Big Sister May Be Watching

Photo by Matthew Henry on Unsplash
By Noa Lapidot, Vaica
Caraline Watkins, Contributor

Ever since Amazon first started making advances into the field of pharmacy, there has been a lot of speculation about what this means. Business Insider recently published an article titled, “A Wall Street Bank has a New Theory on Amazon’s Plans to get into Healthcare”, that reviewed the different avenues Amazon could possibly take as it grows its pharmacy business. One choice would be to incorporate medication adherence with their new automatic, AI in-home device, the Amazon Echo, or, “Alexa”. This device has a technology that can complete various tasks via voice command. It can surf the web, play music, and make phone calls. A user can extend the Alexa capabilities by installing “skills” (developed by various vendors and similar to apps). When thinking about the possibility of combining health tech and AI, this could potentially improve and assist a very wide range of patients by personalizing different treatments and connecting it to their home in a very smart, intuitive way. One of the advantages of the Alexa is that it can be in a constant listening mode, learning one’s habits, routines and schedule. But, does this ‘extra’ cross the line? Would patients still have health privacy if they were constantly monitored?

The article argues that Amazon is unlikely to get into the business of dispensing medications, as Amazon’s pharmacy licenses have expired and have yet to be renewed. To practice pharmacy, you need to have an appropriate license to ensure you are following all the laws and regulations of each state.

The marriage could include technologies that would allow the patient to ask questions, schedule appointments, and request refills on medications. It could also potentially monitor when a patient goes to bed, when he takes his medication, as well as other personal habits using surveillance and tracking technologies. The availability of these many capabilities raises a very important question: what amount of monitoring is enough to get the job done and still allow a patient their privacy? And when does it simply become invasive and harmful?

In a 2016 Deloitte Survey of US Health Care Consumers, it was reported that there was interest in monitoring health but about one third of the people expressed concern with their privacy. Making sure that the patient feels safe and even more importantly, is safe, is an extremely big concern when a new technology like Alexa is introduced, especially in the AI field. There still needs to be patient autonomy when it comes to someone’s health.

In fact, there are already technology solutions out there that can increase medication adherence without getting too close to the boundary of patient autonomy or the safety of their health information. These allow patients to be able to track their adherence and encourage them to follow their prescribed plan from their doctor. It will be interesting to see what pharmacy avenue Amazon will decide to take, but for now, we must consider weighing the pros and cons of allowing technology too much access. We already know that the “big brother” is constantly watching, do we also want to invite “big sister” into our homes?