Dr. Vinh Gupta, MPA, Pulmonologist and Air Force Veteran, is the Chief Medical Officer of Amazon Pharmacy. He was hired by Amazon in January 2020 to lead the company’s efforts to grow its presence in the healthcare space. health economics We sat down with Gupta at the HIMSS23 conference in Chicago to discuss the latest trends in healthcare and what Amazon’s growing presence in the industry means for physicians.
Health economics: Where is consolidation going in health care? Will a few big players dominate the market, similar to the retail industry?
Vin Gupta, M.D.: I feel there are many opportunities in the market. I’ll step away from Amazon’s role for a moment, but the U.S. healthcare system is estimated to cost him $6 trillion by 2028, but access remains difficult, and in three he 1 person is not sufficiently insured. And there are many opportunities. That’s where I feel so lucky to be part of Amazon. Because we think he’s just one player out of many, we’re focused on access, engagement, and convenience. So it’s not the integration that matters to me. I think it’s about solving the problems that are currently prevalent. Because I think those problems will continue to exist unless there are newcomers like us and others.
ME: So Amazon is bringing a new perspective to healthcare?
VG: absolutely. It’s truly engagement through convenience. We believe we can make it easier for you to get medications that help you stay at home. And for those with chronic conditions and taking multiple medications, the simplicity of free home delivery and price transparency at the time of prescription, auto-refills, pill packs, and other features will help. The way we experience medicine today is not by involving the patient, but by embracing us as providers. I believe there is an opportunity to add new perspectives to build engaging experiences, and we know how important that is to improving outcomes.
Me: That sounds great for patients, but what does it mean for doctors?
VG: Consider a pharmacy coupon as an example. I am very optimistic about what this means for my fellow healthcare providers. It means that the point of prescribing becomes much more helpful, not only for the patient, but also for the provider. I found that the coupon was automatically applied if the information was a concern. No need to search for coupons, no administrative burden. At the time of prescription, I can explain to the patient the pros and cons of the drug and how much it will actually cost if any out-of-pocket costs are incurred. Previously, this was not a standard experience for providers. Usually it’s “Hey doctor, the pharmacy down the street is too expensive, I didn’t know you had that coupon.” A 2018 survey showed that 85% of these individuals had never redeemed an available coupon, suggesting that simplifying the basic experience would not only help patients, but also healthcare. I think it will also help to dramatically reduce the administrative burden on providers. It makes patients happier and hopefully they can stay healthy at home without going to the clinic. I also think it will ease your workflow.
Me: The big theme of HIMSS this year is AI. What does all this big data and AI mean for the average doctor? Where does a doctor fit in all this?
VG: I am incredibly optimistic about some of the particularly large language models being built to facilitate differential diagnosis. Many of these applications are now being used by trainee clinicians, especially for medical education, by young doctors and young nurses in training at home or while seeing patients on an extended basis. , and better resources are now available. first time. Now the way we test and train our trainees is you right or wrong. In licensing exams for continuing medical education, we are now entering a world where we can actually help you understand your decisions in real time. Where was the failure point in the clinical decision-making process? Thanks to AI, we can get to the root cause. Ah, they got 8 steps right in this diagnostic framework, they just missed step 9, so let’s dig deeper there. At this point it’s either you’re right or you’re wrong. Therefore, our ability to provide highly targeted support will create better clinicians overall. It’s also useful when having a particle “Have you thought about this?” is useful. Have you thought about it? Ultimately, I hope it helps enable better care in the long run.
Me: Burnout is a big problem for doctors everywhere. Will these technology solutions help? Physicians were promised EHRs would help and were the number one cause of burnout.
VG: I think it’s too early to say yet, but I really think technology can help us maximize our potential. An announcement was made that ChatGPT will be incorporated into Epic as a clinical adjunct. I love this kind of innovation. Because it helps with transcription and workflow. I think AI should be applied thoughtfully to make life easier for clinicians, or for decision support for medical education and stressful inner-city healthcare providers. With this, there is a way to directly address burnout and make clinicians’ lives easier, allowing them to practice at the highest level of critical licensing. With fewer MDSs and DOs to care for a larger population, by the end of the decade now, one in five of her doctors will be 65 or older. And the relative number of health care providers caring for them will decline. Therefore, there is an urgent need for the highest sanctioned medical practice. I think AI will make it possible. But again, it won’t be all that effective if you don’t partner up and hear the provider directly. We hear a lot of opinions and partnerships at Amazon Pharmacy. This is one of the reasons why the partnership has seen our company grow in double digits over the last four months. I love that we are open to that kind of dialogue. And I think those at the forefront of AI must do so as well.
ME: Administrative burden also affects burnout. AI could help doctors with the cumbersome paperwork they have to deal with on a daily basis.
VG: I think we are already seeing signs that AI could help streamline pre-approval. Pre-approval is one of the worst experiences for clinicians and, ultimately, for subsequent patients. I know that multiple stakeholders are thinking about this issue, just like us. Therefore, I suspect that over time, we will see permanent solutions that allow AI to solve these problems. AI is part of the solution. But frankly, I think it’s important to go back to basics. And that’s what we’re doing really well with Amazon Pharmacy today. We will integrate and expand in 2023 through coupons, price transparency, affordability, value selection, delivery to your home at the time you want, and what retailers are familiar with. I think it’s about doing something basic. Elucidate the roots and apply it to pharmacies. If we get it right at scale, I’m very excited to see what it means for patients and how it will help reduce the administrative burden. I think what you’re doing with pharmacy coupons removes administrative hassles for what should be a really simple experience. And in parallel, these innovations in AI will also help. But we haven’t even been able to get the basics right at scale. And I think we can derive unique value from our technologically advanced approach that combines our core strengths and logistics.
ME: You mentioned prior permission. Do you think it will be possible to get approvals in real time?
VG: It kind of stepped into my role as a clinician in a way, and from the perspective of the wider ecosystem, this is totally what we do today as pharmacies and I think it’s possible. increase. We’ve reached a stage where we can be smart enough from a technical software standpoint that needs an ICD 10 code, has some understanding of what has been tried in the past, and combines that information into an algorithm that says, I think that person is actually eligible for the next step up treatment. It’s not hard to imagine it being automated. That’s what we think, and we know what many of our colleagues think. I suspect that with time it will be resolved.
ME: What does it take for tech companies to do better in healthcare?
VG: I think that what we are building will build a relationship of trust with patients because we can provide them with what they expect. But other healthcare services are also experiencing a wave of digital innovation, with messaging and medical information arriving at this moment, but from what we’ve seen over the past three years, they’re not being trusted as much. So if you translate that to me, at this point where I think I have trust and trust, not from Amazon’s point of view, but from just being a clinician, patients have all these things that they have. I always wonder how you would think about great tools. Health message damaged. How do we ensure trust in what works? We need to recognize that we are starting where we weren’t in 2019. How can we build the trust of many patients and remember that we have to regain it even with these wonderful tools that we have.
