What is Amazon Clinic? And will it protect your privacy?

What is Amazon Clinic? And will it protect your privacy? unknown

I don’t have asthma attacks very often, and when I do, they’re more inconvenient than scary. My tight, crackle-y breathing happens mostly when I exercise outdoors in the cold. Like now. In February. That’s why I needed to pick up an inhaler before going on a snowshoe adventure in the mountains this weekend.

Should be pretty easy, right?

Last week, I spent more than five hours over three days trying to get my common asthma medication with a year’s worth of refills moved from our old pharmacy in Oakland to our new pharmacy outside of Seattle.

The process should have taken a few taps on my online health portal. After all, we transferred the same coverage – by the same provider – from California to Washington. Simple? Of course not.

It took that same system 11 months and a dozen phone calls just to change our address. Our first appointments for check-ups with a new primary care doctor, scheduled for this week, have now been delayed by two months. (The doctor called in sick, and that’s how long it takes to book a new ten-minute window with her.) Bills for visits often contain costly errors. The list of frustrations goes on. Still, we feel it’s the best coverage we can afford.

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Why is healthcare so painful?

We’re the lucky ones. We’re healthy. We have medical insurance. We’re able to advocate for ourselves and get treatment, eventually.

That’s not the case for millions of Americans – many with their own complaints much more serious than ours.

A recent Gallup poll shows – for the first time in more than two decades – more than 50% of Americans are not happy with the healthcare industry. An estimated 100 million of us feel like we pay too much for too little when it comes to our health.

“Healthcare is such an important industry, but it’s also high on the list of experiences we think can and should be better,” Dr. Nworah Ayogu, GM and Chief Medical Officer of Amazon Clinic told me over Zoom.

Enter Amazon Clinic

It took less than an hour to get that same prescription refilled through Amazon’s new online virtual health clinic.

Amazon Clinic rolled out quietly last November for people ages 18-to-64. It’s currently available in 33 states and offers digital care for 24 common health conditions such as allergies, acne and pink eye. It also lets you get prescription renewals for existing issues like asthma, high blood pressure, or migraines.

What it’s like to use Amazon Clinic

If you’ve ever used Amazon, the way Clinic works is familiar: Go to clinic.amazon.com and sign in using your existing Amazon account. Create a new, four-digit PIN code, enter that, and it takes you to a landing page with specific conditions.

Tap the one you need help with, and it takes you to another page filled with information to help you figure out if this is the correct course of treatment. Choose your state, and then pick a preferred provider, such as HealthTap or SteadyMD.

For my asthma inhaler, I chose the $30 consultation from SteadyMD. This fee is not covered by insurance and varies depending on the condition, state, and provider. (I chose HealthTap for another test of this service for a Latisse prescription for a video review of Amazon Clinic.)

Next comes a HIPAA consent form authorizing the sharing of health information on your behalf.

This is the part that gives most people pause, in light of big tech’s past missteps with our personal and private information. A recent special investigation into the data-sharing practices of 50 direct-to-consumer telehealth companies showed Amazon Clinic was the only one that did not share any information with outside platforms. Below, we dive deeper into this issue – including Amazon’s response to security concerns.

From here, you’ll need to answer a series of questions from dropdowns and checklists, add any notes or specifics, and, if required, upload a photo of your last prescription.

The entire process took less than 10 minutes. Once you hit complete and pay, you get a text message that you’ll get a follow-up message through the Amazon Clinic portal and should check the visit status in “two hours or less.”

The next text message came just 20 minutes later. When I signed back in to the portal, there was a long message from a nurse with a treatment plan, text box area to type any questions (for up to two weeks after the initial consult), and instructions on how to use the inhaler.

It then gives you the option to fill the prescription via Amazon Pharmacy, which delivers to your doorstep in two days if you have Amazon Prime, or you can go to your neighborhood pharmacy.

This part is often covered by insurance minus your specific co-pay, the same as it often is after a traditional trip to a doctor's office. I paid $20 for the inhaler through Amazon Pharmacy. The final cost? Less than one hour of my time and $50.

The new inhaler arrived in an unmarked package at my house before my own healthcare provider could even update my online records.

The convenience, alongside the time, hassle, and frustration saved – was worth the price of admission a million times over.

Does Amazon Pharmacy take Medicaid?

Amazon Pharmacy accepts many Medicare and Medicaid plans. Customers can check to see if their insurance plan is accepted at Amazon Pharmacy by creating a profile and checking insurance eligibility online.

Can we really ‘Amazonify’ basic health services?

Make no mistake, this isn’t a replacement for face-to-face visits with your primary care providers. It can’t touch a relationship you’ve built with a physician or clinician over time. Its scope and reach are limited to text messages for fairly basic issues.

“For us, it’s really about making sure that when people have a problem – a simple, well-defined problem – they can get to a solution when they need it,” Dr. Ayogu explained. “ So whether that is, ‘I need birth control,’ ‘I have athlete's foot,’ ‘I have a migraine,’ when you have that problem, you need a solution rapidly.”

Amazon said the top conditions they’re currently seeing include UTI’s, sinusitis, and pink eye. They also said they added Covid-19 and athlete’s foot treatments based on early feedback and patient needs.

These are basic needs and common conditions. How this changes when, and if, Amazon’s $3.9 billion acquisition of primary care provider One Medical clears regulatory hurdles – is yet to be seen.

And that’s the part that makes people nervous.

Concerns with high-tech healthcare

Even with massive, ongoing tech-company layoffs – the digital health sector is booming. Analysts expect telehealth and digital wellness spending to reach more than $32 billion this year.

The big four – Alphabet (Google), Amazon, Apple, and Microsoft – lead the charge into this new Wild West of tech’s next big industry to disrupt and conquer.

Critics worry there’s not yet critical oversight or clear regulation in place.

“We already have a massive concentration problem in the healthcare industry that’s been linked to a whole host of problems – driving up costs, limiting choice, reducing quality of care,” says Stacy Mitchell, co-executive director of the Institute for Local Self-Reliance and outspoken critic of tech’s target on healthcare. “Is adding a giant monopolistic company to the mix helpful to that problem? Will it make it better or worse?”

There are also privacy concerns.

In a joint investigation, health news site STAT and The Markup – which investigates the ways powerful institutions use technology to influence society – found that 49 of 50 direct-to-consumer telehealth startups leaked sensitive medical information to ad platforms like Google and Facebook. The only one that came away with a clean bill of health was Amazon Clinic.

Amazon’s Dr. Ayogu explained that they are governed by HIPAA – the same as your doctor, hospital, and insurance company.

“It’s no different than what you’re already doing with your healthcare providers.” he said.“(With Amazon Clinic) we follow all the same HIPAA and other applicable laws; our castle just has higher walls.”

Mitchell’s not so sure. “My observation about Amazon and data is that Amazon’s goal is obtaining data for its own purposes, not necessarily selling it to someone else,” she said. “But their ability to exploit that data for their own gain – that’s the part that we should all be asking about.”