What place do big tech companies have in the healthcare industry?

The world’s five big tech companies—Amazon, Alphabet (Google’s parent company), Facebook, Apple and Microsoft—have had their eye on the healthcare industry for a while. In 2018, Amazon acquired online pharmacy company PillPack for just under $1 billion. In 2015, Apple launched the Apple Watch, which is essentially a wearable healthcare device (apparently it also tells time). Google Cloud just released their new healthcare consent management API. Facebook wants to connect users to healthcare resources. And Apple’s own Health Records System has already been rolled out in several hospitals, allowing patients to plug into their medical records from anywhere.

Most experts see this as the next phase of healthcare evolution. Big Tech and Big Medicine, together at last. Essentially, we’re talking about privatised healthcare with a digital hook, but most people, especially most tech people, won’t use words like ‘privitisation’. They prefer ‘digitsation’, which is an easier pill for consumers to swallow. Everyone wants healthcare to be tech-savvy, efficient and informed by the best science. ‘Private’ healthcare is a little murkier. But this sort of model—big tech companies driving healthcare innovation—is happening, whether we like it or not.

So, the big question: is this a good thing?

Let’s look at some of the advantages first. Big tech companies do handle some things much better than governments. Innovation, for starters. Private companies are financially incentivized to innovate, and each tech giant brings its own particular expertise to healthcare. For Apple, it’s consumer goods and data collection. For Amazon, it’s supply chain logistics and cloud-based services. For Facebook, it’s building communities and connecting people.

Take the Apple Watch, for example. It’s hard to imagine a government ever producing what is (essentially) the world’s most powerful and ubiquitous health monitoring device. The Apple Watch might look trivial, but it represents a huge leap forward in the way healthcare handles patient data. For starters, it puts that data in the hands of patients (Apple’s CEO, Tim Cook, famously said Apple wants to “empower people to own their own health”). Apple can also share biometric data with medical practitioners, hospitals and clinical trials, building a picture of community health that would have been unthinkable 10 years ago. The company is leading some of these trials themselves, partnering with prominent research institutions to study gynecological conditions, heart rate, patient mobility, and hearing loss. A strange tangent for the brand that invented the iPod…or perhaps not.

“With the Apple Heart Study, we found that we could positively impact medical research in ways that help patients today and that make contributions that will benefit future generations,” said Jeff Williams, Apple’s chief operating officer. “Today’s announcement carries our commitment to health even further by engaging with participants on a larger scale than ever before.”

This stuff really matters. Over 17 million people die each year from cardiovascular disease, about 31% of all premature deaths worldwide. Imagine a watch that would constantly monitor your heart, and seamlessly synch that information with your GP, or local hospital, in real time—there’s a genuine potential to save millions of lives. The Apple Watch has already been shown to be comparable in accuracy to clinical heart tests, and you’d expect those numbers to improve over time.

Even the most ardent traditionalists would have to admit that the healthcare system could be faster, simpler and more accessible. And those are three things that tech companies do quite well. The opportunities are pretty much endless: broad-scale telehealth delivery, better medical supply logistics, faster healthcare payments, precision medicine, backed by world-leading AI, remote patient monitoring. The list goes on and on. Google has already unveiled a cloud-based AI that will help researchers trawl through medical records. And Amazon is going one step further, launching Amazon Care, a 24/7 virtual healthcare network that covers telehealth, in-home appointments and contact-free prescriptions (Amazon Care’s website promises to help patients “skip the waiting room”).

Of course, there are serious concerns about big tech companies (who, let’s face it, are beholden to shareholders) jumping into something like public health. What if profits come before patients? This isn’t just a tech issue, obviously. Pharmaceutical companies, medical equipment providers and private hospitals are all, basically, money-driven enterprises. But tech faces some extra hurdles. Specifically: trust. The Big Four tech giants don’t have the best record when it comes to data security (Cambridge Analytica still looms like a specter over the entire industry), and winning over consumer trust might be a long-shot when people’s lives are at stake. Would you put your blood pressure in Google’s hands? Or your lungs in the care of Amazon?

Examples pop up all the time. According to the Wall Street Journal, in 2019 Google entered into a partnership with Ascension, one of America’s biggest hospital systems, which collected and crunched the health data of 50 million patients—without their knowledge or consent (this is 100% legal in America, by the way). Google promised this data wouldn’t be used for commercial purposes, but the ethics are murky at best.

“The law is silent on the issue of whether companies can use the patient data to develop and sell new products,” Dr. Robert Pearl wrote in Forbes. “After all, without the 50 million Ascension patients (who never gave Google permission to access their personal health information) Google couldn’t develop commercial consulting tools for others. This is an ethical grey area, one that has put the industry watchdogs on high alert. They note that healthcare is a very different kind of service than search, because of dramatically different user expectations, fears and risks.”

As always, it’s a case of innovation outpacing oversight. The law struggles to keep up with technological progress, so while this kind of data sharing might not be illegal, it probably doesn’t pass the pub test. Some critics have said that healthcare is simply too big a beast to disrupt: a lumbering, bureaucratic mastodon that will never bend to the will of Silicon Valley progress. The next five years will probably be critical either way. COVID-19 has changed consumer expectations around healthcare: people want it faster and cheaper, and they want it on their own time. There’s a public desire for innovation and change. And if Big Tech is good at anything, it’s selling our desires.

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