As Amazon takes page from pharma's EHR playbook, smarter DTC could be on the way

Amazon’s latest move into healthcare had the industry buzzing recently with talk about trials that use patient electronic health records to enable doctors to "prescribe" off-the-shelf medical products, complete with buy links to Amazon. That’s old hat for pharma—doctors have been evaluating branded drugs and messages inside EHRs and sending prescriptions to retail pharmacies for a while—but it could have future implications for the industry in Amazon prescription sales via its recent PillPack pharmacy acquisition.

Yet the larger interest area for Amazon, as well as for Apple and other emerging tech players in health, is data—specifically, the loads of patient data held within digital medical records. To that end, Amazon is also working with pharma on other use cases.

Angelo Campano, Ogilvy Health VP, customer experience in EHR, said his group worked with Amazon on a project from August 2017 through January 2018 that used its technology to mine EHR record information. The Amazon tool, which didn’t have a name at the time, could search an integrated central database of EHR information to look for specific patients—in this case, people potentially undiagnosed for a particular kind of narcolepsy. The information would then be relayed to the pharma company to create smarter DTC ads to those personally de-identified (but locatable) patients, as well as to target doctors for potential sales visits.

Campano noted that Apple is working on similar kinds of projects in healthcare and pharma with the overall end goal of both Amazon and Apple to create user-friendly transparent and portable patient records.

"If I’m a patient and I have six doctors, each one has a different EHR about me and they don’t necessarily talk unless they’re in the same health system," he said. "So it gives the patient the ability to go to a doctor who doesn’t have access to their information and show them their history of previous interactions and keeping it consistent from physician to physician."

Around all of the data sharing, there is of course a concerted effort to protect patient privacy. The integrators building databases, for example, enter into business associate agreements to guarantee privacy and take on liability. Amazon also enters into similar privacy agreements as a third party.

Also, any data collected by Ogivly Health and Amazon in the trial, for instance, was de-identified. The physicians were not de-indentified unless they had fewer than two patients who met the targets—the rationale being that with only one patient there was a theoretical chance to identify that patient.

When it comes to EHRs, pharma companies don’t need Amazon for scripts. Most electronic records today include branded drug information along with patient-specific details such as availability and cost under their insurance coverage. In fact, Amazon’s deal with Xealth to list or tag retail products follows the pharma model where a doctor sends a digital prescription to the pharmacy.

"That’s the point that Apple and Amazon are trying to get to—all digital system for scripts, retail and data gathering," Campano said.

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