Summary: With the acquisition of One Medical, Amazon becomes a primary care middleman. It wants to access your medical records and sell the data, sacrificing your privacy.
To become an Amazon Clinic patient, first you sign away some privacy, Washington Post, May 1, 2023, by Geoffrey A. Fowler
This Amazon form is asking for something more extraordinary: āuse and disclosure of protected health information.ā It authorizes Amazon to have your ācomplete patient fileā and notes that the information āmay be re-disclosed,ā after which it āwill no longer be protected by HIPAA.ā
Wait, you agreed to what? Amazon is essentially pushing people to waive some of their federal privacy protections, say the lawyers at the Electronic Privacy Information Center whom I asked to inspect the jargon. Amazon is required by law to say doing so is voluntary ā but in practice you must agree to become a patient at its Clinic. Thereās only one button to click: āContinue.ā
What could go wrong? There are lots of icky ways Amazon could use your health information: to upsell you on other services, to target marketing for its giant advertising business, or to build out artificial intelligence or patient-risk models.
What you really give away when you sign up for Amazon Clinic, Komando.com, May 2, 2023, by Albert Khoury
Though Amazon declares itās ācompliant with HIPAA and all other applicable laws and regulations,ā thereās more to theĀ fine print.
When you sign up for treatment through Amazon Clinic, you āauthorizeā all entities involved. This includes doctors, pharmacies and labs to share your Protected Health Information (PHI) with Amazon.
Hereās what constitutes PHI:
- Contact InformationĀ (for example, email address).
- Demographic InformationĀ (for example, date of birth).
- Account and Payment InformationĀ (for example, insurance information).
- Your complete patient file, including medical and billing records related to the services that any HCP supplies to you through Amazon Clinic.
Amazon has the right to āretain, use and disclose this informationā for two purposes: If an HCP you used through Amazon Clinic no longer provides service there, Amazon will ācoordinate healthcare servicesā on your behalf.Ā How nice of them.
Hereās the kicker: Amazon can use your PHI āin relation to any Amazon servicesā to āfacilitate services from other providers.ā Who exactly are these providers? Doctors? Other businesses?
Amazon Clinic is not actually a clinic. Itās a service that connects you with third parties such as HealthTap, HelloAlpha and SteadyMD, delivering telehealth services with clinicians.
Amazon Clinic Chief Sees Intersection of Retail and Healthcare, PYMTS, April 6, 2023
The future of healthcare will look a lot more like retail with customer experience coming first and artificial intelligence (AI) playing a larger role in that transformation.
These were among the takeaways from a series of discussions during the CNBC Healthy Returns 2023 Summit last week, as leaders from healthcare, Big Tech and the investment world discussed how the consumerization of healthcare and applications of AI will transform healthcare as we know it, in some cases on a time horizon of as little as three years.
Amazon ClinicĀ Chief Medical Officer and General ManagerĀ Dr. Nworah AyoguĀ said during his segment that one reason many people are not receiving needed care is access, which Amazon is addressing with acquisitions likeĀ One MedicalĀ and its expanding network of retail clinics.
āI would think of Amazon Clinic as a marketplace, similar to what Amazon does well on its retail site, connecting buyers and sellers to the products they need,ā Ayogu said. āI think weāre doing the same thing with Amazon Clinic. I would think of it more as a marketplace where you can find providers and provider groups for your issue.ā
ā¦ As for broader implications for Big Tech bringing AI into the healthcare space, (Breyer Capital CEO, Jim) Breyer said, āMy personal view over the last 12 months is that our mega-cap companies ā¦ are not just doubling or tripling down on healthcare and medicine. Itās 10x 50x over the next couple of years.ā
Comment:
By Steve Auerbach, M.D.
Those of us who read JAMA or NEJM, or even Health Affairs, are clearly reading the wrong journals to keep up with healthcare practice in the United States. Unfortunately to find out who and what is controlling healthcare one needs to read business and finance articles like the above.Ā You will learn that Amazon, the online retail conglomerate and data-mining company, which has beenĀ expanding into healthcare for years, has been marketing their so-called Amazon āClinicā in anticipation of their purchase of OneMedical. I received an unsolicited email to sign up.
Amazon Clinic is both more and less than meets the eye. It is less because it is not a clinic, but justĀ a virtual message-based service that connects consumers with third-party telehealth providers. It is more because, in return for connecting you to third party partner telehealth companies (such as HealthTap, Hello Alpha, and SteadyMD ā¦ which you could sign up for directly), Amazon requires you to you to āauthorizeā data sharing. That is, all entities involved can share all your protected health information (contact info, demographics, financial and medical records) with any service they connect you with and Ā āretain, use and disclose this information to ācoordinate healthcare servicesā on your behalf and to āfacilitate services from other providers.āā This applies for Amazon itself and any other company with which they do business.
And this being Amazon, they can then link your healthcare data with all of your other Amazon purchase, search, and financial and credit data. Amazonās power comes from their combination of self-interest and self-dealing: The same company sells drugs, medical supplies, medical equipment, and data. So no doubt your medical and other personal data will be linked back to all the other data they and their business partners have collected on you.
What could possibly go wrong? And since the Supreme Courtās decision in the Sorrell v IMS HealthĀ and similar decisions, ācorporate free speechā overrides privacy and protection concerns.
We need, and could have, guaranteed access to universal healthcare, paid for through progressive taxation affordable for all and without point of service financial or administrative barriers. The overall system would be publicly accountable while leaving the doctor-patient relationship between just the doctor and patient. Ā We donāt want to turn our entire lives over to corporate overlords. WeĀ need to support nationalĀ M4A and local single payer movements, while also working with anti-privatization and anti-monopoly allies to fight the hyper-financialization of our health care and lives.
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