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One medical deal gives him access to my most private information.

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One medical clinic

One Medical

For the better part of a decade, One Medical was my primary healthcare provider. It’s convenient, with Bay Area locations, and I like being able to schedule a same-day physical or get a quick referral to a specialist.

One Medic 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 test results, and update 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 stuffs my Kindle with book recommendations and my smart TV offers movies, tells my kids the weather when they call Alexa, and offers Prime discounts when I shop at Whole. Foods is going to provide my medical services and own portals containing my most sensitive information.

I’m not the only person to have such disturbing thoughts on Thursday after waking up to find out that Amazon agreed to buy One Medical for about $3.9 billion. At $18 per share, Amazon is paying a 77% premium on the price the primary health care company estimated a day earlier.

As one member tweeted, “After a generally positive experience with One Medical, I canceled my membership today. I don’t believe Amazon will act in good faith with my health data.”

Law and customer trust

Founded in 2007 and based in San Francisco, One Medical offers clinical services in 16 US 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 allay my concerns by announcing its acquisition. The company didn’t say anything to comfort One Medical’s customers, and there was no conference call to discuss the acquisition, as is common in many major deals. The deal will need regulatory approval to close.

In response to a query about this story, Amazon offered a minimum level of assurance that it will comply with government regulations under the Health Insurance Portability and Accountability Act (HIPAA) that restrict the company’s use of protected health information, or PHI. . This includes all personal information as well as medical history, lab results, and other health data.

“As required by law, Amazon will never share personal health information about One Medical customers outside of One Medical for the purposes of advertising or marketing other Amazon products and services without the express permission of the customer,” an Amazon spokesperson said in an email. “If the deal closes, One Medical’s HIPAA-protected customer 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 remain in this secure bunker. Whatever profile Amazon builds about 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 go to great lengths to convince consumers – and probably politicians – that its intentions are pure and its main goal is to help “significantly improve the quality of healthcare over the next few years,” as the head of Amazon Health Services Neil Lindsay. says the message announcing the deal.

After all, along with its giant retail and cloud divisions, Amazon has built a highly profitable advertising business that generated over $31 billion in revenue last year and grew by 58%. Most of that money comes from brands paying big bucks to promote their products on Amazon sites, where the competition for attention is getting more expensive.

According to Insider Intelligence, Amazon controls approximately 13% of the online advertising market in the US, second only to Google and Facebook.

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

Seeley George said in an email that the issue of health privacy is particularly important following the Supreme Court’s overturning of Roe v. Wade, which ended the constitutional right to abortion. Some reproductive health decisions that until recently were protected by law now have the potential to be considered illegal.

Amazon has already restricted sales of emergency contraceptive pills after a surge in demand following the Supreme Court ruling. And Google said it would work to quickly remove location history for people visiting abortion sites.

“Moving forward in healthcare raises serious concerns, especially in a post-Roe reality where people’s data could be used to criminalize their reproductive health decisions,” Seeley George said.

Seeley George also wonders if Amazon, in addition to HIPAA rules, could roll out a fertility or mental health tracking app and collect information that “could be used to create insinuations about a person that could be used against them.”

Amazon already has a health tracker called Halo that collects information such as body fat percentage, activity level and sleep.

“Not Their First Rodeo”

Techno-optimists are likely to laugh at such cynicism. The status quo in healthcare is deplorable. Systems are outdated and do not interact with each other, billing is notoriously opaque and complicated, and medical care is ridiculously expensive.

Amazon has been advancing in healthcare for years, acknowledging the system’s many shortcomings 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 is investing in a telemedicine service called Amazon Care, which was launched as a pilot for some employees in 2019 and is now available to other employers as a service to their employees.

Dina Shakir, a partner at venture capital firm Lux Capital and an investor in numerous health tech startups, said this is “not the first healthcare rodeo for Amazon.”

“Amazon knows very well how to handle HIPAA considerations and has experience with multiple products,” Shakir wrote in an email. A deal of this type “should spur additional partnerships between big companies and big players in the healthcare technology space,” she wrote.

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

Analysts say Amazon is poised to destroy the $934.8 billion global pharmaceutical industry.

Tablets

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, Amazon has a lot of consumer confidence, he said.

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

And while there are strict rules for using this data, consumers might reasonably ask what happens if a company like Amazon breaks the rules.

“Unfortunately, there are no reliable technical solutions to provide access to data, which is a big weakness,” Bali said in an interview. Whether patients should be concerned about this is a “personal decision,” he said.

Bali is generally optimistic about Amazon’s jump into space. Bali said that when Amazon makes a big announcement about its entry into an old market with big actors, the existing players are forced to act in order not to be wiped out.

He cited Amazon’s purchase of PillPack as an example. Bali said while Amazon has struggled to catch on in the drugstore business, the market entry has pushed companies like Walgreens and Walmart to expand their digital offerings in a way that benefits consumers. The One Medical deal could also lead to improvements in primary health care products and services.

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

— Annie Palmer of CNBC contributed to this report.

WATCH: Amazon deal with One Medical is part of an “options package”

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