Amazon Makes Big Play into Health, Diagnostics

Tech giant offers grants for COVID-19 testing and other diagnostic tests, adds primary care services

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CEO SUMMARY: Amazon is prepared to award $12 million in grants and is soliciting proposals for developing diagnostic technologies for detecting SARS-CoV-2 and other infectious diseases. This is the latest indication that the multi-billion-dollar enterprise would like to disrupt healthcare in the United States. Amazon has built clinical labs to provide COVID-19 testing to its one million employees. It is now collaborating with a primary care provider to establish clinics near its distribution centers, and these are just a few of its activities involving clinical care.

EVIDENCE CONTINUES TO BUILD that Amazon wants to become a big and disruptive player in healthcare. Significantly, there is growing evidence that clinical laboratory testing is one element in this company’s strategic plans. 

Given Amazon’s track record at disrupting one industry after another since its founding in 1994, this is a threat that clinical laboratory administrators and pathologists should take seriously. 

Just last month, Amazon announced that it would distribute $12 million this year to fund COVID-19 testing and to pay for diagnostic assays for other infectious diseases. In its announcement on April 12, Amazon said it was launching the next phase of its Amazon Web Services (AWS) Diagnostic Development Initiative (DDI), a project it started in March 2020. 

In addition, the tech giant has developed a partnership with Crossover Health, a company in San Clemente, Calif., that provides primary care, mental health, and other healthcare services to self-insured employers and health plans. 

Under this partnership, Amazon and Crossover will develop health centers near Amazon’s fulfillment and operations centers. These health centers will provide primary care and other health services to Amazon employees. (See sidebar below). 

In addition, since the start of the pandemic, Amazon has built clinical laboratories near its distribution centers. These lab facilities provide SARS-CoV-2 testing for its almost one million employees. (See, “Amazon Building Labs to Do COVID-19 Testing,” TDR, Aug. 3, 2020.) 

Operates Its Own Labs

With Amazon operating its own clinical labs for COVID-19 testing, the Diagnostic Development Initiative project serves as a case in point in assessing the company’s plans to be disruptive in healthcare. According to announcements from Amazon, the AWS DDI effort is designed to accelerate research and innovation and to promote the development of testing for the SARS-CoV-2 coronavirus that causes COVID-19. 

Amazon also said the DDI is designed to accelerate research and innovation to advance the collective understanding and detection of COVID-19 and other infectious diseases in an effort to mitigate current and future outbreaks. 

In its announcement of the DDI last year, Amazon said it would invest $20 million over two years in diagnostic-related projects from accredited research institutions and private entities that use AWS. The funds are to support research for such work as molecular, genetic, and other testing projects that generate vast amounts of data requiring extensive storage on the web. 

Diagnostic Technologies

Notably, Modern Healthcare reported that funding provided by Amazon could be used for research-oriented projects aimed at developing point-of-care testing that consumers could do at home or that could be used in health clinics to produce same-day results. 

Of that initial $20 million in grants, AWS invested $8 million in a variety of companies and organizations to develop molecular tests and data analytics tools that use artificial intelligence and machine learning to detect the SARS-CoV-2 coronavirus. The company also invested in diagnostic imaging and wearables. 

Now, the company is preparing to review applications for the remaining $12 million and is accepting proposals at www.aws.amazon.com from clinical diagnostics companies, research institutions, and other organizations. 

This year, AWS said it is particularly interested in early disease detection to identify outbreaks at the individual and community levels, tools that can be used to understand disease trajectory, and efforts to bolster viral genome sequencing worldwide. Among the projects the company will consider from diagnostic testing companies and other institutions are proposals in four areas:

Diagnostics. In this category, eligible projects could include molecular tests for nucleic acids or tests for antibodies and antigens. Other projects in this category could include imaging diagnostics, methods that put connected medical devices such as wearables to use, and predictive analytic tools such as artificial intelligence and machine learning systems.

Early disease detection. In this category, eligible projects include early warning systems for outbreaks; connected medical devices such as stethoscopes, devices for electrocardiograms and for measuring oxygen levels in patients’ blood; and wearables that can detect pre-diagnostic factors such as body temperature associated with infections or potential outbreaks.

Public health genomics. In this area, eligible projects can include efforts to sequence viral genomes, initiatives to conduct viral genomic surveillance, and sequences made available on open data systems.

Prognosis. In this category, eligible projects could include tools that would assess or analyze a patient’s molecular factors, such as genetics, inflammatory response, metabolism, or co-morbidities. Other projects include those that report on a patient’s ethnic, demographic, or socioeconomic factors, which could be useful in guiding treatment to improve patient outcomes.

The initiative’s top priority is to evaluate COVID-19 diagnostic projects. However, Amazon said it also will review projects focused on other infectious diseases.

Transformative Innovations

“We have seen transformative innovations in how we diagnose disease over the past year, from machine learning-powered X-ray imagery analysis to new developments in rapid, high quality, and direct-to-consumer tests,” said Vin Gupta, MD, Chief Medical Officer of Amazon’s COVID-19 Response. Gupta also is an Affiliate Assistant Professor of Health Metrics Sciences at the Institute for Health Metrics and Evaluation (IHME) at the University of Washington, according to his LinkedIn profile. 

“We have already seen inspirational results from the Diagnostic Development Initiative, and we look forward to supporting broader uses of cloud technologies to enable organizations and communities to identify and respond even faster to future outbreaks,” he added.

In one DDI-funded project, Illumina used next-generation sequencing to improve the identification of viral mutations. Illumina uses a variety of Amazon services on the web to keep its computing and storage costs low. 

In another DDI-funded project, researchers at the Stanford University School of Medicine developed a smartwatch-based diagnostic system that flags signs of a person’s immune system fighting a potential COVID-19 infection. 

The Stanford researchers aim to increase the system’s ability to detect signs of COVID-19 in real time. 

Can Amazon’s Moves Involving Health Services Be a Plan to Become a Healthcare Behemoth?

IN 2020, AMAZON FORMED AN ALLIANCE WITH CROSSOVER HEALTH to launch health centers near its fulfillment centers and operations facilities. Crossover Health specializes in delivering primary care, mental health services, and other forms of care in neighborhood health centers to serve Amazon workers and their family members in Detroit, California, Dallas-Fort Worth, Phoenix, and Louisville, Fierce Healthcare reported in March.

Since beginning their partnership last year, the two companies have started 17 health centers to provide services to more than 115,000 Amazon workers and their dependents after the program started late last year. The companies say they offer “full-spectrum acute, chronic, and preventive primary care, same-day pediatrics, prescriptions, vaccinations, behavioral health services, physical therapy, health coaching, and care navigation for specialty referrals and diagnostic services,” Fierce added. “Crossover fully operates and staffs the centers and also provides virtual care to employees.”

More than 75% of Amazon’s workers in the United States are within 10 miles of one of these centers, the companies said.

Founded in 2010, Crossover works to cut employers’ healthcare costs by ensuring that workers get well-coordinated care aimed at improving outcomes and reducing costs. One of its earliest customers was Apple. Later, it added Microsoft and LinkedIn. 

To optimize availability and access to care, each center operates on extended hours during the workweek and weekends and offers 24-7 on-call services to accommodate the various employee work and family schedules. 

Crossover also is registering to be a vaccination provider participating in the U.S. COVID-19 Vaccination Program. Once registered, Crossover will be able to administer state-supplied vaccines to Amazon employees who meet eligibility criteria based on state and local health agency guidelines, the company said.

“Access to convenient comprehensive primary care is essential for all employees and we are proud to see the Neighborhood Health program with Amazon continue to expand throughout the country,” said Sally Larwood, RN Chief Nursing Officer at Crossover Health, in a statement.

Last year, Amazon announced it was working with another primary care company, called Care Medical, to develop a virtual health benefit service for employees and their families in the Seattle region called Amazon Care. In this program, the company aims to offer virtual and in-person visits at patients’ homes or offices, as well as prescription delivery. 

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