[Update: This piece has been updated to clarify where Care Medical is based and the program's original scope.]

Amazon is expanding an initiative allowing employees to access healthcare via text-based messaging or video call from the Seattle area to throughout Washington state.

The service, called Amazon Care, is available via a downloadable app to office workers and to warehouse employees. It allows individuals to communicate with a provider from Care Medical – a Seattle-based medical group – using in-app text messaging or video calls.

Users in the greater Seattle area can also access in-person care – including a COVID-19 test – or have prescription medications delivered.

According to the Amazon Care website, with a user's approval, "the clinician will send a Mobile Care nurse to [their] home, a designated room on the Amazon campus, or other private location within our service area. The Mobile Care nurse may collect lab samples, perform some onsite testing (such as strep tests), administer common vaccines, or perform certain physical examinations."

WHY IT MATTERS  

The service expansion represents yet another foray for the software giant into the healthcare sphere.   

Amazon Care, which has been available to Seattle-based office employees since September 2019 and to eligible fulfillment center employeees in nearby Kent since May, is subsidized by Amazon – to an extent. Although Care Chats are free, video chats and mobile care are not (although the fee structure has not been made clear on Amazon Care's website or in executive interviews about the initiative).   

Prescription delivery is free in eligible areas, but medication costs vary, and clinicians can only prescribe medications for healthcare conditions that Care Medical treats. All fees associated with COVID-19 will be waived.

"Care Medical’s healthcare services are not billed to your health insurance, and will not count towards your deductible," explained Amazon Care's FAQ section. The service also does not accept payment through a medical savings account like an FSA or an HSA, although users can submit receipts for reimbursement themselves.  

According to the company, users can receive care in their preferred language and request live interpretation services – both features that have been flagged by telehealth advocates as important for widespread accessibility. The website does not make clear whether live captioning is also available.

To be eligible, Amazon employees must live and work in Washington, have a mobile device with either iOS 12.0+ or Android 6.0+, and be enrolled in an Amazon-sponsored health insurance.  

THE LARGER TREND  

Notably, Amazon employees who are enrolled in Kaiser Permanente are not eligible for the service. Amazon's announcement comes on the heels of one regarding Kaiser's "virtual-first" health plan, which will make telehealth the foundational modality of care for patients in Washington.  

"Virtual care is the health care of today and tomorrow. The pandemic has reinforced the need to provide care in the most convenient, accessible, and safe way for our members, and that’s what Virtual Plus does," said Dr. Paul Minardi, president and executive medical director of Washington Permanente Medical Group, in a statement.

The fact that Amazon Care services are Washington-only should also shield it from complications around interstate licensing, a continued point of contention for virtual care providers. During the public health emergency, restrictions around licensing have been lifted, but various professional groups – including the American Medical Association – have pushed back on making such relaxations permanent.  

ON THE RECORD

"This is the first big step," said Kristen Helton, director of Amazon Care, in an interview with CNBC's Christina Farr. "We’re expanding our virtual service across the state."

Kat Jercich is senior editor of Healthcare IT News.
Twitter: @kjercich
Email: kjercich@himss.org
Healthcare IT News is a HIMSS Media publication.