Can hospitals compete with Amazon Clinic?

Amazon recently expanded its new telehealth service nationwide, putting hospitals and health systems on alert that the tech giant is going all in on virtual care.

Some health system digital leaders told Becker's that Amazon Clinic's 50-state rollout is a sign they need to work harder or partner with the tech giant, while others say Amazon can't match the in-person care and patient relationships they've been building for years.

"We aren't surprised Amazon Clinic went national or retail organizations are applying their consumer expertise to support consumer health," said Sara Vaezy, chief strategy and digital officer of Renton, Wash.-based Providence. "We should be learning from them — taking proven technology that supports health access and navigation and applying it to the much more complex care journeys that health systems manage."

She said health systems should also look to partner with Amazon Clinic to "bring together patients and providers around their marketplace."

"We should be joining together as health systems in order to create a more standardized, commercial-grade, person-centered technology architecture upon which channel partnerships can be built," she added.

Amazon Clinic debuted in November, offering video visits and messaging-based consultations. The company rolled out the virtual appointments to all 50 states Aug. 1, while the messaging is available in 34 states. The telehealth service doesn't accept insurance — the video appointments are $75 each while the consults via messaging cost $35.

While Amazon doesn't have its own telehealth platform or providers, it connects patients with companies such as Curai Health, Hello Alpha, SteadyMD and Wheel. What it does have is name recognition and a huge customer base (along with their credit card information).

It was yet another marker in Amazon's foray into healthcare, after its digital Amazon Pharmacy and $3.9 billion purchase of One Medical's hybrid primary care clinics.

Eric Smith, senior vice president and chief digital officer of Houston-based Memorial Hermann Health System, said Amazon is giving consumers what they want: "cost-effective care that is available to them when and where they need it."

"This is what Amazon has built its consumer-centric approach on from the beginning — delivering products and services with an emphasis on efficiency and convenience," he said. "They have simply extended this approach to healthcare, now available nationwide." 

But Memorial Hermann is aiming to provide the same experience to its patients and going farther, he said: by "building meaningful, long-lasting, personalized relationships" and focusing on prevention rather than just treatment.

"We're also working to improve our digital offerings by streamlining the process of making an appointment, enhancing the way we communicate with our patients, and finding new and innovative ways to use data to improve overall population health," he said.

Michelle Conger, chief strategy officer of Peoria, Ill.-based OSF HealthCare and CEO of OSF OnCall Digital Health, said Amazon is simply responding to patients' expectations for accessible, convenient healthcare. She said her health system has been doing the same since it started transforming digitally five years ago.

"We have invested in the technology, education and clinicians dedicated to virtual care options that provide 24/7 access and convenience, including currently being a provider of the largest hospital-at-home program in Illinois," she said. "We leverage digital platforms to operate virtual nursing, ICUs and hospitalist programs that are helping us provide expert care in rural communities. This is likely just the beginning of the transformation all healthcare providers will be part of."

Amber Fencl, senior vice president and chief digital health officer of Winston-Salem, N.C.-based Novant Health, argued that virtual care is most effective when it's "complemented by a network of providers and facilities that support a continuum of care."

"This allows our patients to have convenient, on-demand access to a provider when needed, without sacrificing a relationship with a primary care provider who knows their health history and can care for them long-term," she said.

Virtual visits through a health system can then seamlessly refer patients to labs, imaging or specialists, she added.

A service like Amazon Clinic will be most beneficial to patients with minor, episodic health problems and people without health insurance, said Kiran Avancha, PhD, chief innovation officer of Scottsdale, Ariz.-based HonorHealth.

"I certainly think that the on-demand nature definitely makes it attractive, as we are already used to the Amazon model for groceries and video content," he said. "However, I believe that it's hard to replace hard-earned trust and touch points between a patient and their regular provider, as this gets built over a period of time."

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