Oct 24, 20229 min read

The Concise Guide to Apple, Google & Amazon in Healthcare

The healthcare industry is fascinating, and though it's been one of the more slow-paced 'systems' to change, there's a massive contrast with the fast-growing needs and demands for better health and the entry of tech giants like Amazon, Google, and Apple into health-related offerings. These companies are huge players in the consumer market, and have been steadily turning their attention to healthcare.

Globally, trillions of dollars are spent in the healthcare system every year, whether you count the cost to governments, the cost to individuals collectively, or the investment of venture capital and new products from the tech sector into health.

Amazon, Apple, and Google continue to ramp up their engagement in healthcare, with Amazon and Google's largest acquisitions being health-related ones (One Medical, and Fitbit), and Apple's latest product announcements and focus have health at the heart. It's worth understanding their activities for several reasons.

First, whatever they do, is done at scale, with an easy consumer experience, and is widely accessible.

Second, these players become the landlord or foundation for many across the ecosystem, simultaneously enabling 3rd parties (eg app stores and marketplaces) and embedding themselves.

Third, they are increasingly partnering with reputable sources including clinical trials (eg. Mayo, Stanford), physical presence (eg. CVS), gaining regulatory approvals (eg FDA, TGA), and cancer research.

They also represent the first place most of us go to discover new things.

Let's take quick a look at some of their activities.

The Helicopter View of Tech Giants in Healthcare

Apple has over 1.65b active devices in the market (characterised by interacting in the last 30 days)
Google hosts 5.4b searches per day, globally, and has invested $47b in infrastructure the last few years.
Amazon has 300m active customers, and almost 2m selling partners (and the world's largest distribution network for supply chain).

Apple, Amazon, and Google are not physically treating you the way doctors, nurses, and allied health professionals do. Instead, they are motivating well-being, producing devices that collect detailed health data, increasing literacy and alerts, enabling sharing with family and health professionals, storing health-compliant data, and contributing significantly to AI and research.

The focus on health for these players, is set against a backdrop of (non health) market share in every pocket, home, calling, location, payment, ID card storage, home address, and in the case of Amazon, supply chain and physical distribution footprint.

Between them, they will almost certainly be the first place you go for health-related information via voice search or search engine, and the host of almost all the world's health-related apps (App store & Play) and the most extensive collection of health and medical devices (eg amazon.com).

The expectations of quality, approvals, and privacy terms and ethics increase with every partnership, research initiative, and week that goes by. (See the end of this article for concerns). Benefits extend to those with middle incomes who can afford the latest smartwatches, through to developing countries accessing health education, information, and translated into languages, via these companies.

The health conditions supported by Apple or Google Watch or phone include sleep, cardiac, stress, oxygen, fitness, Parkinson's, hearing, vision loss, and Autism spectrum; with related features to assist with getting help, detecting falls, reminders for medication, tracking symptoms, and apps to remote monitor heart and seizures realtime to name a few.

Check out the list below, as it's likely there's a lot more you can do that you realize to stay well, with what you already have.

For more information and updates on the world's health technology, you can interact with a collection of health related tech from tech giants, or other health tech from the world's top consumer health tech providers in this list, or browse by a specific health need eg dementia, heart etc.

Amazon

Broadly an online marketplace underpinned by supply chain sophistication, cloud services (AWS), and physical devices. Currently, they employ 1.6m people, have 200m+ Prime members, and 65% of the smart speaker (home hub) market.

Their superpower is a relentless focus on customer experience, reduced costs, and supply chain, and it follows then they have a great deal of data hosted on their web platforms, and insights gained.

Amazon's healthcare activities include [not exhaustive]:

Marketplace

Search from millions of health-related products and technology (Amazon.com)

Amazon Devices

Voice assistants/Smart speakers - Ask health-related questions, set medicine reminders, or access medical services via Home Hubs and Voice assistants (Alexa Echo Dot, Echo Show) . Amazon extends to specific health services via Alexa skills and Seniors care.
Halo Health - Amazon's wearable to track health with support for applications from third-party providers, in a band or watch display, and the newly announced Halo Rise bedside sleep tracker. Combined with the Alexa smart speakers, ask "Alexa, what's my heart rate?"
Medical Devices - Branded on Amazon as 'Amazon Choice', integrated with the Amazon Choice App and Apple Health.
Amazon has a range of other devices of value in holistic health care and caregiving help, such as the Amazon Astro and their range of smart plugs, doorbells, and cameras (through their purchase of Ring).

Supply chain & logistics

Warehousing through to physical stores such as Wholefoods.

Pharmaceuticals & Diagnostics

Home medication delivery through Amazon Pharmacy, Pillpack acquisition with licenses in all US states, and Amazon Dx.

Amazon Web Services for Health

Compliant with medical standards and supporting major data providers from cloud storage to reporting, research, and analytics.

Partnerships and acquisitions

Such as Teledoc (talk with a doctor), One Medical (primary care in the US), National Safety Council Partnership to combat musculoskeletal disorders (workplace injury), and an AWS Healthcare Accelerator to name very few.

Apple

Broadly a consumer devices company with 1.65b devices active in the market. Recently they've further advanced their consumer devices that measure and collect health data, with deeper approvals, partnerships, and the sharing of health data through medical records and 3rd party apps.

Apple's healthcare activities include [not exhaustive]:

Apple Devices

Apple Watch - Tracks and computes over 150 types of health data like activity (VO2 max, speed, step length), exercise, and clinical (oxygen sats, resting heart rate, ECG waveform, and Atrial fibrillation) as well as breathing and mindfulness.
iPhone - captures health measures from a range of sources, apps, and sensors in the Apple Health App, including HealthKit for 3rd party app providers to work with Apple Health.

3rd Party Apps

Tens of thousands of apps on the App store now use Apple's Healthkit API, many at high levels of clinical quality, ranging from relaxation and mental health, motivating activity, for Autism Spectrum, through to inbuilt features and sensors utilised by 3rd parties such as detecting seizures, real-time remote heart monitoring, tracking symptoms, and reminders for medication.

Apple Health Records

Partnerships with more than 800 institutions to securely store and share medical information.

Research & Partnerships

including sharing, capturing, and facilitating providers such as Harvard, John Hopkins, and other hospitals, through to smart home devices and products like sleep mats.

Related Functionality

Such as emergency calls, fall detection, and Accessibility across all devices, for those with challenges or special needs such as hearing, vision, autism spectrum, or mobility.

Apple has made the most progress of Amazon, Google (and Microsoft) in medical approvals by regulators such as the FDA, TGA, etc of their device functionality such as blood oxygen and EEG, Afib, etc. They also have the strongest published set of initiatives, partnerships, and clinical trials available.

Google (& Alphabet)

The world's most well-known synonym for "Search", Google has the largest influence and share in search and data domains, as well as physical devices such as mobile phones and tablets (via Android), smart speakers, apps, and wearables. Google has 93% of the search engine market, has invested $47b in technology infrastructure the last few years.

Their superpower is providing health-related information in response to search queries, data storage, AI and analytics, and research partnerships.

Google's healthcare activities include [not exhaustive]:

Devices

Consumer health and fitness devices like the new Google Watch and Fitbit
Google has a large presence in homes via its smart speakers (Google Nest Hub range) and smart home products (plugs, and sensors for doors, leaks, smoke, and carbon monoxide detection).
The products have the ability to return search information (what should I do if I have COVID?), detect movement or drop in to check on a loved one, and new capabilities to track and improve sleep whilst maintaining privacy.
Specific services exist with a health focus, for example, "Ask WellWithDiabetes" What's the glycemic index of an apple?"

Operating System Platform Android OS and Wear OS

The open-source platform (Android) has 2.5 billion devices across 190 countries because Android resides on Phones, Watches, and Tablets devices with the opportunity to collect health data and help support users' mental health. Google is reportedly building a newer Google Health app to help with the sharing of insights and integration to medical records.

Google Play Store Apps

Millions of highly rated health and fitness apps are downloaded on Google Play, both free and paid, and many with approvals and evidence.

Curating health information

Providing clinical quality responses to ensure data integrity for important queries like mental health and COVID
Google Cloud and Analytics provide a compliant set of tools and systems for healthcare providers, which is listed comprehensively, here
Care Studio is a Google tool and app for Clinicians, with a search bar that helps find information across various sources and patient records without needing to know where to look.

Partnerships

Google has a range of partnerships and research, such as for Breast Cancer, Mental Health, Communities, and health work in Developing Countries, and through to enabling consumers to sign up to health research trials with Clinical providers. Android users can download the Google Health Studies App, sign up to participate, and enable data to be collected on their devices on an opt-in basis.

Investments in Health care and Health Tech

Google has invested billions in health care, from research to platforms to acquisitions such as Fitbit and Nest.
Google's parent company Alphabet made a $1 billion investment in its health technology business Verily, which focused on using data from a wide variety of sources to determine the best intervention for a person or community.
Verily bought SignalPath last year, a company and service that makes it easier for health providers to run and manage Clinical Trials.

Google also hosts Google Scholar, which is a reputable source for research papers eg "apple watch health" covering trials and peer-reviewed research papers.

Concerns

Challenges and risks of the tech giants in health include the following.

Data privacy, and the balance between profit, privacy, and data ownership.

Reducing competition, the inability of niche or smaller providers to compete given many companies with innovative products fail to be found. There's often a list of which small companies just became obsolete, following the tech giant's new product announcements.

Quality of health information provided, for example when a voice assistant returns erroneous or harmful information. For example in one study "help me quit, pot", may equally send you to a quitline or the nearest provider, or define the word. We saw the same during the recent pandemic and covid questions.

Equity, diversity, and inclusion have a long way further to go in terms of recognising different skin tones and gender and biases accurately for health applications.

Occasionally Amazon is called out for being one of the world's most profitable companies and setting their health care ambitions back in the old word (eg buying pharmacies).

Increasingly the tech giants are working together to align to standards and interoperability between them and their ecosystems and ensure these are open for all providers.

Questions To Ask as a Consumer

It can be confusing to know what devices to choose. Here are some steps to make it easier to decide what might be good for you. (Always consult your doctor, health provider or those closest to knowing what's best for you).

First, what are you hoping for? What's important to you?

For example, you'd like to keep track of your health information in general, or more specifically you'd like to monitor your blood oxygen or sleep.
You want it to be medically approved, and be able to share it with your doctor.

Second, what's available and what fits my needs?

Search for what's available and what form suits you best (ie. beside the table, worn or carried)
Consider the functionality, approvals or accuracy, reviews, and price.

Third, what are the risks and how do I reduce them?

Set the device up in the way it suits you (eg. closing camera shutters or sharing with those closest)
Read and select the terms and privacy conditions (eg. opt out of sharing, see how data is managed.
Check in periodically on unusual activity (ie. make sure tracking is turned off, review the history of what your device has searched or shared and who has access).
Always consult your doctor, medical provider, or those closest to you.

Conclusion

Apple, Amazon, and Google are placing significant firepower and resources into health care and consumer well-being. Their research and investments are adding value to a health system under pressure, and it's most likely there are features, services, and products available in your pocket, on your desk, or in your home, that you can utilize to stay well.

These offerings and devices enable an extraordinary level of information, self-literacy, and connections to professionals via telehealth. Hopefully they will help us stay well. As always, our hats off to the Doctors, Nurses, Physios, Allied Health, and Researchers who continue to work tirelessly and help us in person.

At the end of the day, technology is only about helping us to better look after each other, and every health tech product, has the role to bring us back to each other with better care or insights.

What have you found helpful from these big companies in healthcare?