Yesterday’s Care (Being Offered) Today
Julie Kliger
Experienced senior advisor focusing on early stage med-tech commercialization and 'real-world' translational implementation in the clinical setting. Expertise in medical and clinical errors, patient safety outcomes.
Like many, I’ve been waiting to hear what Amazon does with their healthcare ‘NewCo’ and their re-invention of healthcare. And this week they dropped the announcement about Amazon Care.
What is ‘Amazon Care?’
It is essentially a company-run medical clinic that exists at the work site and remotely and virtually. To my mind, it’s a modern-day mash-up between Kaiser Permanente’s Healthcare model and the (very old approach), Visiting Nurse model…..
Amazon’s ‘reinvention’ seems to be providing convenient, customized primary care. Presumably less waiting, less red tape, less irritation… Not terribly inspirational is it?
‘Where’s the Beef?’
As the critics used to say in the 1990’s—where’s the beef? Where is the thrill? Is this what the greatest Creatives could come up with? Many clinics and medical groups already routinely provide care virtually. Lot’s of people nowadays already gets medications delivered to their homes overnight. Take for example, Kaiser Permanente, where more than 50% of their visits are virtual and have been for several years as well as overnight delivery with medications.
‘Old School’ Care
What Amazon Care reminds me of is what I used to do as a nurse—take care of patients where ever they were and where ever I was. Years ago, I used to lead High Sierra backpacking trips for the Sierra Club where we would hike miles into the mountains at elevations above 10,000 feet. Not uncommonly, someone would feel ill or take a spill and sprain an ankle or wrist. In the photo above, I’m bandaging up a ‘patient’ at a high altitude, off-trail mountain pass. Taking care of the patient at 12,000 feet was what I call ‘convenient, customized care!’
Two Reasons to Stay Status Quo
There really are only two reasons for this the model: Either because people are, at their core, only seeking simple, basic solutions to healthcare including well, convenience and customized primary care.
Or, because those designing the model lack an appreciation and guts for ‘A Bold New Vision’ of care delivery and provision. Given how disruptive Amazon has been to the world of retail, I would have expected a bigger Play, utilizing the emerging world of IoMT (Internet of Medical Things).
Lot’s of Sizzle in Healthcare
There is plenty of ‘sizzle’ going on in healthcare, yet, none of it appears in Amazon Care:
For example, where is the option to get ‘smart pills’ that tell you if you’ve taken the medicine via a tiny sensor which records when the pill is taken and sends the data to your smart phone? Or, skipping the lab visit all together and instead use ‘lab on a stick’ technologies and let your phone to analyze the blood sample right there on the spot? Or what about skipping the nurse and doctor all together and let your smart phone detect skin cancer, depression, Parkinson’s disease, Alzheimer….? All of these capabilities exist yet I’m not reading them in the Amazon Care model. Sure, they are using technology to improve medical records but, isn’t that the ‘floor’ of improvement rather than something to tout?
Missed Opportunity
This seems like a missed opportunity for Amazon and it’s too bad since they could have been the ‘test bed’ for deploying these IoMT in vivo—meaning in context to delivering comprehensive, consistent care management over years to employees. And to study and evaluate these new capabilities to determine which of these ‘shiny new’ technologies actually helps improve the health of populations over time while improving cost, quality and safety efficiencies.
Be a Role Model—Not just Another Model
If I were an employee of Amazon, I’d ask for an ‘upgrade’ in the model. Ask Amazon to be a Role Model, not just a company-run model for healthcare delivery.
It is not too late.
About the author: Julie Kliger is recognized by LinkedIn as a "Top Voice" in Health Care in 2015 & 2106, & 2107. She is a Healthcare ‘Strategic Realist’ who is passionate about improving health care and improving lives. She specializes in future-oriented healthcare redesign, optimizing existing operations, implementing new care models and strategic change management. She is an adviser, clinician, health system board member, speaker and author.
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School Nurse at Healthcare District of Palm Beach County
5yI happen to miss the art of personally caring for another human being. You know.... human connection. Slamming Amazon.... yeah, you are throwing cyber-stones at an entity instead of sharing ideas and encouraging a fellow human being. Another missed opportunity.
Founder & CEO at CareCentra
5yProvocative, Julie Kliger, and a substantial post as always! My thesis is that any "role model" of care in the digital milieu needs to stand on three axes- clinical credibility, personalized precision, and social authority. Let me explain. In the emerging ferment of digital health, there is a lot more attention being paid to "digital" than "health". Unless the healthcare professional is fully on board, the value proposition would lack the clinical credibility that is critical. Models like Noom would struggle to maintain quality at scale given the lack of clinical gravitas. The second axis is about making the experience personal and precise. Personalized behavior shaping technologies are invaluable to patients and the era of the smartphone epitomizes that pillar. Just-in-time triggers can help patients act on their health through tiny steps that shape health behaviors over time. IoMT plays a significant role in this area as you point out. In our work, we find growing responsiveness to integrating devices from simple pedometers to smart scales through glucometers and heart monitors via Apple Health or Google Fit that provides lifestyle information for deep personalization. This is not just among the savvy Millenials but even among senior citizens in our heart health or medication adherence programs. Finally, the need to observe other 'patients like me' in a community setting drives the social authority axis. Nick Jonas' drives the largest group for T1D patients on FB for example and there are several on IG that are condition-specific that provide the perfect complement to personalized content. Being able to balance these three axes will, in my view, be critical to disrupting the old paradigms. Amazon's attempt would be about convenience and cost-shifting. The object of these models is to drive tasks from a high-cost place (like hotel rooms for Airbnb) to lower-cost venues (peoples homes). I am willing to wait and watch where Amazon takes this - but they do have a huge opportunity for reimagining healthcare.
CEO and Founder at Door Space Inc.
5yDo you think Amazon is looking at how to save money on employee health plans without reducing quality of care? My first thought when Amazon announced this program was that it can eliminate the insurance companies which are costing employers and employees more and more every year.
High Impact Operator & Strategist @ PWM Associates | MBA
5yThis is a classic post even for Julie Kliger!