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: “use and disclosure of protected health information.” It authorizes Amazon to have your “complete patient file” and notes that the information “may be re-disclosed,” after which it “will no longer be protected by HIPAA.”
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 — but in practice you must agree to become a patient at its Clinic. There’s only one button to click: “Continue.”
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 it’s “compliant with HIPAA and all other applicable laws and regulations,” there’s more to the fine print.
When you sign up for treatment through Amazon Clinic, you “authorize” all entities involved. This includes doctors, pharmacies and labs to share your Protected Health Information (PHI) with Amazon.
Here’s what constitutes PHI:
- Contact Information (for example, email address).
- Demographic Information (for example, date of birth).
- Account and Payment Information (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 “retain, use and disclose this information” for two purposes: If an HCP you used through Amazon Clinic no longer provides service there, Amazon will “coordinate healthcare services” on your behalf. How nice of them.
Here’s the kicker: Amazon can use your PHI “in relation to any Amazon services” to “facilitate services from other providers.” Who exactly are these providers? Doctors? Other businesses?
Amazon Clinic is not actually a clinic. It’s 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 Clinic Chief Medical Officer and General Manager Dr. Nworah Ayogu said during his segment that one reason many people are not receiving needed care is access, which Amazon is addressing with acquisitions like One Medical and its expanding network of retail clinics.
“I 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,” Ayogu said. “I think we’re 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.”
… As for broader implications for Big Tech bringing AI into the healthcare space, (Breyer Capital CEO, Jim) Breyer said, “My personal view over the last 12 months is that our mega-cap companies … are not just doubling or tripling down on healthcare and medicine. It’s 10x 50x over the next couple of years.”
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. You will learn that Amazon, the online retail conglomerate and data-mining company, which has been expanding into healthcare for years, has been marketing their so-called Amazon “Clinic” 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 just 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 … which you could sign up for directly), Amazon requires you to you to “authorize” 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 “retain, use and disclose this information to ‘coordinate healthcare services’ on your behalf and to ‘facilitate services from other providers.’” 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. Amazon’s 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 Court’s decision in the Sorrell v IMS Health and similar decisions, “corporate free speech” 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. We don’t want to turn our entire lives over to corporate overlords. We need to support national 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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