Delays in Patient Care Increase Since Amazon Took Over One Medical

Amazon might be efficient at delivering packages, but the company’s approach to health care appears to be endangering patients’ health.

Internal documents leaked to the Washington Post indicate that care has suffered for elderly patients of One Medical, the primary care service Amazon acquired in 2022. Since taking over the service, Amazon has been routing patients to a call center in Tempe, Arizona staffed by contractors with limited to no medical training. One Medical’s contractors receive two weeks of classroom training followed by one week of coaching, and then field calls with supervision for two weeks. They must be able to use a phone and a computer but are not required to have medical experience, although Amazon says new hires should be “comfortable navigating or learning all things health care.”

According to The Post, the center failed on numerous occasions to seek immediate medical attention for callers with severe symptoms. For example, when one patient mentioned symptoms of a “blood clot, pain, and swelling,” the staff scheduled an appointment for the patient instead of referring them for immediate medical attention.

When Amazon acquired One Medical, the service included a $199-per-year subscription primary care service that enables patients to use an app to schedule medical appointments at clinics across the U.S., and access to a clinic for chronically ill Medicare patients. The service has since eliminated free rides, shortened appointment times, and laid off staff. These moves have raised concerns that Amazon’s approach to medical treatment might be causing delays in care and endangering patient safety.

Can delayed medical care be considered medical malpractice?

Delayed medical care can potentially be considered medical malpractice under certain conditions. Medical malpractice occurs when a healthcare provider deviates from the standard of care in their profession, resulting in harm to a patient. Here are a few key points about how delayed medical care might constitute malpractice:

• Standard of care violation: The delay in medical care must represent a deviation from the standard of care that a reasonably competent healthcare professional would have provided under similar circumstances.
• Causation: There must be a direct link between the delay in care and the harm suffered by the patient. It must be shown that the delay caused or significantly contributed to the worsening of the patient’s condition.
• Damages: The patient must have suffered actual harm as a result of the delay. This can include physical injury, additional medical bills, loss of income, pain and suffering, and other types of damages.

When Amazon’s call center staff scheduled an appointment for critically ill patients instead of obtaining immediate medical care for them, and if the failure to diagnose or treat their condition led to a worse health outcome than if they had been treated promptly, this might be considered malpractice.

What other medical malpractice concerns might One Medical’s business model present?

Identifying severe symptoms when talking to patients on the phone can be challenging, and as a result, patients weren’t sent to emergency rooms or urgent care clinics when they should have been. Here are some other risks that might arise from the nature of remote consultations and the technology used:

• Misdiagnosis: Limited by the inability to perform physical exams and direct tests, providers may misinterpret symptoms or fail to diagnose serious conditions. Miscommunication or insufficient information can exacerbate these risks.
• Documentation errors: Accurate documentation is crucial in healthcare, but the fast-paced, remote nature of call center operations can lead to incomplete or inaccurate record-keeping, which can result in inappropriate treatment decisions.
• Technology failures: Dependence on technology means that any malfunctions or disruptions can hinder the delivery of care, such as dropped calls, poor connections, extended hold times, or data breaches, all of which can potentially lead to patient harm.
• Privacy and security breaches: Handling sensitive medical information over electronic platforms increases the risk of privacy violations and data breaches, which can lead to legal issues beyond traditional medical malpractice.
• Inadequate patient assessment: Without physical cues and tests, providers might not fully assess a patient’s condition, leading to inadequate or incorrect treatment plans.
• Cross-border licensing issues: Providers offering services to patients in different jurisdictions may face legal complications if they are not properly licensed in the patient’s location, leading to potential liability issues.
• Communication barriers: Misunderstandings due to language differences, technical issues, or simply the lack of face-to-face interaction can lead to errors in understanding the patient’s condition or in taking appropriate action. Symptoms can be hard to describe to call center staff, particularly if they have no experience with a particular condition.

To mitigate these risks, providers typically need to implement robust protocols for documentation, invest in reliable technology, ensure compliance with licensing and privacy laws, and develop clear communication practices. Training and ongoing education in telemedicine best practices are also crucial.

Does technology itself present medical malpractice issues?

Technology has revolutionized healthcare delivery, offering new tools and methods to treat and manage patient care. However, it also introduces specific risks and potential avenues for medical malpractice. Here are a few ways technology can present medical malpractice issues:

• Electronic health records (EHR) errors: EHR systems are crucial for documenting patient care, but they can also be a source of errors. Incorrect entries, software glitches, or design flaws can lead to incorrect information being recorded or transmitted, potentially resulting in inappropriate treatment decisions.
• Artificial intelligence and algorithms: AI tools used for diagnosing or predicting patient outcomes can sometimes be biased or incorrect if they are not properly trained on diverse data sets or if their algorithms are flawed. This can lead to inappropriate treatment plans or missed diagnoses.
• Over-reliance on technology: Healthcare providers may over-rely on technological outputs without applying their clinical judgment. This can be particularly problematic with decision-support systems or diagnostic tools.

Failure to diagnose a medical condition or illness can delay a necessary or lifesaving treatment. When that failure is the result of negligence on behalf of healthcare providers, it may be an act of medical malpractice. Paulson & Nace, PLLC has extensive experience helping victims of medical malpractice throughout Washington, D.C. To schedule a free initial consultation with a compassionate medical malpractice attorney, call us or fill out our contact form today.