcare it’s common to speculate as to how or when their non-pharma players will disrupt the sector. In Haven, which now wants to deliver “better outcomes, satisfaction and cost efficiency in care”, Amazon – and its partners – are certainly setting their sights high.

Amazon has come a long, long way since it was first incorporated in 1994 as Cadabra, Inc – a name swiftly dropped after a lawyer visiting Jeff Bezos pronounced it ‘cadaver’.

Thankfully, its prospects in health are, well, much healthier today and, 25 years after it began life as an online bookshop, the flurry of healthcare activity witnessed in the last 12-18 months could well reflect Amazon’s own commercial evolution into the ‘everything store’.