During the first week of our Focus on Innovation in September, we asked HIMSS Media readers which of the big partnerships currently coming together will have the greatest impact on healthcare?

Specifically, the choices were Amazon, Berkshire Hathaway and JPMorgan Chase vs. CVS Health and Aetna vs. Amazon itself. The final option was “too soon to tell,” of which 20.2 percent of the 213 anonymous respondents chose.

CVS-Aetna as a merged entity led the pack at 31 percent. The reason?

“I want to say Amazon, but Aetna has the benefit of being an incumbent,” one reader commented. “It can act immediately on its partnership with CVS once its merger is finalized. Sentiment is largely positive for Amazon's involvement in healthcare, but incumbents will be a barrier to action for it in the near-run.”

CVS Health’s $69 billion acquisition of Aetna is expected to close by year’s end, with media outlets reporting last week that a judge could approve the deal in the next few weeks.

Other respondents to our poll pointed to CVS Health and Aetna having considerably more domain expertise than Amazon, Berkshire and JPMorgan and mentioned Aetna’s 22 million members as being much broader than the 1 million employees Amazon and its partners have thus far said they intend to serve.

Among those who picked Amazon, Berkshire and JPMorgan, however, one wrote that the combined companies “will allow different solutions for different patient situations,” while another commented that “integration and collaboration is important across all industries. This will allow us to create true trends and trade.”

Granted, it’s difficult to know exactly what Amazon, Berkshire and JPMorgan Chase — some readers anointed the partners ABHJPMC — have in store at this point since the company currently exists as two publicly-known employees: Noted author, surgeon and Harvard professor Atul Gawande, MD took the CEO post in late June and, in turn, brought on former Optum and Comcast executive Jack Stoddard as chief operating officer.

The enigmatic nature of the developing company is no doubt part of the reason why more readers picked Amazon itself (including but not limited to ABHJPMC) as having the potential to be the second biggest disruptor at 26.3 percent and 22.5 percent, respectively.

One could also interpret these results such that nearly half of readers expect Amazon, in one way or another, to the biggest disrupter to healthcare.

Amazon has “been prepping healthcare entry for long and is by far the most disruptive of the trio,” a reader noted. To which another acknowledged the company’s “visionary and single-minded focus on the customer,” as a particular and unique strength.

Healthcare has plenty of room for innovation of course — different HIMSS Media research showed in 3 charts revealing where innovation is headed — so all of the above will play key roles in that disruption while the industry waits to see who makes the biggest impact and where.

Another reader wrote what might be the most prescient comment of the bunch, thereby demonstrating how difficult the future can, at times, be to predict even when we can look at the past for clues:

“While CVS and Aetna have proven to be very strategic in their moves,” the reader said, “Amazon tends to come out of left field more often.”

Twitter: SullyHIT
Email the writer: tom.sullivan@himssmedia.com