One Medical deal gives him access to my most private information

For the better part of a decade, One Medical has been my primary care provider. It’s convenient, with locations around the Bay Area, and I love being able to schedule a same-day appointment or get a quick referral to a specialist.

A medical knows a lot about me. In addition to years of clinic visits and virtual chats, I use the mobile app to record my resting blood pressure and heart rate, check my lab results, and refill prescriptions as needed. For this I pay a membership fee of $199 per year.

But I never considered the possibility that Amazon might one day own One Medical.

The same company that sends me countless boxes every week, loads my Kindle with book recommendations and my smart TV with movie suggestions, tells my kids the weather when they call Alexa, and offers major discounts when I shop at Whole Foods , is about to provide my medical services and I own the portals containing my most sensitive information.

I’m not the only person who had that deeply troubling thought Thursday after waking up to the news that Amazon had agreed to buy One Medical for about $3.9 billion. At $18 a share, Amazon is paying a 77% premium to the primary care company’s price a day earlier.

As one member wrote on Twitter, “After a generally positive experience with One Medical, I canceled my membership today. I don’t trust Amazon to act in good faith with my health data.”

Founded in 2007 and based in San Francisco, One Medical offers clinical services in 16 U.S. markets, with three more coming soon, according to its website. At the end of last year, the company had 736,000 members.

Amazon did little to assuage my fears with its acquisition announcement. The company said nothing to put One Medical customers at ease, and there was no conference call to discuss the acquisition, as is common in many large transactions. Completion of the transaction will require regulatory approvals.

In response to an inquiry for this story, Amazon offered the minimum level of assurance that it would comply with government regulations under the Health Insurance Portability and Accountability Act (HIPAA), which limit how the company can use protected health information, or PHI. This includes all personal information as well as medical history, laboratory test results and other health data.

“As required by law, Amazon will never share the personal health information of One Medical customers outside of One Medical for the advertising or marketing purposes of other Amazon products and services without express authorization from the customer,” an Amazon spokesperson said in an email. “If the transaction closes, One Medical’s customers’ HIPAA-protected health information will be handled separately from all other Amazon businesses, as required by law.”

In other words, everything One Medical knows about me must stay in this secure silo. Whatever profile Amazon has built on me and my family, from our shopping habits and travel preferences to the shows we watch together on the weekends, won’t mix with my health data.

Despite the laws, Amazon will have to work hard to convince consumers — and possibly politicians — that its intentions are pure and its main goal is to help “drastically improve the healthcare experience over the next few years,” as Amazon Health Services’ Neill leads Lindsey was named in the news release announcing the deal.

After all, alongside its massive retail and cloud divisions, Amazon has built a hugely profitable advertising business that generated more than $31 billion in revenue last year and grew 58%. Most of that money comes from brands paying big bucks to promote their products on Amazon properties, where the competition for eyeballs is getting more expensive.

According to Insider Intelligence, Amazon controls roughly 13% of the US online ad market, trailing only Google and Facebook.

“I don’t think Amazon can do anything to get people to trust the company with their health information,” said Caitlin Seeley George, campaign director for Fight for the Future, an advocacy group focused on technology and digital rights. .

Seeley George said in an email that the issue of health privacy is especially important after the Supreme Court overturned Roe v. Wade, which ended the constitutional right to abortion. Some reproductive health decisions that until recently were protected by law can now potentially be considered illegal.

Amazon has already restricted sales of emergency contraception pills after demand spiked following the Supreme Court ruling. And Google said it will work to quickly delete location history for people who visit abortion sites.

“Continuing in health care raises some serious issues, especially in a post-Roe reality where people’s data can be used to criminalize their reproductive health decisions,” Seeley George said.

Seeley George also wondered whether, outside of HIPAA regulations, Amazon could launch a fertility or mental health tracking app and collect information that “could be used to make assumptions about an individual that could be used against them.” .

Amazon already has a health tracker called Halo that collects information like body fat percentage, activity levels and sleep.

Techno-optimists would probably scoff at such cynicism. The status quo in health care is miserable. Systems are old and don’t talk to each other, billing is proverbially opaque and complicated, and medical care is ridiculously expensive.

Amazon has been entering the healthcare space for years, recognizing the system’s many flaws and inefficiencies and trying to offer better care to its massive employee base, which jumped to 1.6 million last year from 1.3 million in 2020.

Amazon bought online pharmacy PillPack in 2018 for $750 million and launched Amazon Pharmacy two years later. The company invested in a telehealth service called Amazon Care, which launched as a pilot for some employees in 2019 and is now available for other employers to offer as a service to their staff.

Deena Shakir, a partner at venture firm Lux Capital and an investor in numerous health-tech startups, noted that for Amazon, this “isn’t their first health care rodeo.”

“Amazon is very aware of how to address HIPAA considerations and has experience with multiple products with this,” Shakir wrote in an email. This type of deal “should encourage additional partnerships between larger companies and major players in health technology,” she wrote.

Shakir’s firm is an investor in Carbon Health, which offers primary care and urgent care in 16 states. The company serves about 1.1 million patients and, compared to One Medical, tends to target less affluent demographics.

Carbon Health CEO Eren Bali agrees with Shakir that Amazon is severely limited in how it can use the data. Compared to other big tech companies like Facebook and Google, he says Amazon gets quite a lot of trust from consumers.

But Bali understands why there might be concern. Medical services companies have a huge amount of personal data, including social security numbers, driver’s license numbers and insurance cards in addition to all the health information in their systems. Patients are much more likely to disclose personal information to doctors and nurses than to other types of service providers.

And while there are strict regulations on how this data can be used, consumers may reasonably ask what happens if a company like Amazon breaks the rules.

“Unfortunately, there are no strong technical solutions to enforce data access, which is a major weakness,” Bali said in an interview. Whether patients should worry about that is “a personal decision,” he said.

Bali is generally optimistic about Amazon’s leap into the space. When Amazon makes a big announcement signaling its arrival in an old market with big incumbents, existing players find themselves forced to take action to avoid being wiped out, Bali said.

He cited Amazon’s purchase of PillPack as an example. Although Amazon has struggled to gain traction in the pharmacy business, entering the market has led companies such as Walgreens and Walmart to strengthen their digital offerings in ways that benefit consumers, Bali said. The One Medical deal could similarly spark improved products and services in the primary care world.

“Big companies usually don’t feel threatened by small startups,” Bali said. “But they are really threatened by Amazon.”

— CNBC’s Annie Palmer contributed to this report.

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