What are Amazon, Apple, Google, and the other Big Tech companies up to in health care? Here are the seven stories you should know about the moves they've made in the past month—and how they could impact the industry.
1. Microsoft and Providence St. Joseph Health want to build the 'hospital of the future'
Microsoft on July 8th announced a partnership with Providence St. Joseph Health, a 27-hospital system headquartered in Washington. Providence CEO Rod Hochman said the health system plans to work with Microsoft to turn an existing Seattle facility into the "hospital of the future," retrofit it with the newest technology, including natural language processing and machine learning tools. "We decided to go big with this partnership," said Hochman, "this isn't just about buying software from them." Hochman said he considered several Big Tech firms for the project, like Google, Apple, and Amazon, but ultimately chose Microsoft because they were not "trying to do health care themselves." He explained, "They aren't trying to be in the health-care business, but are trying to make it better." The partnership will be an important opportunity for Microsoft to build a stronger presence in the health care, and overcome the several high-profile difficulties they've faced in the past.
2. Apple opens its portable health record platform to all US providers
Ricky Bloomfield, Apple's head of clinical and health informatics, on June 26 tweeted big news: all U.S. providers with compatible EHRs can join Apple's mobile record platform. Apple had previously opened the tool to select health systems, as well as the Department of Veteran's Affairs. But now, Apple is allowing any U.S. provider with an Epic, Cerner, athenahealth, or CPSI EHR that adheres to the FHIR framework to self-register for the platform at Apple's Health Records registration page. This registration allows patients to download and access their medical records on their phone (upon logging in with the provider's patient portal). Apple said that 300 health care organizations, clinics, and labs have already registered for the platform.
Now that Apple has opened the floodgates for providers, the next step will be getting patients to actually download their records. Apple hasn't publicly disclosed how many patients are using the feature, but noted that the company is taking steps to make the data more engaging and actionable for users. For instance, Apple said it is testing the ability to show graphical trends of lab results, a feature they believe will be available in the next release. If Apple succeeds in making the tool more useful and more developers use Apple's HealthKit tools to build apps that draw on data from the records, the company may be able to expand consumer adoption (and avoid the low adoption that doomed Microsoft and Google's similar efforts).
3. Uber moves into the self-insured employer market with new partnership
Uber on June 19 announced a partnership with Grand Rounds, a venture-backed start-up that aims to reduce large employers' medical costs by providing their employees with medical guidance and support. The partnership will allow Grand Rounds' care coordinators to book free rides for members to get to the doctor—a strategy that they're hoping will reduce expensive hospitalizations and other costs down the line. For Uber, the partnership is indicative of the company's continuing movement into the health sector. It also provides access to the potentially lucrative market of large companies that are self-insured, like Grand Round customers Comcast, Walmart, and News Corp.
4. NHS announces first-of-its-kind partnership with Amazon's Alexa
The UK's National Health Service (NHS) announced a partnership with Amazon's Alexa which will allow UK residents to get vetted health advice from NHS' website on the voice assistant devices. When UK residents ask their Alexa device simple health questions, they'll receive answers that have been directly provided by NHS. The health department said the move is designed to reduce strain on general practitioners (GPs) in the country by giving people a reliable way to get advice for their low-acuity needs. They also said it would help patients who are blind, elderly, or unable to access the internet get easier access to reliable information. Considering that experts predict that half of all internet searches will be conducted via voice speakers by 2050, such a high-profile partnership could provide Amazon more credibility in the medical space—and push it past competitors like the Google Home. However, the partnership won't necessarily allow the tool to move beyond simple health questions. If users ask questions not on the NHS site, they could still be directed to unhelpful or even dangerous medical advice. Plus, if these outside answers raise unwarranted health fears, Alexa could actually lead to greater health care utilization.
5. Apple will sell a consumer-focused diabetes monitor in its stores
Apple on June 27 announced that select Apple Stores will sell One Drop, a blood glucose monitor that integrates with the iPhone's Health app to help those with diabetes manage their blood sugar. The glucose monitor is meant to be both easy to use for patients and simple to connect with the One Drop phone app. The purchase also includes a year of free diabetes coaching from a certified educator. Apple's decision to sell the equipment in their brick-and-mortar stores reflects their decision to chart a consumer-focused course to break into the health industry, and desire for the iPhone to be a can't-miss tool for tracking health. It also might serve as an early test case to see if the company will pursue blood glucose tracking into future iterations of its Apple Watch—or just build their own monitor.
6. Amazon's supply chain efforts may not be going well, according to a new UBS survey
While Amazon is continuing to push into the medical supply chain business, a new survey suggests it may be losing steam. UBS' research group AG surveyed 100 medical supply purchasers and found that the percentage in sourcing agreement talks with Amazon declined from 11% last year to 7% this year. Many respondents raised concerns about a lack of control or oversight when using Amazon (30%), product quality (20%), and perceived limitations about the types of products available (10%).
The survey authors also noted that Amazon's medical supply prices have become less appealing, either because Amazon may be discounting them less frequently or because competitors lowered their own prices to match the online retail giant. Regardless, most survey respondents said they intend to increase their supply purchasing through Amazon in the next three years—though perhaps not at the pace Amazon expected. Overall, the news is troubling for Amazon, which has made the bet, as their global health care leader Chris Holt put it, that "health care leaders are desperate for new models [in the supply chain] and are eager to try new things." This news indicates that this may not be true, and that hospital's group purchasing organization (GPO) ties are stickier trickier to bust into than imagined.
7. IBM, Merck, and Walmart team up to use blockchain in the supply chain
FDA on June 13 announced that the agency has chosen IBM, Merck, and Walmart, along with consulting group KPMG, to join in a pilot program supporting the U.S. Drug Supply Chain Security Act (DSCSA). The pilot will track drugs and vaccines created by Merck and those sold by Walmart using IBM's blockchain platform. It will include a consumer-facing mobile app that will allow patients receiving prescriptions to scan a QR code to discover important details about that specific batch of medication, such as the manufacturing site, how long it's been on the shelves, and more. The program is expected to be completed by the fourth quarter of 2019. The partnership is being billed as a further test case for how blockchain can be used in health care, specifically how it can protect sensitive health care information. Since the technology allows for real-time monitoring of drugs, but also allows people to see who has seen tracking information without necessarily view the information itself, experts say it could be a more transparent way to track the movement of drugs.