Alexa may be key to Amazon’s looming domination of the healthcare market

Alexa, how do I become a health ‘entrepreneur’?

Amazon announced its latest move in this direction last week by introducing a feature that allows British users of its Alexa digital assistant to seek medical advice, with responses provided by Britain’s National Health Service. For example: “Alexa, how do I treat a migraine?”

American Alexa users can now receive general health information from companies like WebMD and Mayo Clinic. But Amazon’s deal with Britain’s state NHS appears to be more treatment-oriented and raises the possibility of similar US ties to Medicare, private insurers or hospital chains.

The partnership with the NHS also highlights Amazon’s unique position in the ability to collect and act on sensitive medical information from Alexa users as a global leader in e-commerce.

This is, to put it simply, new territory.

“It’s the new world of the unimaginable consequences of fledgling technology,” said Anita Cava, a law professor at the University of Miami.

She stated that the Health Insurance Portability and Accountability Act, also known as HIPAA, the federal medical privacy law passed in 1996, never anticipated a scenario where individuals would voluntarily disclose confidential medical information to a private company through from a voice-activated computer in your living room.

“HIPAA does not apply to Amazon in this situation,” he said. “Amazon has no relationship with Alexa users as a healthcare provider. In theory, the company could do almost anything with that information. “

Which begs the key question: What could I do?

An Amazon spokeswoman in Britain, who requested that her name not be published, said of the NHS deal that “all information is treated with high confidentiality.”

“Amazon does not share this information with third parties,” he said, “nor does it sell products or make product recommendations based on that health data, nor does it create a health profile on customers.”

Not yet, in any case.

Many observers say it’s only a matter of time before data-driven Amazon starts mining this trove of medical information from Alexa users for commercial purposes.

“I hope this contributes to Amazon’s growing share of the healthcare market,” said Jodyn Platt, assistant professor of health sciences learning at the University of Michigan.

Amazon last year bought a San Francisco-based online pharmacy called PillPack. Since then, PillPack mail order facilities nationwide have been licensed to sell in most states.

Wall Street analysts have speculated that Amazon aims to gain experience selling drugs online by first meeting the healthcare needs of the company’s hundreds of thousands of employees. Then you will begin filling prescriptions for your millions of American customers.

Does anyone really think that Amazon CEO Jeff Bezos would ignore the valuable health data that Alexa users enter his company’s servers?

“Jeff Bezos is not a charitable soul,” said Cava of the University of Miami. “He is an entrepreneur. That’s what he does. “

Britain’s NHS, the country’s leading healthcare provider, says its link to Alexa can provide quick answers to questions like “Alexa, what are the symptoms of chickenpox?”

That sounds relatively benign. Now consider the possible ramifications of questions like “Alexa, what are the warning signs of a heart attack?” or “Alexa, how can I control the blood sugar level of diabetics?”

Or “Alexa, how do I know if I have hepatitis?”

Or “Alexa, how do I know if I have a mental illness?”

These questions, and the possible conditions they reveal, would be of great interest to insurers and employers.

They would also be appreciated for what could soon be the largest pharmacy in the world.

“This information we’re talking about is powerful,” said Craig Klugman, a professor of health sciences at DePaul University. “Personally, I would never share such information with an intelligent voice system. I wouldn’t trust it. “

I asked the Amazon spokeswoman if the company intends to use the information gleaned from user inquiries in Britain for potential online drug sales.

“There are no plans to do that,” he replied, a response that does not entirely reject such a prospect.

Kerry Hall, an Amazon spokeswoman from the company’s Seattle headquarters, said of the NHS deal that “we are always looking for ways to add more information to the Alexa knowledge graph, and this is just another example of that.”

He declined to answer my questions about whether a similar agreement could be reached with Medicare or other US health care entities.

He also declined to address how that data could influence an Amazon online pharmacy.

The US healthcare industry has been characterized for years by relentless consolidation. A recent development has been the establishment of ever closer links between insurers and pharmacies as a way to address rising pharmaceutical costs.

CVS Health’s acquisition of insurance giant Aetna last year suggests guidance on how Bezos might want to improve Amazon’s reputation for one-stop shopping.

In the same way that Amazon Prime promotes, happy Prime Day everyone! – As a way to keep customers loyal to the company, why wouldn’t Bezos want to enhance the value of an Amazon online pharmacy by offering premium health coverage as a way to promote additional savings for customers?

“I can imagine Amazon using the information to target advertising that would lead customers to its own new pharmaceutical company,” Platt said at the University of Michigan. “Amazon may also share the data it obtains from Alexa Health for third-party targeted advertising in the same way that it currently uses personal information.”

Google and Facebook track your every move on their sites. They use that data to learn everything they can about you in the hopes of making you more attractive to marketers. Amazon does that too.

Even if Amazon didn’t share users’ health information with others, it’s hard to imagine the company not trying to make as much revenue as possible for its own businesses.

What responsibilities would accompany such efforts? That is not clear.

What would Amazon do, for example, if an Alexa user revealed suicidal tendencies or was a victim of abuse? Would the company alert the authorities? Would you decide that is none of your business?

Amazon workers listen to recordings of Alexa users to enhance the technology’s voice recognition capabilities.

“Sometimes they listen to recordings that they find disturbing or possibly criminal,” reported Bloomberg. “Two of the workers said they caught what they believe was a sexual assault.”

The employees said that after seeking guidance from the company in such cases, they were told that “it is not Amazon’s job to interfere.”

As Cava said, this is a happy world. Eventually, lawmakers will have to move privacy laws into the digital age to address unforeseen uses of medical information.

For now, all we can do is watch Amazon’s healthcare plans unfold.

And keep in mind that for all its genius, this is a company that has never hesitated to mercilessly dominate whatever market it enters.

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