About five years ago, we began to see a series of moves made by major tech corporations into the healthcare space. Companies like Alphabet long had a presence in biotech research and development, as well as genetic sequencing and bioinformatics through its subsidiaries Google, Verily and Calico. Apple had always directed its computational business to serve the needs of the scientific community, including biological and drug discovery research, and analytical laboratories. Subsequently, an increasing number of tech giants began launching initiatives across healthcare sectors such as pharmacy, electronic health records (EHRs), telemedicine, health services-directed cloud computing and information technology, and clinical trials.
Some even announced efforts aimed at reconfiguring and streamlining healthcare delivery. One such initiative was the venture announced in early 2018 by Amazon, Berkshire Hathaway, and J.P. Morgan called Haven. Although only offered initially to the three companies’ approximately 1.1 million employees, the initiative promised to bring technological solutions that could reduce primary healthcare costs while providing high quality services. Apple, Microsoft and Google announced similar visions for revolutionizing care, and created new divisions, such as Google Health, focused on improving overall patient health. We asked at the time whether this might be the start of a real change in the U.S. healthcare industry or become yet another stalled start. So where are we now?
The results have been mixed. The most ambitious “moonshot” initiatives like Haven, Google Health, and Apple’s employee-focused efforts were halted or completely disbanded. Industry experts have speculated that these failures resulted from the tech companies’ inability to fully understand the complex clinical, regulatory, biological and social factors that affect the healthcare space. The fact that these Big Tech efforts ventured far beyond their respective developers’ core competencies also likely played a role. Moreover, while enterprises like Haven proposed interesting ideas for improving healthcare delivery, neither Haven nor the three companies involved in its founding had sufficient share in the healthcare marketplace to generate momentum and compete successfully with established players. However, healthcare overall represents a $4.1 trillion market, making it an attractive target for tech-based optimization. As a result, several Big Tech companies are now directing their competencies and expertise to solve specific healthcare problems.
Some are applying tech solutions to improve the interactions between companies, healthcare providers, payers, and patients. For example, in December 2021, Microsoft announced an alliance with CVS Health aimed at delivering more accessible, personal and affordable next-generation care models through a cloud-based platform that extends digital health applications from an in-store point-of-care to patients’ homes. Similarly, Microsoft’s Azure infrastructure and tools are leveraged by the clinical research organization ICON and data provider Veradigm to integrate their respective technologies in a new EHR-based Clinical Research Network. The goal: to accelerate recruitment and enrollment rates by expanding physician and patient access to clinical research studies.
Other tech companies are investing in the universal delivery of high-quality care, irrespective of where patients are located, and empowering patients by democratizing access to information, services and products. One such example is Amazon Care. Launched in 2019, it combines virtual care with a new approach to in-person care that allows patients to receive a spectrum of services at home, ranging from on-demand primary care to chronic disease management. Amazon first offered Amazon Care to its employees and is now expanding its availability to other U.S. employers. Apple, instead, is applying its strengths in consumer product to turn its wearables and phones into clinical research tools and portable patient health hubs. For example, the company is building on the medical applications for its popular Apple Watch platform to provide tools that help patients and physicians better manage chronic health issues, including fall detection, ECGs, and blood and sleep monitoring, as well as for remote monitoring use in clinical trials. Apple recently teamed with researchers at the Mayo Clinic to study the ability of the Apple Watch to detect low ejection fraction (a lessening of the blood pumped out of the heart with each beat), an often-symptomless condition linked to worsening heart failure.
And still other tech companies are focused on enabling a high-resolution view of personal and population health that can facilitate research and contribute to better decision-making and value-based care. For example, in 2017, Verily launched Project Baseline, which is creating a connected research system and a comprehensive set of health data from over 10,000 volunteers. Project Baseline’s goal is to engage more people in research, improve the efficiency of clinical studies, and collect higher quality, more comprehensive real-world data. Verily is collaborating with several academic and research groups. For example, in 2021, Verily, Otsuka, and Click Therapeutics formed an alliance to focus on decentralized clinical trials, initially with an effort to measure the effectiveness of digital therapeutics to treat major depressive disorders.
Big Tech’s move into healthcare still faces some important challenges that go beyond the general complexity of the healthcare ecosystem. Given the cybersecurity issues that have affected other industries in recent times, a key challenge will be to gain the trust of consumers in how tech companies handle their healthcare data. Tech companies need to be able to guarantee data privacy and ownership, while still making data shareable and actionable within the healthcare system. Those companies moving into areas such as pharmacy (Amazon) and the EHR industry (Alphabet) will face considerable competition from existing players seeking to retain and expand customer relationships. For example, traditional pharmacies like Walgreens and CVS have been adding new digital health, medical referral, and home delivery offerings for their customers. Moreover, efforts like Amazon’s attempt to change care delivery will face scale-up issues, heightened by widespread shortages of healthcare workers and low profit margins across healthcare services. But by bringing tech’s unique strengths to specific healthcare problems, and working to better understand the healthcare environment, we foresee Big Tech playing an increasing role in many facets of healthcare.