From Health Care to Grocery Shopping, Amazon Continues to Try to Take Over Your Life

From an AP story by Tom Murphy and Anne D’Innocenzio headlined “Amazon’s voice assistant Alexa to start seeking doctor help”:

If there is no doctor in the house, Amazon’s Alexa will soon be able to summon one.

Amazon and telemedicine provider Teladoc Health are starting a voice-activated virtual care program that lets customers get medical help without picking up their phones.

The service, for health issues that aren’t emergencies, will be available around the clock on Amazon’s Echo devices. Customers can tell the voice assistant Alexa that they want to talk to a doctor, and that will prompt a call back on the device from a Teladoc physician.

The program, announced Monday, marks Amazon’s latest expansion into health care and another push by the retail giant into a form of care that grew rapidly during the COVID-19 pandemic.

“Telehealth now is something that patients have gotten used to and may come to expect as an option for their care,” said Lori Uscher-Pines, a senior policy researcher with Rand Corp. “(Before) the pandemic, there might not have been this much awareness that this was a service that was available.”

Amazon already dispenses prescription drugs and is expanding an Amazon Care program it launched in 2019 that offers telemedicine visits with an option to send a care provider to the patient if they need an in-person visit.

The company’s latest health care expansion comes as several competitors including Walmart and the drugstore chains CVS and Walgreens also beef up their medical offerings. They are adding care clinics or virtual programs to make it easier for patients to find regular help in the fragmented U.S. health care system.

Insurers and employers that pay medical bills are pushing for this as a way to improve health and cut down on hospital stays or other big medical expenses.

“Health care is a huge industry of enormous value, and it is ripe for disruption,” said Neil Saunders, managing director of GlobalData Retail. “And Amazon views itself as a disruptor.”

Some hospitals already use Alexa as a voice assistant in patient rooms. In Great Britain, Alexa works with that country’s National Health Service to help answer medical questions with advice from the country’s official website.

The service announced Monday will be available for customers who create an Alexa voice ID. After telling the voice assistant that they need to talk to a doctor, people will be connected to a Teladoc call center and then get a call back from a physician.

The calls are audio-only for now, but the companies say they expect to add video soon. In some cases, doctors will be able to prescribe medications.

Customers can get a call back the same day, but that may depend on the availability of doctors in the state where the patient is located, Teladoc spokesman Chris Savarese said. He noted that the ongoing pandemic may lead to longer wait times.

The cost for a visit can vary depend on the patient’s coverage. Without insurance, the calls will cost $75.

Savarese said Amazon will not be able to access, record or store the content of the ensuing call.

Amazon is moving deeper into health care as other growth engines slow. In its most recent quarter, the Seattle-based company reported that its online retail business dropped 1%.

Kate McCarthy, senior research director at research firm Gartner, sees room for Amazon to expand beyond simple doctor calls. She noted that the company’s health care segment in its cloud computing division is aimed at coming up with new services and health care products.

McCarthy said she could see Amazon eventually helping to monitor patients that go home after a hospital stay, using Alexa and sensors to check how often they flush the toilet or open the refrigerator.

With its prescription services, Amazon hasn’t bit off meaningful share from its drugstore rivals, but McCarthy noted it could become a legitimate player.

“There isn’t one kind of magic market entrance,” she added “It will be a combination of things.”

Telemedicine in general grew rapidly when the pandemic first hit the United States and patients wanted to hunker down at home instead of visiting the doctor’s office.

Virtual visits have since leveled off a bit as office visits have widely resumed. But Uscher-Pines said research shows that patients remain interested.

Many want telemedicine available when they need its convenience, not as a replacement for in-person care.

“Most people don’t want that to cannibalize their in-person care,” she said. “They still want those options.”
From a New York Times story by Cecilia Kang headlined “Here Comes the Full Amazonification of Whole Foods”:

“Would you like to sign in with your palm?”

That was the question a cheerful Amazon employee posed when greeting me last week at the opening of a Whole Foods Market in Washington’s Glover Park neighborhood. She blithely added, “You can also begin shopping by scanning the QR code in your Amazon app.”

“Let’s go for the palm,” I said.

In less than a minute, I scanned both hands on a kiosk and linked them to my Amazon account. Then I hovered my right palm over the turnstile reader to enter the nation’s most technologically sophisticated grocery store.

For the next 30 minutes, I shopped. I picked up a bag of cauliflower florets, grapefruit sparkling water, a carton of strawberries and a package of organic chicken sausages. Cameras and sensors recorded each of my moves, creating a virtual shopping cart for me in real time. Then I simply walked out, no cashier necessary. Whole Foods — or rather Amazon — would bill my account later.

More than four years ago, Amazon bought Whole Foods for $13 billion. Now the Amazon-ification of the grocery chain is physically complete, as showcased by the revamped Whole Foods store in Glover Park.

For a long time, Amazon made only small steps toward putting its mark on the more than 500 Whole Foods stores in the United States and Britain. The main evidence of change were the discounts and free home delivery for Amazon Prime members.

But this 21,000-square-foot Whole Foods just north of Georgetown has catapulted Amazon’s involvement forward. Along with another prototype Whole Foods store, which will open in Los Angeles this year, Amazon designed my local grocer to be almost completely run by tracking and robotic tools for the first time.

The technology, known as Just Walk Out, consists of hundreds of cameras with a god’s-eye view of customers. Sensors are placed under each apple, carton of oatmeal and boule of multigrain bread. Behind the scenes, deep-learning software analyzes the shopping activity to detect patterns and increase the accuracy of its charges.

The technology is comparable to what’s in driverless cars. It identifies when we lift a product from a shelf, freezer or produce bin; automatically itemizes the goods; and charges us when we leave the store. Anyone with an Amazon account, not just Prime members, can shop this way and skip a cash register since the bill shows up in our Amazon account.

Amazon has tested such automation for more than four years, starting with 24 Amazon Go convenience stores and several Amazon Fresh grocery stores around the country. The palm-scanning technology, known as Amazon One, is also being licensed by others, such as a Hudson convenience store at Dallas Love Field Airport and Shaquille O’Neal’s Big Chicken restaurant at Climate Pledge Arena in Seattle.

Those stores were valuable experiments, said Dilip Kumar, Amazon’s vice president of physical retail and technology. The company is treating Whole Foods as another step in its tech expansion into retail stores, he said.

“We observed areas that caused friction for customers, and we diligently worked backward to figure out ways to alleviate that friction,” Mr. Kumar said. “We’ve always noticed that customers didn’t like standing in checkout lines. It’s not the most productive use of their time, which is how we came up with the idea to build Just Walk Out.”

He declined to comment on whether Amazon planned to expand the technology to all Whole Foods stores.

My New York Times colleague Karen Weise, who covers Amazon from Seattle, said the company operated on long time horizons, with the patience and money to execute slowly. That has allowed it to transform labor, retail and logistics over many years, she said. Groceries are just one piece of its ambitions.

The Whole Foods in Glover Park has operated for more than 20 years, a cornerstone of a neighborhood that is within walking distance of Embassy Row and the vice president’s Naval Observatory residence. Four years ago, the store closed over a dispute with the landlord and a rat infestation. Amazon announced last year that it would reopen the store as a Just Walk Out pilot project.

The rats may be gone, but not the neighborhood angst. The renovated store has sparked a spirited local debate, with residents sparring on the Nextdoor community app and a neighborhood email listserve over the store’s “dystopian” feeling versus its “impressive technology.” Some neighbors reminisced about how the store used to invite people to just hang out, with free samples and fluffy blueberry pancakes sold on weekends.

Alex Levin, 55, an 18-year resident of Glover Park, said people should not reject the store’s changes.

“We need to understand the benefits and downsides of the technology and use it to our advantage,” he said. He added that he had tried tricking the cameras and sensors by placing a box of chicken nuggets in his shopping bag and then putting the item back in a freezer. Amazon wasn’t fooled, and he wasn’t charged for the nuggets, he said.

But others said they had found errors in their bills and complained about the end of produce by the pound. Everything is now offered per item, bundle or box. Some mourned the disappearance of the checkout line, where they perused magazines and last-minute grab bag items. Many were suspicious of the tracking tech.

“It’s like George Orwell’s ‘1984,’” said Allen Hengst, 72, a retired librarian.

Amazon said it didn’t plan to use video and other Whole Foods customer information for advertising or its recommendation engine. Shoppers who don’t want to participate in the experimental technology can enter the store without signing in and pay at self-checkout kiosks with a credit card or cash.

As a longtime customer of Glover Park’s Whole Foods, I had missed the dark, cramped and often chaotic store and was excited to explore the changes. But somewhere between the palm scan and the six-pack banana bundles, I began to feel ambivalent.

I noticed a sign near the entrance that forbade shoppers to take photos or videos inside. My eyes drifted toward the ceiling, where I noticed hundreds of small black plastic boxes hanging from the rafters.

An employee jumped in. “Those are the cameras that will follow you during your shopping experience,” she explained, with no hint of irony.

Several workers milled about the entrance to guide customers through check-in, while others stood behind the seafood counter, cheese station and produce areas. Mr. Kumar said the stores would always employ humans, but I wondered for how much longer. Amazon, under scrutiny for its labor practices, said employees’ roles might shift over time and become more focused on interacting with customers to answer questions.

There were early signs of a more self-service future. At the bakery, I looked for someone to slice my $4.99 Harvest loaf and was directed to an industry-grade bread slicer for customers. A small label warned: Sharp blades. Keep hands clear of all moving parts.

Mr. Kumar wouldn’t share data on the accuracy of Just Walk Out, so I tested the technology. I picked up an organic avocado and placed it on a pile of nonorganic avocados. After walking around the store, I went back and picked up the same organic avocado. If the cameras and sensors functioned properly, Amazon would be on top of my actions and charge me for the organic avocado that had been misplaced in the conventional bin.

When I was ready to leave, I had the option of using a self-checkout kiosk or skipping the process. I decided on the latter and waved my palm again over an exit turnstile. The turnstile’s arms opened.

“You should receive your receipt within two to three hours,” an employee at the exit said.

I walked out. It felt discomfiting, like I might be mistaken for a shoplifter.

An email from Amazon landed in my inbox an hour later. A link sent me to my Amazon account for details. It said my shopping experience had lasted 32 minutes 26 seconds. My total bill was $34.35 — and I was correctly charged for the organic avocado.

Cecilia Kang covers technology and regulation and joined The Times in 2015. She is the co-author, along with Sheera Frenkel of The Times, of “An Ugly Truth: Inside Facebook’s Battle for Domination.”

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