Designing Health Tech Tools for Atul (Part 2 of our coverage on the new Amazon, Berkshire Hathaway, JPMorgan Chase Venture)

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Now that we’ve given you a primer on Atul Gawande, we want to dig more into the company he’ll be heading and offer insights on aligning with this upcoming venture.  (If you missed our introduction to Atul, we strongly suggest you go back and read why we’re so excited.)


What we know:

Bezos, Buffet, and Dimon are still very tight-lipped about the venture, but have divulged that it will be a company aimed at providing health care to their employees. Their motives seem to be both ideological and financial. The company, which they describe as “free from profit-making incentives and constraints,” will attempt to provide both better services and more manageable costs for their health care.


It’s no surprise that another group is taking aim at health care in the US; the country spends more than 17% of its GDP on care but doesn’t achieve the same health outcomes as many other nations. If you’re reading this, chances are you already know what’s broken, and that there are many ideas on how to fix the health care system, but that no one has yet managed to solve the problems on a large enough scale to make a difference nationally.


Already we see the venture beginning to take shape. Yesterday Amazon announced the acquisition of online pharmacy PillPack, a Boston-based company (with pharmacy licenses in all 50 states) that offers pre-sorted and dosed packages of medications shipped to customers’ homes with options to refill and renew prescriptions. This move fits Amazon’s pattern for disrupting the industries it enters by streamlining the supply chain, and we can glean insight into the direction of its new venture based on the company’s history.


What this means for patients:

It almost goes without saying that Amazon is known for disrupting industries. The company has solved the world’s biggest supply chain problems and shaken up competitors from online sales to cloud infrastructure services, artificial intelligence to, most recently, groceries with the acquisition of Whole Foods last summer. As the largest provider of cloud infrastructure services, they stand poised to scale any technology they develop immediately. Also a trailblazer in AI, they could lead the shift toward connected health. And Bezos will guide the company toward efficiencies even if it means cannibalizing current companies along the way. For the health care patient frustrated with inefficient and rising costs, this is a great thing.


Health care in the US is a difficult-to-follow supply chain managing the flow of goods, data, diagnoses, medicine, money, and more. It’s not always clear who the customer is- from a pharmaceutical perspective, doctors are the customer as much as the patient because they need doctors to prescribe their products. After surgeries or major medical expenses, hospitals negotiate pricing with insurance companies rather than the patients receiving care.


Amazon, alongside other heavy hitters like Google or Facebook, maintains its dominance through data. They make sure they know who their customer is, what goods that customer is interested in, when a product is ordered, when it arrives, and if the customer was satisfied. The potential uses for such data harnessing in health care are massive: given a specific person with a specific medical history, what devices or medications are they likely to need or want?


What this means for the health tech developer:

With Atul at the helm, these business titans will be looking for the most cost effective way to provide good health care. Practically, that means they will begin gathering data or looking for people to gather data better for them with the ultimate goal of simplifying data collection.


Certainly there are inefficiencies to be found. Some hospitals and clinics still don’t use electronic health records, and the ones that do aren’t connected in a useful way. Today the fax is our standard for communication of a person’s medical history, but technologies like block chain could be the next step toward totally decentralizing health record transmission.


Traditionally, health data is generated sporadically by a doctor or health care provider during visits that occur mostly at the patient’s discretion, and the player that ends up with the largest swath of medical data is the insurance company. Many insurance companies are working to leverage this data to grow the margin between cost of care and profitability, and they are looking for developers to help them provide high quality care at lower costs. Throwing more data into the mix, the advent of smartphones, wearables, and IoT devices could give doctors unprecedented access to continuous health monitoring outside the office.


In discussing his reasoning behind the venture, Dimon has emphasized the impact of incentivizing people toward wellness to reduce the development of serious (and expensive) illnesses. We read this as an obvious call for products, especially apps, that emphasize fitness tracking, diet, nutrition, and other healthy lifestyle behaviors. Today’s health tech developers are focused on getting more data in a more novel way than their competitors in order to attract medical device, health technology, and health care companies like the Amazon/ Berkshire Hathaway/ JPMorgan Chase venture. Developers should look to incorporate national data policies and standards within their plans; leveraging such policies and standards to promote interoperability of data can make or break scalability for new apps or software.


What we hope:

Though traditionally health insurance companies pay for health care, Amazon, Berkshire Hathaway, and JPMorgan Chase are major employers who can throw their weight with big insurance. Under Atul’s guidance and with Amazon’s business model, they will no doubt be seeking out data in order to identify and eliminate inefficiencies in health care delivery. With both money and influence behind the project, they have the option to micro-target individual inefficiencies or make changes on a grand scale to disrupt the health care industry in the US for good.


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