Memo to Amazon: Make the Healthcare System Put Patients First

Published February 2, 2018

Amazon, JPMorgan Chase and Berkshire Hathaway are teaming up to lower healthcare costs. Just the announcement of this dream team of disruption and value creation sent shares of health insurers and pharmacy benefit managers plunging and has everyone speculating about what’s next. Aggressive employers like GE have attempted to reshape healthcare in the past, mostly through direct contracting with providers and pay for performance programs. Usually the impact has been slight given the complexity of changing the $3 Trillion, heavily regulated system. On the other hand, Kaiser, one of the most admired and differentiated health plans in the country, was nurtured by an industrial employer.

Amazon has transformed retail and the healthcare industry is already bracing for the company’s entry. The early consensus is that Amazon will steal share and margin from some of the incumbents. To the company’s credit, CEO Jeff Bezos does not appear to have a fixed view of how to tackle healthcare.

So here’s some free advice to Amazon and its partners: Focus on the patient as a consumer and a vulnerable participant in a system that’s too often stacked against them. Insist that the delivery and payment system take specific actions if it wants the companies’ business.

Here are three ideas:

Mandate self-service scheduling

Treat the average patient at least as well as the typical person looking to dine out.

Restaurants permit diners to use Open Table to book, modify and cancel reservations, but doctors make booking appointments way too hard. When an office offers online scheduling, it’s usually just an appointment request system. Even after entering all sorts of information (contact details, birth date, insurance, medical problem, etc.), a patient will be lucky to receive a return call from the practice and often has to start from scratch, calling the office to book an appointment the old fashioned way and providing all that information again.

The barriers to self-service scheduling are cultural, not technological. Amazon should insist that providers offer self-service. If providers need to add more intelligence to the system to figure out the urgency for the visit or the length of time needed – why not ask the patient? Self-service scheduling is an important step toward shifting healthcare from a provider-centric to a patient-centric mentality.

Introduce a universal patient portal

Make the patient’s job easier. Pretty much every major hospital, physician group and health plan now offers a patient portal that allows patients to review their medical records and lab reports, send messages, and (sometimes) to pay their bills. Unfortunately, that means the typical patient is overwhelmed with multiple portals with varying capabilities, user interfaces and technical requirements. None of them talk to each other. Some are well monitored by the provider or health plan and some are not. When a patient adds a doctor, changes health plans, or changes employers, it’s time for yet another portal.

Is it any surprise that utilization is low and frustration is high?

Amazon should introduce a universal patient portal and make all providers and plans use it. The patient should be allowed to take the portal with them when they change jobs or retire. Next Amazon could work on a common claims insurance claims form but one step at a time.

Improve the quality of provider reviews

Patient voice matters! Reviews help patients choose a doctor or hospital as well as learn how to navigate the system. Existing review sites suffer from limitations such as a small numbers of reviews per provider, lack of confidence in whether the reviews are real, and a shortage of connections to objective quality data. Amazon does an excellent job of integrating customer feedback into its own website, including “verified purchase” to confirm that a reviewer actually bought the product, designation of the most helpful reviewers and reviews, and a forum to ask and answer questions. All of this is included alongside more objective product information and suggestions of similar products.

Amazon’s review approach provides a useful template for patient reviews and could be refined and improved for healthcare use. By encouraging their employees to use the same review platform, and requiring providers to include review information alongside their own doctor listings, Amazon and team could make patient feedback a lot more useful and usable, and make it more likely that providers would take the feedback to heart.

Change is coming but it will not be easy

These three suggestions should be relatively easy to implement, but incumbent hospital systems, health IT companies and health plans will likely resist. Amazon and its partners will need a tough, sustained strategy to make even the simple things change.