Asynchronous Care

The Amazon Clinic Headlines Overshadow the Real Story

November 29, 2022

The Amazon Clinic Headlines Overshadow the Real Story

Everyone scoffed when Amazon ramped up Amazon Care. Then they shuttered it after announcing the purchase of OneMedical, and the care community rejoiced. In unison, we all said, “See, it isn’t so easy.” Right after we finished wagging our fingers at them, word leaked that Amazon was trying something new: asynchronous care. (Well, new to them. We’ve been doing this 15 years and even wrote the guide on it, but we’ll get into that later.)

Amazon didn’t simply change their name from “Amazon Care” to “Amazon Clinic.” The company completely shifted strategies and modalities. Prior efforts relied on traditional audience acquisition approaches. That path involved selling Amazon Care as an employer benefit or partnering with payers; however, this time Amazon is bypassing all of it. They stuck Amazon Clinic on the consumer site, skipped all other reimbursement models, and removed the first layer of access friction: traditional reimbursement models.

Amazon is also applying their marketplace principles and letting two provider networks duke it out over price and response times. Patients can pick a provider in the same way they can choose between different sellers of the same toaster—comparing delivery time and cost. The approach is cool; however, the most innovative aspect of Amazon Clinic is its mode of delivery. Yes, it’s telemedicine, but the tech is not video based. Amazon is using asynchronous care.

What is asynchronous care? 

Asynchronous telemedicine is care delivery that is not simultaneous or concurrent in time. It is used synonymously with the term “store-and-forward.” Amazon is trying to implement a robust form of async that leverages adaptive interviews. Intelligent adaptive interviews involve using clinical protocols that mimic the questions that a provider might ask a patient or another provider during a consultation. After each response, the subsequent questions adjust to collect more information on symptoms and aid in diagnosis. The net result:

  • Standardized data gathering that is more thorough than a conversation
  • Standardized documentation that’s easier for a clinician to read
  • Time savings by reducing the need for follow-up questions
  • Automated documentation due to the ability to “stitch together” SOAP notes and care plans in just a few clicks

For over a decade, most traditional health organizations turned a blind eye to asynchronous adaptive interviewsThat’s right, the tech is not new—we’ve been implementing and refining async since 2008. However, health systems and provider groups have been slow to adopt it due to reimbursement, regulations, or misconceptions that EHRs and patient portals are the end-all be-all. These excuses are all tied to healthcare’s over-regulated underbelly of insurance reimbursement.

Patients don’t care about your reimbursement models or your patient portals. They want quick access to care so they can feel better. We’ve known that, now Amazon has finally realized it too.

Why Async Wins in Patient Acquisition

Async is the ideal modality for low-acuity visits because consumers generally evaluate purchases based on three factors: speed, quality, and cost. Healthcare is no different except it traditionally delivers a slow service at a high cost.

Triple Constraints: Fast, Cheap, Good Care–Pick 2?

What consumers want is in the impossible area of the Venn diagram. With traditional care models, it is impossible because scheduling, staffing, and clinical capacity create limitations in terms of speed and affordability. This is where asynchronous care excels because treatment does not have to occur at the same time as the patient interview, providing flexibility and efficiency that don’t exist in other approaches.

triple constraints fast cheep good pick 2

Asynchronous Telemedicine is High-Quality Care

Asynchronous intelligent interviews are standardized and adaptive, meaning they ask additional questions based on a patient’s response. For example, if a patient says they have mucus, the follow-up question will ask about the color. Meanwhile, patients who don’t report mucus as a concern will not receive those questions. Adaptive interviews are more thorough than an in-person visit because they are standardized—compared to a physician who may bypass some questions or ask them differently, provoking different patient responses. Plus, clinical adherence increases with async due to the same standardization. Quality box checked.

Asynchronous Care is 10x Faster Than In-Person and Video Visits

The largest constraint in healthcare is clinician time. But if physicians move fast, they miss details—resulting in low-quality care. This is true of video or in-person care. However, async standardized and adaptive interview process increases speed 10 fold. Four million encounters have been conducted on the Fabric platform and the data shows that it takes:

  • An average of 7 minutes for a patient to complete an interview
  • Less than 9 minutes for a provider to pick up a case
  • 89 seconds for a provider to diagnose and treat the patient

For physicians, a platform like Fabric is 10x more efficient than any other mode of care and it removes 99% of administrative work.

For patients, async prevents them from:

  • Waiting 2 weeks to get into their primary care
  • Sitting in an urgent care a few hours
  • Going to the ER and waiting even longer
  • Not seeking treatment at all

Asynchronous care is clearly the path of least resistance. Now that Amazon is starting to leverage async, is the healthcare industry ready to catch up?

Asynchronous Telemedicine is Inexpensive (Cheap isn’t the right word)

Offering inexpensive healthcare is directly tied to solving physician capacity constraints. An asynchronous platform can be 10 times more efficient than any other mode of care—at least it is with Fabric—so it only makes sense that async decreases the cost of care. Most organizations that leverage Fabric charge between $25-$40 for a visit, making it by far the most affordable mode of care. For those keeping score at home, this is called doing the impossible. Ironically, traditional delivery models only offer one aspect from the triple constraints, good. Every other modality or point of care is time consuming and expensive.

Quantitatively, Patients Love Asynchronous Care Too.

We regularly measure patient sentiment via net promoter score and 5-star reviews. Our net-promoter score is a 64 which puts us on par with top consumer brands like Disney and Starbucks. As for 5-star reviews, we have over 5,000 reviews that average a 5-star rating.

Stuck in Traditional Healthcare? Team Up with Asynchronous Care Experts

It is time to stop talking about transformation and start acting, and who better to work with than experts who’ve been in the business 15 years. Inertia will just result in death by a thousand paper cuts and each cut is just a little more patient leakage that contributes to greater care fragmentation.

I’ve had conversations with health systems, provider groups, and senior product leadership from large EHR companies. Each of these groups shared the same startling statistic: 29% of visits go unused due to cancellations or no-shows. Physician time is the most valuable resource in healthcare, and we are squandering it due to relying solely on antiquated scheduled workflows.

Hybrid On-Demand Care: Increase Capacity and Revenue

Implementing an asynchronous care platform removes the barrier of scheduled workflows. This approach to hybrid care allows physicians to manage an on-demand queue during any time block that might become available due to cancellations or no-shows. By repurposing one unused 15-minute visit block per day, physicians can gain 60% capacity and grow their revenue.

Hybrid Care Makes Time for Value-Based Care

Some health systems ask us to implement solutions within primary care groups. By offloading most low-acuity visits to an asynchronous platform, physicians free up time for those that truly need in-person care. Shifting 100 visits per month to async frees up 1,500 minutes of physician time, creating time for 50 complex visit blocks. At a much larger scale, Fabric helped health systems during the peak of the pandemic in March of 2020.

Asynchronous telemedicine is likely the most valuable and underutilized tool in healthcare, and it should be on your roadmap whether your organization is concerned about losing market share to Amazon or tapping unused capacity. Reach out and let’s discuss how asynchronous telemedicine can positively impact your provider organization. If you would prefer to casually learn more, download “The Definitive Guide to Async“.


Asynchronous Care

Asynchronous Telemedicine Guide + COVID-19: The Largest Case Study on Async

When we built this guide, we set out to create a single comprehensive resource for everything healthcare professionals will ever need to know about asynchronous telemedicine. It’s 29 pages of pure data, research, and the largest case study ever conducted on async. 

Case Study

Gain capacity to care

Maximize clinical capacity, reduce administrative burden, expand access, and increase patient satisfaction.