November 30, 2022 – Amazon is encouraging patients to “skip the waiting room” with the launch of Amazon Clinica virtual health care service that aims to offer treatment for nearly 2 dozen common health conditions.
Taking a step beyond a typical telehealth visit, the service promises personalized treatment with no appointments, video calls, or live chat. Patients can answer questions about their symptoms and health history to receive a treatment plan and prescription medication through a messaging platform.
The new service could fill the gap for people who want a quick answer, have a history of a condition, or need to address common issues such as seasonal allergies or dandruff.
“During the pandemic, the use of telehealth accelerated throughout the country. Although face-to-face visits are returning, telehealth certainly still has a role, especially in areas with less medical care, and can enable faster diagnosis and help with tracking disease progression,” says Edwin Takahashi, MD, a radiologist at the Mayo Clinic who has studied recent telehealth benefits and challenges.
“I think Amazon Clinic is an innovative approach to health care delivery,” he says. “I’m interested to see its impact in society and on patients. It’s so new that we need to see what its role will be in the future of health care.”
How It Works
To start, patients select one of the common conditions – such as acne, heartburn, or sinusitis – and then choose an online clinic that will review their case. After completing a questionnaire, patients receive a treatment plan from a US-licensed health care provider, which may include a prescription or recommendations for over-the-counter treatments and self-care strategies.
Users can message the provider with follow-up questions after receiving the treatment plan at no additional cost for up to 14 days. Based on the information provided, the provider may also recommend seeing a health care professional in person.
For now, most conditions appear to be served by two clinics – HealthTap and SteadyMD – for $30 to $40. Depending on the day and time, the clinics have a listed response time of 1 hour to several hours.
What to Consider: The Benefits
The service allows users to start a visit quickly and discreetly, at whatever time works best for them, with no need to speak to anyone. Amazon promises that the health data is secure and protected by law.
Amazon Clinic also offers prescription renewals for common medications that treat asthma, high blood pressure, high cholesterol, hypothyroidism, and migraine. The health care provider can’t prescribe new medications, change medication doses, or order lab testing, but this option may be useful for people who simply want to re-up their current regimen.
“Every telehealth provider on Amazon Clinic has gone through rigorous clinical quality and customer experience evaluations by Amazon’s clinical leadership team,” Nworah Ayogu, MD, chief medical officer and general manager for Amazon Clinic, said in an announcement.
“We believe that improving both the occasional and ongoing engagement experience is necessary to make care dramatically better,” he said. “We also believe that customers should have the agency to choose what works best for them.”
What to Consider: The Limitations
Amazon Clinic is available in 32 states, with plans to expand in the coming months. Users can check the services offered in their state, the prices, and the response times by clicking on one of the common conditions. Certain health issues require a prior diagnosis, including eczema, genital herpes, and rosacea.
Amazon Clinic does not accept health insurance at this time. Instead, patients pay a flat fee for the service they choose, which they can pay for by using a flexible spending account (FSA) or health savings account (HSA) debit card, submitting a receipt to their insurer for reimbursement, or funding out- of-pocket. (Amazon Clinic isn’t intended for those who receive coverage from federal or state health care payers, such as Medicaid and Medicare.)
The cost of medication is not included in the cost of the visit. Health insurance plans may cover the prescriptions, but Amazon advises talking to an insurer or pharmacy directly about any questions.
“This service provides value for some people — for young and healthy patients who want to be checked out for a low-risk, straightforward issue,” says Graham Walker, MD, an emergency physician in San Francisco. Walker co-founded MDCalc, a virtual medical reference tool for health care providers.
“However, my main concern is that it’s not a solution for certain populations or the way that health insurance works in the US,” he notes. “When the health concerns are more complex, involve other medical problems, or require new medications, it’s hard to provide a quality consultation.”
The Future of Telehealth
Doctors and health care organizations are weighing the pros and cons of telehealth as the health care industry pivots around pandemic-related changes. In November, the American Heart Association issued a new statement that highlighted telehealth as an effective option for care but pinpointed access barriers that may limit widespread use.
For instance, Takahashi and colleagues found that telehealth can reduce costs, improve access to care in rural and underserved areas, and increase care quality and patient satisfaction. At the same time, telehealth offerings are often hindered by inconsistent reimbursement, state licensing requirements, inconsistent internet access, and challenges in scheduling. Limited uptake based on age, technology expertise, and personal perceptions can also play a role – for both patients and health care professionals. Privacy and security concerns factor in as well.
“Spurred by the COVID-19 pandemic and the adoption of innovative technologies, the US health care system is transitioning to a new era of digitally enabled care,” says Jack Resneck Jr., MD, president of the American Medical Association.
Since 2016, doctor use of technology to provide remote care has accelerated by more than five times, with 80% of doctors offering televisions or virtual visits, Resneck says, based on a recent American Medical Association survey.
“Patients have come to rely on telehealth and overwhelmingly support continued access, yet this access is jeopardized if health plans discontinue coverage or payment for telehealth or make it harder for patients to access telehealth from their established physicians who know them well and can integrate their care ,” he says.