The Week in Disruption goes beyond the headlines to uncover the significance of emerging trends in healthcare and beyond.

Amazon makes its healthcare play

While efforts by UnitedHealth and CVS to gain footholds in virtual and outpatient care pose more immediate headaches to hospitals and health system leaders, Amazon’s digital prowess and two-decade-old track record disrupting industries large and small are never far from their minds.

56% of respondents to the 2019 Kaufman Hall State of Consumerism in Healthcare survey cited Amazon as a strong or extreme threat to hospitals and health systems, the third biggest threat behind UnitedHealth/Optum and CVS Health/Aetna. What’s more, 98% of respondents said their organization’s digital experience is inferior to Amazon’s.

Amazon reignited those fears this week with the launch of its pilot Amazon Care virtual medical clinic for Seattle-based employees and their families, in partnership with Oasis Medical. The service offers text chats with nurses for health-related advice, video visits with physicians and nurses, house calls from nurses to homes and offices for exams, tests, and treatments, and door-to-door delivery of prescriptions. For now, the services are available from 8 am - 9 pm on weekdays and 8 am - 6 pm on weekends.

Amazon is not the first business, of course, to contract with a third party to offer telemedicine and virtual care services to its employees. But much like Walmart’s launch of WalmartHealth.com alongside the opening of a single primary care clinic in Georgia earlier this month suggests larger plans in the offing, it’s hard to believe that Amazon Care will focus solely on treating employees—and not the general public—in the years to come.

The dawn of ‘rigorous’ digital health?

In the years following the release of the iPhone and other smartphones, mobile health applications enjoyed a brief moment as the care model of the future, before the reality of a landscape of overwhelmingly wellness- and exercise-focused apps with little clinical value set in.

But a new wave of “digital therapeutics” is hoping to realize the initial promise of mobile health apps with a more clinically oriented focus. CVS Health is now offering Sleepio—an app that offers cognitive behavioral therapy to treat insomnia—to employers as a benefit alongside more traditional prescription therapies. The “Prof,” a cartoon therapist with a Scottish accent, advises users on how to address barriers to improved rest, including scheduling and lifestyle issues. CVS chief medical officer Troyen A. Brennan, MD, recently told the New York Times that Sleepio was picked as the company’s first foray into digital therapeutics precisely because it was backed by rigorous published research.

“It’s important for us as a pharmacy benefit management company, as a big retail pharmacy, to endorse digital therapeutics when they work as good as or better than medications one can take by mouth,” Brennan said.

Promising results for Intermountain telehealth program

As digital health and telehealth services proliferate, many hospitals and health systems are responding to the likes of Amazon and CVS with consumer-friendly, cost-effective options of their own. A recent Journal of Telemedicine and Telecare analysis of Intermountain’s Connect Care telehealth program found the program is less costly than care provided in urgent, primary, or emergency care settings. For the most common diagnoses, virtual care cost $429—or $232 less than urgent care, $278 less than primary care, and $2,974 less than emergency department care. Connect Care charges users, many of whom are insured through Intermountain’s SelectHealth arm, up to $59 per call—and counts about 25,000 visits each year.

"We've invested a lot in this service, primarily as another access point to our patients, with the idea that we can reduce the overall cost of care and help people receive care in a more appropriate setting," Jim Sheets, vice president of outreach services at Intermountain Healthcare, told HealthLeaders.

Innovation at a glance

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Haydn Bush

Haydn Bush

Haydn Bush has two decades of experience as a journalist and communications professional in healthcare and related fields. He currently serves as VP of Thought Leadership.

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