US tech giants such as Google, Apple, Facebook (Meta), Microsft, are all active in healthcare, each with their own strategy, and what they do is of interest to all of us, given the huge resources they commit to this. Recent news attracted our attention to Apple and Amazon.

Apple,  a global player, published a white paper on its own accomplishments. We already knew that Apple’s healthcare strategy for the past 8 years, has been truly global, thanks to a combination of its products including iPhone, iPad, Apple Watch, Apple TV, and their interaction with user health data collected especially via the iPhone and Apple Watch, but the report brings it home. The Apple report [1] presents ambitious objectives from the title on, «Empowering people to live a healthier day », thanks to… 🥁Apple’s support of  « personal health, research, and healthcare. »
Almost all of the achievements listed in the report are global:
·     Thanks to the l’iPhone and Apple Watch,  which are available in 200 countries and territories, the user can store and share 150 types of  his or her personally-collected health data, as well  data from healthcare institutions in the UK, the US, and Canada.
·      Having collaborated with Stanford Medicine on  the « Apple Heart Study », the largest (419,297 patients!) clinical study known to date, and devoted to the detection of AFib), Apple has also completed studies in women’s and ear health using the same model.
·      The « HealthKit API » or application programming interface from Apple is  now included in tens of thousands of partner apps  et, according to Apple, this reduces the time required for executing clinical trials.
·      90% des nurses in main healthcare establishments in the US use the iPhone to manage clinical communication.
·      Apple manages 55 Apple Watch wellness programs in companies in 17 countries.

Amazon pursues its US-oriented healthcare strategy and acquires the One Medical care network.

Amazon already owned and managed several healthcare activities : PillPack, Amazon Care, et Healthlake, which the One Medical acquisition complements. 

• In May 2018, Amazon acquired PillPack, an online pharmacy for the US, which delivers medicines directly to the patient’s address.  According to the AHA (American Hospital Association), the US prescription pharmaceutical market is worth US$500 B and Pillpack clients spend $ 5000 ( !)  annually, whereas  for Amazon Prime clients the annual budget is “only” $1300 per year on average.
• In September, 2019,  Amazon launched Amazon Care a hybrid or virtual + in person healthcare program for its own employees, and subsequently for some of the largest employers in the US.  This is an ambitious program, to reach all US employers providing healthcare insurance to employees ( a legal requirement although executed with great variations). This employee service which had begun in  Seattle at Amazon headquarters is now available  nationally with the in-person piece present in 20 US cities.
• In July, 2021, Amazon launched Healthlake[2], a service which manages patient data including images and facilitates retrieval in a health record type of concept.  Amazon HealthLake is HIPAA  compliant, offering healthcare organizations and life sciences companies the ability to extract a 360° view of an individual’s health data, as well as to perform large-scale requests and analysis on health data.

Accessing care “when, where, and how” the individual wishes…thanks to Amazon…?

One year later, on July 21st, 2022, the vice-president of Amazon Health Services announced [3] the news of Amazon’s US$3,9 B acquisition of the One Medical healthcare network,, afin in order to give all (US-based) Amazon clients the possibility of accessing healthcare where, when, and how they wish.   One Medical is a website and a mobile app, which for a US$199 annual subscription opens the possibility for the user to access services including teleconsults, appointment-making, and prescription management from his or her online health record. Headquarters of One Medical are in San Francisco, with 72 in-person doctors’ offices around the US.

Opinions on the acquisition are mixed. What economies of scale can Amazon make on doctors’ offices, other than software and some admin? How will Amazon, a mega-business be able to establish the kind of ethics required of a physician’s office? Overall, the combination of Amazon and complete personal health data is a “terrifying” perspective for those concerned about patient data confidentiality. As one US witness said, “Amazon just purchased my doctor’s office. I give Amazon one month to convince me to stay, or I’ll go find another doctor.”[4].

By the way, One Medical is still losing money, but the number of subscribers is rising. Alphabet (Google) was among the early investors in One Medical. Hmmm.

Denise Silber

[1] https://www.apple.com/newsroom/pdfs/Health-Report-July-2022.pdf
[2] https://aws.amazon.com/healthlake/faqs
[3] https://press.aboutamazon.com/news-releases/news-release-details/amazon-and-one-medical-sign-agreement-amazon-acquire-one-medical/
[4] https://www.washingtonpost.com/technology/2022/07/22/amazon-one-medical-privacy/