Leaked documents reveal patient safety issues at Amazon’s One Medical

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Since Amazon acquired the primary-care service One Medical, aged sufferers have been routed to a name middle — staffed partly by contractors with restricted coaching — that failed on greater than a dozen events to hunt quick consideration for callers with pressing signs, in line with inside documents seen by The Washington Post.

When one patient reported a “blood clot, pain and swelling,” name middle employees scheduled an appointment moderately than escalating the matter for medical analysis, in line with a notice in an inside incident monitoring spreadsheet dated Feb. 19.

Over the next two days, medical staffers flagged 4 extra call-center errors involving aged sufferers with pressing complaints, together with abdomen ache and blood in stool, a spike in blood strain, an insect chew and sudden rib ache, in line with the inside spreadsheet.

The call-center incidents had been amongst dozens flagged by medical doctors, nurses and assistants at One Medical Seniors between Feb. 19 and March 18 within the documents, a yr after Amazon acquired the primary-care service. One Medical started routing aged sufferers to the decision middle in Tempe, Ariz., staffed partly by newly employed contractors with restricted coaching and little to no medical expertise, in accordance inside documents seen by The Post and interviews with 4 present and former One Medical staff.

Since Amazon formally acquired One Medical in February 2023 in a $3.9 billion deal, the corporate has alarmed sufferers and staff by eliminating free rides, shortening appointments and shedding employees. Now proof of probably life-threatening conditions at the Tempe name middle is elevating recent concern that Amazon’s frugal method to well being care could also be imperiling patient safety.

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“There were a lot of things slipping through the cracks,” mentioned a former One Medical worker, who like others interviewed for this story spoke on the situation of anonymity to keep away from skilled retaliation.

With its devotion to “customer obsession” and comfort, Amazon argues that it will possibly add worth to America’s damaged health-care system, which is tormented by lengthy waits, excessive prices and rampant inefficiencies. But since launching a push into well being care in 2018, Amazon has struggled to guard patient privateness, ship high quality care, and discover a enterprise mannequin that works for purchasers.

In April, Amazon CEO Andy Jassy acknowledged that the corporate’s method to well being care “can sometimes feel random.” But he mentioned he stays optimistic and Amazon lately ratcheted up its efforts, providing One Medical membership reductions to Prime members.

When Amazon acquired One Medical, it included two companies: An upmarket $199-a-year subscription major care service that permits sufferers to make use of an app to ebook physician appointments at clinics all through the United States and Iora Health, a clinic for chronically in poor health sufferers largely reliant on Medicare.

In 2022, the yr Amazon purchased One Medical, Medicare funding made up somewhat over half of its annual income of $1.05 billion. Amazon declined to supply up to date figures.

Amazon mentioned it created the Tempe name middle for its senior sufferers final yr “to increase access and quality of care.” Amazon founder Jeff Bezos owns The Post.

Asked to reply to the incidents, Amazon spokeswoman Dawn Brun responded by way of e mail: “While we are confident in our safety protocol … we take feedback from our providers seriously and will always address anything that is less than a great experience.” Brun added that Amazon doesn’t become involved in One Medical patient care selections.

Amazon mentioned it was not conscious of any sufferers who had been harmed due to name middle errors.

Natalie Benda, an assistant professor at the Columbia School of Nursing, mentioned making a name middle just like the one in Tempe might certainly enhance patient entry to medical care. But “if it’s not done by someone who is trained appropriately,” she mentioned, “I can see how it would be a patient safety issue.”

Internally, the Tempe name middle is known as “Mission Control.” Calls are fielded by a mixture of full-time staff and contract staff employed by Teksystems, a staffing company.

The contract staff will not be required to have expertise within the medical discipline, and the primary {qualifications} are having the ability to use a pc and telephone, in line with job listings and two staffers who labored within the name middle. Call middle staff bear two weeks of classroom coaching earlier than they begin taking patient calls, in line with a former name middle worker, who spoke on the situation of anonymity for worry of retaliation.

Amazon mentioned its contractors take calls below supervision for 2 weeks after classroom coaching, adopted by per week of teaching. The firm pointed to job listings that say new hires ought to be “comfortable navigating or learning all things health care.” Amazon mentioned it’s extra environment friendly to rent via Teksystems, which has its personal sick depart coverage, and that its coaching program is ample.

One Medical’s opponents in geriatric major care, CVS’s Oak Street Health and ChenMed additionally use name facilities to discipline inquiries from sufferers. (Archwell Health, one other competitor, permits sufferers to position calls on to clinics.)

According to coaching documents obtained by The Post, One Medical is conscious that “speaking with someone from outside the office might conjure concerns about delays in patient care or diligence,” particularly for sufferers who had been beforehand in a position to name their physician’s workplace instantly.

“We do not need to draw attention” to who’s “handling patient concerns,” the documents say. “However, if a concern is expressed, our goal is to reassure the patient that we are a trained and skilled One Medical Support Specialist and Part of their Care team.”

But two former name middle staff known as that steerage deceptive, and disputed the declare that decision middle staff are sufficiently “trained and skilled” to deal with patient calls.

One of them, who labored as a supervisor, mentioned the corporate tries to cram an excessive amount of info into two weeks within the classroom. He mentioned he steered extending the coaching interval and hiring extra staff instantly moderately than as contractors, however administration denied his request.

“My feedback to them was, fine, but understand, if we try to pump these people out of these classrooms, you’re going to have an increase in patient safety issues. Which we did,” mentioned the supervisor, who famous he was fired in March.

According to One Medical coaching documents seen by The Post, if a senior patient calls in with certainly one of 17 “red flag” signs corresponding to shortness of breath or sudden headache, name middle staff are presupposed to escalate the decision to One Medical’s digital medical employees.

But figuring out these signs when speaking to sufferers may be tough, present and former One Medical staffers mentioned. As a consequence, there have been sufferers “who should have been triaged to emergency rooms or urgent care, and that wasn’t happening,” the previous Colorado-based worker mentioned.

For instance, on March 7, a physician in Colorado flagged a name from a patient experiencing chest tightness. According to the spreadsheet, the decision middle staffer had scheduled an in-office appointment the subsequent day.

The first of the 17 purple flag signs is “chest pain/pressure/heaviness.” The physician who flagged the decision famous that it ought to have been escalated and expressed concern that decision middle employees don’t “understand that they are triaging patients themselves.”

Such errors elevated issues that decision middle employees had been making medical selections they weren’t certified to make, the present and former staff mentioned.

Amazon mentioned the decision middle employee concerned within the incident was retrained and that the patient was not harmed.

“I don’t want Amazon taking care of me.”

Amazon mentioned it created the Tempe name middle as a part of a centralized help system supposed to reply patient telephone calls quicker and unlock clinic employees to give attention to sufferers. The firm mentioned patient visits lately elevated from round 5 per day per physician to as many as 14 per day.

But not all One Medical sufferers see the adjustments as an enchancment.

Late final yr, Mary Ann Stone, 92, was experiencing confusion, ache, impacted bowels and a recurring urinary tract an infection — signs her daughter mentioned had been “hard to describe to a call center, especially a call center that has no experience with this kind of thing.”

One Medical inspired her to come back in for an appointment, however Stone finally wound up within the hospital. Her daughter mentioned she needs she’d taken her mom there sooner: Stone died in March.

“I don’t want anyone to have to go through this,” mentioned the daughter, who spoke on the situation of anonymity as a result of she fears retaliation. “I don’t want Amazon taking care of me.”

A Colorado patient who mentioned he known as One Medical thrice and waited between 30 and 90 minutes to speak to somebody was “concerned with the lack of communication access,” in line with the inner documents. Another patient’s daughter mentioned she was apprehensive her mother “may not try to contact [One Medical Seniors] for medical concerns if she think no one will answer,” incident stories mentioned.

Marilyn Overcast, 79, a One Medical patient in Shoreline, Wash., mentioned she waited hours for a name again about her thyroid treatment. “It’s frustrating,” mentioned Overcast, who mentioned she additionally was shocked when her physician abruptly left the corporate.

Amazon mentioned One Medical clinicians function independently of Amazon and that “quality of care and positive health outcomes are their number one priority.”



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