Patient safety concerns arise over Amazon's One Medical call centers after document leak – PBS NewsHour

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Serious questions are rising over a new player in American health care: Amazon. In 2023, the online giant bought One Medical and its primary care clinics across the country. But leaked documents reported by The Washington Post show call center staff who lacked medical training put more than a dozen patients at risk. Lisa Desjardins speaks with Washington Post reporter Caroline O’Donovan for more.
Notice: Transcripts are machine and human generated and lightly edited for accuracy. They may contain errors.
Lisa Desjardins:
Serious questions are rising over a new player in American health care. Amazon, the online giant, has been moving more aggressively into hands on medicine, including last year when it bought One Medical, a business providing primary care with scores of clinics across the country.
But recent reporting from the Washington Post is highlighting new concerns about patient safety. Leaked documents show more than a dozen patients safety was put at risk when their care was handled by call center staffers with little to no medical training.
Caroline O’Donovan is a tech reporter covering Amazon for the Washington Post. Caroline, I want to start actually with the big picture here. Can you talk about how significant you think this move is by Amazon in general, and how significant for healthcare in America is it that Amazon is looking to get into this market?
Caroline O’Donovan, The Washington Post:
Absolutely. So Amazon, of course, is, you know, the second largest employer in the United States. It’s an absolutely massive company. It has an entire cloud computing inside of it. It’s one of the biggest retail companies in the country.
One Medical, the primary care clinic that they bought, it’s sort of a drop in the bucket of the overall American healthcare system. But recently, Amazon has been sort of completing its plan, if you will. They opened up a discount for One Medical to all Amazon prime subscribers, which would take the number of people who are currently using one medical and potentially increase that to the millions of people who have Amazon prime. They’re also increasing their telehealth offerings that you can access without insurance.
So it has a potential not only to impact a large number of patients if all prime members were to sign up for it, but also to kind of lead the market. Right. You can see other companies following what Amazon’s doing here.
Lisa Desjardins:
So let’s talk about your reporting about what we know so far, a little bit about One Medical. Now, that company’s promoted itself is very patient centered. However, your reporting found out that they outsourced a key part of the medical process for their patients. That initial call that someone might make to express a medical concern, what did that mean for patients exactly? What did you find out?
Caroline O’Donovan:
So many one medical patients, the primary way that they’re accustomed to interacting with their health providers is through an app.
But what a lot of people didn’t know, and what I didn’t know when I started reporting this story is that before Amazon acquired One Medical. One Medical had acquired a company called Iora, which is a senior healthcare company. And that company was all about providing people the most engaged, the most frankly expensive and intensive care that they could upfront in hopes of keeping people on Medicare out of the hospital over the years to come.
Those patients were obviously accustomed to being able to text with physicians’ assistance, call their doctor’s office, and get someone on the phone right away. In the year following Amazon’s acquisition of One Medical, though, they made the decision to shift those phone calls to a call center in Tempe, Arizona, which they refer to internally as mission control.
When you have these 65 and older patients, many of whom have chronic healthcare issues, who are used to having a very close, intimate relationship with their healthcare provider, and now they’re calling that same exact phone number, and the call is being picked up by someone who may not actually have all the details about their charts and their health conditions and stuff like that. Obviously, some of the patients have been fairly frustrated.
Lisa Desjardins:
Can you help us with some specific examples of what happened to the patients when they called this call center?
Caroline O’Donovan:
Yeah. So what was happening, what we found through the documents that I was able to obtain and see is that patients were calling in with what are called red flag symptoms internally. There’s 17 of them. Things that would suggest, okay, maybe something urgent is going on in about a dozen cases. What we saw, at least, rather than connecting those people to a virtual health provider who could answer their questions right away, someone who is medically trained.
The call center employees, they were scheduling appointments for these people same day or the next day or in some cases, a couple days into the future, rather than connecting them by phone with someone who could help them.
There is a period of time in mid-February when this change was initially happening, when it seemed like just in this Colorado area alone, this was happening almost every day. Someone dealing with symptoms of a blood clot, someone with sudden rib pain, someone calling in with stomach pain and blood in their stool.
So in the documents that were leaked to us, there’s a doctor who wrote a note saying, I don’t think these call center people even realize that they’re triaging patients, which is not something that they’re qualified to do.
Lisa Desjardins:
What does Amazon say about this?
Caroline O’Donovan:
Amazon obviously says that patient feedback is important to them. They really emphasize the fact that as far as they know, no patients were harmed. In a couple of cases, they acknowledged that the process didn’t go as it was supposed to, and they retrained the employees involved. But they said, you know, by and large, everyone is okay.
And moreover, one medical is a separate company and no one’s medical care is being cited by Amazon is what they said is, you know, one medical doctors are free to make their own independent decisions. They also said that the call center, you know, is there to increase patient access, which essentially means, like, you can get your phone call answered faster.
But the patients I spoke to again and again, and some of the one medical employees I spoke to said, there’s a difference between getting your phone call answered faster, literally someone picking up the phone and actually getting your problem solved.
Lisa Desjardins:
Is it clear this was motivated out of a hunt for increased profits? Or do we know?
Caroline O’Donovan:
I don’t think we necessarily know about profits. Amazon famously didn’t make profits for a number of years. It’s a very data oriented company. So things like how many minutes it takes for someone’s phone call to get answered or how much work one individual type of worker is doing in an amount of time, that’s kind of the way Amazon approaches these things and thinks about them.
And I don’t know necessarily if they’ll find in the long term that taking care of these patients who are on Medicare, who are 65 and older, who have chronic health conditions, necessarily melds with their approach to doing this.
Lisa Desjardins:
Is it clear Amazon plans to do nothing but expand into this area, into healthcare?
Caroline O’Donovan:
Amazon has very large ambitions in the healthcare space, and I think we know that because we’ve seen them experiment with different things and shut them down, but then keep going, which is another very Amazon way of doing business.
Their CEO, Andy Jassy mentions healthcare every time he talks about the state of the business. They recently started offering discounts One Medical to all prime members. They’re trying to get One Medical patients to use the Amazon pharmacy system, which they say that in some places you can get your prescriptions delivered in under 2 hours by drone. So definitely they see healthcare as fitting into the Amazon way of life.
And if you think about what Amazon did for shopping, right, taking something where you want the stuff, but you don’t necessarily want to get off the couch, that’s, I think, what you’re going to see them trying to do with this healthcare thing.
Lisa Desjardins:
Caroline O’Donovan, thank you so much.
Caroline O’Donovan:
Thank you.
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Lisa Desjardins is a correspondent for PBS News Hour, where she covers news from the U.S. Capitol while also traveling across the country to report on how decisions in Washington affect people where they live and work.

Andrew Corkery is a national affairs producer at PBS News Weekend.
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