Two of Amazon’s recent proposed acquisitions are raising concerns about the retail giant’s expanding reach into the everyday lives of Americans. Continuing a pattern of expansion into health care, Amazon has announced plans to acquire nation-spanning primary care practice One Medical for $4 billion. Already in the online pharmacy space since 2020, this move has raised patient privacy concerns as it could give the company access to sensitive medical records. Amazon has also agreed in principle to buy the combination defense contractor and automated floor cleaning specialist iRobot for $1.7 billion, makers of Roomba robots that have the potential to be used for home mapping.
Patient privacy concerns grow as Amazon expands into primary care
Amazon has been making the biggest moves into direct involvement in patient care as of late, however, beginning with its 2018 acquisition of online pharmacy PillPack that led to the launch of Amazon Pharmacy in late 2020. The proposed acquisition of One Medical bolsters its existing Amazon Care division, which began as a telehealth service for its employees in 2019 (and has already raised both patient privacy and safety concerns). Amazon Care expanded to serving other corporate clients in 2021, as it also expanded its internal operations outside of the company’s home hub in Seattle and added clinics for in-person visits around the same time.
It remains to be seen how Amazon will handle One Medical should the deal hold up, but the company has attempted to address patient privacy concerns with Amazon Care by farming out handling of patient records to an independent company called Care Medical (founded by an employee of Amazon in 2018). Questions have already been raised about this setup, however, including the company’s decision to go with a “bargain” third party record management tool and for numerous other needs that it was unable to staff without external contractors.
Patient privacy concerns might be assuaged if Amazon were to demonstrate that patient care records were held by a fully independent company and were being secured properly. But some observers believe that Amazon made the One Medical move out of a specific interest in the privatization of Medicare Advantage. The ACO REACH program, which was initiated under the Trump administration but recently expanded by the Biden administration, moves some Medicare recipients to private for-profit health plans such as the ones offered by One Medical. Once it has become connected to a stable stream of government-backed Medicare money, some critics worry that Amazon will become addicted to it and use its outsized leverage in the market to advocate for even more privatization.
The move could represent an unprecedented opening of American health care records to big tech revenue models that are not necessarily concerned with patient privacy beyond the extent the law requires them to be. At present the largest for-profit health care corporation in the US, HCA Healthcare, only holds medical information for about 1% of the country’s population. Some recent surveys have found that over 90% of the country has shopped with Amazon at this point, and 44% are regular users that subscribe to its Prime shipping and benefits service. HIPAA protected health information is required to be separated from other purposes in this way, but there are potential legal workarounds for a company the size and scale of Amazon that the pre-internet drafters of the bill did not anticipate.
Could Amazon use Roomba for home mapping?
If concerns about Amazon’s reach into patient privacy, retail, entertainment streaming, grocery shopping and home monitoring were not enough, the proposed acquisition of Roomba manufacturer iRobot is already sparking fears of home mapping.
iRobot is a former defense contractor that manufactured “civil defense” tactical robots for reconnaissance of dangerous situations, but has since divested that aspect of the company. The part that Amazon is interested in is Roomba, the popular robot vacuum cleaners that are estimated to be traversing about 15 million American households. The devices function by creating home mapping files for the robot to draw on, and there are concerns that these essential blueprints could be accessed by Amazon and added to its portfolio of marketing-focused consumer data.
The home mapping concerns are exacerbated by the existence of Amazon’s Astro, a more advanced and sensor-equipped security robot. Currently available in limited quantities to those that filed invitation requests in late 2021, the bot adds cameras, microphones and the ability to integrate with Alexa to the basic home mapping concerns sparked by misuse of Roomba data.
Roomba home mapping files are presently only accessible to iRobot, but it is unclear what the cloud-focused tech giant will opt to do with them if the $1.7 billion deal ends up going through. Patient privacy advocates also see a potential connection between these two acquisitions; Amazon might combine data gleaned from its home mapping and monitoring products with risk assessments for health insurance, essentially spying on the customer in their own home to determine costs.