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Digital Health Fragmentation – Is Amazon the Answer?

July 31, 2017 Digital Health 7 Comments

Digital health updates are written by LoneArranger, an anonymous industry insider.


Thousands of startups in the digital health space offer a wide variety of features and functions, generally targeted at specific conditions and diseases or designed to address relatively narrow use cases. Relatively few of these are actually being prescribed by providers, and the most popular consumer apps do not typically ingest data from EMRs or other healthcare information systems.

They may have the capability to export data to these systems, but not necessarily in a way that yields any real value for providers or patients. Further, many are standalone tools or part of limited proprietary collections of loosely related applications that fail to offer the value proposition that would engage a large number of users.

This lack of critical mass has impeded broader adoption and limited the potential of digital health solutions to have a significant impact, at least in the near term. Other than the mobile versions of EMR portals like MyChart, few universally applicable solutions cut across large numbers of health systems and users. Even then, they may function differently depending on the sponsoring organization or local community policies. Just having a large number of mHealth apps in the major app stores does not constitute a critical mass for the purposes of delivering value that customers will actually pay for.

What is needed is a comprehensive, cohesive, and interconnected ecosystem that provides greater value for both providers and patients. The goal would be to create an environment that encourages innovation, but also provides a framework for connecting the myriad of applications into logical clusters and leveraging functionality and data that already exists in legacy health IT systems.

This may be the ultimate goal of the newly announced Amazon 1492 health research initiative. The 1492 group reportedly has been working on ways to streamline medical records management, to make the information more readily available to consumers and doctors. In addition, it reportedly has been considering a plan that could improve US healthcare for those with limited access to a doctor. The group is also exploring health applications for existing Amazon hardware, including Echo and Dash Wand. While there’s no evidence that the team is currently exploring connected health devices, it’s possible it could eventually do so.

Obviously Amazon has already built a comprehensive marketplace for selling and distributing a wide variety of goods and services, and global scale which puts it in a prime position to create a mass market once these new offerings are launched. It has existing relationships with many potential customers and through its portfolio of Cloud and other technology products and services has strong connections to enterprise customers, including many in the healthcare industry.

Amazon could use all of these capabilities to create a national framework for digital health delivery that could also provide local customization, working with leading health systems across the country. This would potentially enable patients to access a broad suite of connected apps and services that shared data across the ecosystem and also integrated with their existing patient records at various institutions where they existed. Data from all sources could be aggregated into a complete longitudinal record that could drive advanced analytics and artificial intelligence to enhance patient care and provide improved patient engagement and interaction with their providers to better manage their health.

This is one (but not necessarily the only) way that the true potential of digital health could be realized.

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Currently there are "7 comments" on this Article:

  1. #AmazonHealthCare has a great opportunity. Just because, #Amazon enters into a very crowded space late in the game. Amazon can learn from the mistakes of the other giants in the same arena. Actually, they all tried and failed. They keep on trying and making the same fundamental mistakes. I believe that the reason for these failures is a failed paradigm. Amazon can learn from the experience of the past. Bring about a paradigm shift that is so necessary. Then and only then, Amazon will succeed and beat the competition, help the public and improve our limping healthcare. #PatientsRus!

    • I see you have a very #specific vision and #outline of the #failures of the other #EHR giants. I’m looking forward to the #future of #healthcare with #Amazon. Whatever that means.

  2. Look Premier is publicly traded and they get a % of supply spend. Premier’s shares are up this year so know one actively involved in health care thinks Amazon has a shot because the oligopoly that exists today shows no sign of breaking with their anti-kickback exemptions.

  3. Two points: First, per the article’s screenshot, Amazon is looking at entering the health care market, but that may have NOTHING to do with digital tools like EMRs. It could mean more supply chain management or device manufacturing. Health Care is not the same as Health Tech is not the same as Digital Health.

    But, for the sake of argument, let’s assume Amazon is actually interested in competing in digital health. The problem is that Amazon only has half the equation solved: they have a large presence with consumers, but that doesn’t mean they have ANY presence in the crowded field of digital health tools that are already in use by care providers or networks (ie. hospitals, clinics, etc.). To succeed in this space, Amazon would need to acquire a major existing player “Whole Foods” style and build it up, so they have a platform to connect existing digital health services to their large consumer base.

    • That’s one way to implement Cerner’s succession plan. Amazon is one of the few companies that can afford to buy Cerner.

      • Cerner has an EBIDTA of $965M (last 12 months ending March 31, 2017) and a bit higher if you include the recent quarter.

        IBM was rumored to have paid a multiple of 16x EBIDTA for Truven and most tech companies are in the range of 12-14x EBIDTA for M&A.

        Imagine Cerner would want the premium IBM paid so you are talking at least $15+B. Amazon could do it even though it would be a major strategic direction for them and why bother at this point?

        Bezos is rumored to want to stick his fingers in multiple pies and take at least 5-10% of them but the health IT wave has already crested in the US and is due for a pullback/major pull back depending on how healthcare reform goes. The US is also the largest market by far for Health IT spending globally.

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