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Pilots underscore Amazon healthcare strategy

Amazon’s initial moves into healthcare have analysts like Forrester’s Jeff Becker wondering what its larger game might be.

In the last two years, Amazon has increasingly set its sights on the healthcare industry as it makes acquisitions and tests healthcare products internally that could be pushed out to customers in an effort to solve larger issues, such as the lack of prescription price transparency and the high cost of healthcare.

The Amazon healthcare strategy includes acquiring online pharmacy PillPack and digital health technology startup Health Navigator. It also includes co-founding Haven. The initiative aims to use their combined resources and test new ways of lowering healthcare costs for their employees and is in partnership with Berkshire Hathaway and JPMorganChase.

“I think the most interesting thing they’re doing is following along the storyline of bringing down their own employee medical cost,” Becker said.

Jeff BeckerJeff Becker

Becker believes the company’s strategy is currently focused on cultivating the use of voice technology in healthcare and creating a “more shoppable healthcare experience” for patients and employers.

Some efforts are already proving fruitful. Others are more of a question mark. Becker pointed to Haven as one place that may not be making the kind of progress it set out to make.

The big picture

The Haven initiative is combining data, technology and resources from Amazon, Berkshire Hathaway and JPMorganChase to lower prescription drug costs and medical treatment for patients, according to the company’s vision statement.

Amazon announced the Boston-based joint venture in January 2018, but it didn’t get the name Haven until earlier this year. According to Haven’s vision statement, it’s not looking to make a profit as it seeks to find ways to lower healthcare costs. Haven plans to “reinvest any surplus” back into the initiative’s work to improve health outcomes and lower costs. While its current focus centers on employees of all three companies, the vision is to eventually share its innovations with others.

One of the first pilot healthcare services to grow out of the Haven initiative is Amazon Care, for Amazon employees in the Seattle area. The pilot service offers virtual and in-person care from Oasis Medical through a mobile app.

Becker called Amazon Care a “digital front door” for lowering employee healthcare costs by addressing an employee’s minor healthcare needs and potentially sidestepping costly urgent care visits.

“If they can reduce the overuse of the ER, the digital front door strategy will pay for itself,” he said.

Amazon Care also offers same-day prescription deliveries. The service utilizes Amazon’s $753 million acquisition of PillPack, a digital pharmacy that sorts medication by dose and delivers to a patient’s door. The PillPack acquisition has since been rebranded as PillPack by Amazon Pharmacy. This month, it started working with Blue Cross Blue Shield of Massachusetts by integrating pharmacy services into the health insurer’s “MyBlue” app.

Amazon also acquired a start-up called Health Navigator earlier this year, its first healthcare-related acquisition since PillPack. Health Navigator provides services such as online symptom checking and triage tools for digital health companies seeking to steer patients to the right location to seek care. The acquisition plays a role in the overall Amazon healthcare strategy as it will become part of the Amazon Care health service.

Kamaljit BeheraKamaljit Behera

“If you go by what Amazon’s spokesperson revealed, they want to eliminate costs associated with travel, as well as the inconvenience associated with waiting times for patients,” Kamaljit Behera, an analyst at Frost & Sullivan, said. “This is where we see Amazon coming strong into the telehealth space.”

The work Amazon is doing through the Haven initiative and pilots like Amazon Care points to what Becker thinks will be the wider Amazon healthcare strategy: a one-stop-shop for patients seeking healthcare options.

What if there was a marketplace for shoppable healthcare experiences?
Jeff BeckerAnalyst, Forrester

“What if there was a marketplace for shoppable healthcare experiences?” Becker said.

That idea is a long way off, but Becker believes Amazon is testing the idea now, starting with its Amazon Care pilot, to find ways to introduce technology and cut down on costs. Yet beyond Amazon Care, the Haven name hasn’t been associated with many projects, and Becker said there hasn’t been much in the way of updates about Haven and the work Haven CEO Atul Gawande, M.D., has been doing — something he will be looking for in 2020.

Behera echoed Becker, saying he believes the Amazon healthcare strategy going forward will be to extend health services with a more consumer-centric offering.

“Amazon will be looking to create a much more curated, personalized space,” Behera said.

Amazon will continue focus on voice

Amazon’s main goal appears to be lowering healthcare costs through its efforts with the Haven initiative, but one area Amazon will continue to develop is voice technology in healthcare, Becker said.

Early partnerships with health systems like Boston Children’s Hospital to build Alexa skills, or voice capabilities, served as indicators of the company’s interest in healthcare. In 2016, AWS partnered with Boston Children’s to start building Alexa skills for parents, Becker said. Recently, Amazon announced the creation of a skill that enables Alexa to refill prescriptions by voice, as well as remind patients to take their medication.

Amazon has continued to build out Alexa skills for the healthcare industry, and Becker speculates that Alexa will be the first virtual assistant to be HIPAA-compliant. Indeed, Amazon is creating healthcare skills that are etching closer to being HIPAA-compliant, such as Express Scripts and Cigna Health Today, which give eligible customers the ability to use voice to manage prescriptions and engage in health improvement programs.

Becker said Amazon has six ongoing protected health information-processing pilot programs. He described the company as the first to “cross the finish line” for voice-only two-factor authentication, which first authenticates a voice profile and then asks for a unique verbal pin to access protected health information (PHI).

“We’ve been waiting for some kind of way they are going to overcome the authentication requirements for starting to process PHI,” he said.

As Amazon builds healthcare skills for Alexa, Becker said AWS will eventually play a major role as a data processing platform for the Alexa voice skills. At the recent AWS re:Invent 2019 conference, Amazon introduced Transcribe Medical, which records patient-doctor interactions and turns voice into text. The service is helping clinicians with medical notes, but Becker believes it points to a longer-term use case as a data processing tool.

Transcribe Medical can be made more robust by combining it with services like Amazon Comprehend Medical, which uses natural language processing and machine learning to extract pertinent pieces of medical information from unstructured text, according to Becker.  

“If you have a HIPAA-compliant Alexa service, Transcribe Medical will convert those conversations to text, and then Comprehend Medical will identify clinical facts within that text,” Becker said. “You’re starting to see a more compelling set of capabilities for having medical conversations with consumers over a voice channel. I think that’s part of what they’re building.”

Frost & Sullivan’s Behera said Alexa and voice technology is an integral part of the Amazon healthcare strategy. It’s looking to address a known healthcare pain point — physician burnout — with emerging tech.

Based on industry estimates, 40% of physician burnout is related to the EHR, Behera said. While interacting with a patient, physicians enter information into a patient’s electronic health record, a process that can be burdensome and negatively impact the patient-physician relationship. Transcribe Medical, which is HIPAA eligible, could reduce the data entry burden. EHR vendor Cerner is partnering with Amazon to introduce the service as a digital assistant for providers.

“AI-driven interactive, virtual assistants are becoming a common background technology for medical transcription, documentation … and even customer relationship management,” Behera said.

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Amazon, Intel, NBCUniversal spill buying secrets at HR Tech 2018

LAS VEGAS — Amazon’s talent acquisition organization has more than 3,500 people, including 2,000 recruiters, and is very interested in testing out new technology. That is probably welcome news to vendors here at HR Tech 2018. But Amazon and other big HR technology users warned against being dazzled by vendors’ products and recommended following a disciplined and tough evaluation process.

“I think it’s important to stay abreast with what’s happening in the market,” said Kelly Cartwright, the head of recruiting transformation at Amazon. “I’m really, really passionate about doing experiments and pilots and seeing whether or not something can work,” she said, speaking on a talent acquisition technology panel at HR Tech 2018.

It’s important to “block out time and take those [vendor] calls and listen to what those vendors have to say because one of them actually might have a solution for you that can be a game changer,” Cartwright said.

A warning about new HR tech

But Cartwright also had a clear warning for attendees at the HR Tech 2018. It won’t help to make the investment in a new technology until “you really clarify” what it is you want to use it for, she said.

What has to happen first in investigating HR trends and new technologies is to “start with a clear problem that you’re trying to solve for,” Cartwright said. She illustrated her point with example questions: Is the problem improving diversity in the pipeline? Or is it ensuring that there are enough potential candidates visiting your recruiting website?

Endorsing this approach was Gail Blum, manager of talent acquisition operations at NBCUniversal, who appeared with Cartwright on the panel.

Blum said NBCUniversal may not always have the budget for a particular new HR technology, but vendors increasingly are offering free pilots. Companies can choose to take a particular problem “and see if that new tool or vendor has the ability to solve that,” she said.

Attendees walk through the expo area at the 2018 HR Technology Conference
New HR tech is in abundance at the 2018 HR Technology Conference & Expo

New tech that doesn’t integrate is next to useless

Critical to any new HR technology is its ability to integrate with existing talent systems, such as an applicant tracking system, Blum said. She wants to know: Will the system have a separate log-in? “That’s always something that we ask upfront with all of these vendors.”

“If you are requiring everyone to have to go to two different systems the usage probably isn’t going to be great,” Blum said, who said that was their experience from some previous rollouts. If the systems don’t integrate, a new technology addition “isn’t really going to solve your problem in the end,” she said.      

There was no disagreement on this panel at HR Tech 2018 about the need to be rigorous with vendors to avoid being taken in by a shiny new technology.

We ask really invasive questions of the vendors.
Allyn Baileytalent acquisition capability adoption transformation leader, Intel

If Intel is going to partner with a talent vendor “it’s a long-term play,” said Allyn Bailey, talent acquisition capability adoption transformation leader at the chipmaker.

“We ask really invasive questions of the vendors,” Bailey said. “The vendors really hate it when we do it,” she said.

But Bailey said they will probe a vendor’s stability, their financing and whether they are positioning themselves to gather some big-name customers and then sell the business. “That freaks me out because my investment with that vendor is around that partnership to build a very customized solution to meet my needs,” she said. 

TechTarget, the publisher of SearchHRSoftware, is a media partner for HR Tech 2018.

MapR Data Platform gets object tiering and S3 support

MapR Technologies updated its Data Platform, adding support for Amazon’s S3 application programming interface and automated tiering to cloud-based object storage.

MapR is known for its distribution of open source Apache Hadoop software. It contributes to related open source projects designed to handle advanced analytics for large data sets across computer clusters. The 6.1 release of the MapR Data Platform — formerly MapR Converged Data Platform — adds storage management features for artificial intelligence applications that require real-time analytics.

MapR Data Platform 6.1, scheduled to become generally available this quarter, features policy-based data placement across performance, capacity and archive tiers. It also added fast-ingest erasure coding for high-capacity storage on premises and in public clouds, an installer option to enable security by default and volume-based encryption of data at rest.

Providing real-time analytics for AI requires coordination between on-premises, cloud and edge storage, said Jack Norris, senior vice president of data and applications at MapR, which is based in Santa Clara, Calif.

“What we’re seeing increasingly is that the time frame for AI is decreasing. It’s not enough to understand what happened in the business. It’s really, ‘How do you impact the business as it’s happening?'” Norris said.

MapR storage additions

MapR Data Platform 6.1 expands storage features by adding policy-based tiering to automatically move data. It now supports a performance tier of SSDs or SAS HDDs; a capacity tier of high-density HDDs; and an archival tier of third-party, S3-compliant object storage. Customers supply the commodity hardware.

The storage management features follow the 2017 addition of MapR-XD software to MapR Converged Data Platform. MapR-XD is based on the company’s distributed file system that was released in 2010. It includes a global namespace that can span on-premises and public cloud environments and support tiers of hot, warm and cold storage.

MapR writes all data to the performance tier and then determines the most appropriate way to store it, Norris said. Its tiering is independent of data format. Norris said the system could write NFS and read S3, or the reverse. For instance, MapR can place and store data as an object on one or more clouds and later pull back the data and restore it as a file transparently to the user.

“We do constant management of the data to account for node failure, disk failure, rebalancing of the cluster and eliminating hotspots,” he said.

New MapR release adds file stubs

The MapR software handles data transformations between file and object formats in the background. With past releases, the MapR system had to go through an intermediate step to shift data between file- and object-based storage. With 6.1, MapR retains file stubs to represent data that the system has shifted to cloud-based object storage. The stub stores the location of the data.

“When you need to access that data, we’re just pulling back an individual file,” Norris said. “You don’t want to pull back a whole directory or a whole volume. If you look at cost economics in the cloud, it’s expensive, because you get charged by data movement.”

The newly added support for the Amazon S3 API includes all core capabilities, such as the concept of buckets and access-control lists, Norris said.

MapR’s new erasure coding spreads pieces of data across disks. Norris said the MapR erasure coding preserves snapshots and compression.

The MapR Data Platform is available in Enterprise Standard and Enterprise Premium editions. The Enterprise Standard offering includes MapR-XD, MapR-Document Database, MapR Event Data Streams and Apache Hadoop, Spark and Drill. The Enterprise Premium software tacks on options such as real-time data integration with MapR Change Data Capture, Orbit Cloud Suite extensions and the ability to add the Data Science Refinery toolkit.

Deviation from Hadoop

Carl Olofson, a data management software research vice president at IDC, said MapR’s file system emulates the Hadoop Distributed File System, but its indexes and update-in-place capabilities set it apart. The challenge for MapR is the potential skepticism of having a “data lake solution that deviates so far from the Hadoop project code,” Olofson said.

“The good news there is that even the other Hadoop vendors are no longer solely focused on Hadoop, so MapR may be on top of an emerging trend,” he wrote.

Policy-based storage tiering is the key new capability in the MapR Data Platform 6.1, Olofson claimed. “As people move data lake technologies to the cloud, they are initially in sticker shock because of the storage costs associated with it,” he said. “The MapR approach not only addresses that, but they say it does it automatically.”

MapR’s competition includes Cloudera, Hortonworks and various open source technologies, according to Mike Matchett, principal IT industry analyst at Small World Big Data. He noted concerns that MapR is “at heart a closed proprietary platform.” But Matchett said he gives MapR an advantage over plain open source in terms of supporting mixed and now operational workloads.

“The theme for MapR in this release is to support big data AI and ML [machine learning] alongside and with business applications,” Matchett wrote in an email.

Job searches reveal top skills for tech positions

Job hunters who know the ins and outs of Amazon Web Services, Amazon’s cloud computing platform, have pretty bright prospects, according to new research by jobs website Indeed.com. So do those with Microsoft Azure skills.

People who can use the JavaScript library React are golden.

The report, published Wednesday, highlighted 15 IT skills that job seekers are betting will land them high-paying tech positions — and that employers want new hires to come equipped with.

The skills were culled from terms typed into the site’s search browser by job hunters and then matched against what terms employers looked for when combing through Indeed’s resume database.

React, a popular collection of JavaScript resources for building web UIs, was by far the most searched-for term, with a 313% increase in job seeker interest from October 2016 to September 2017 when compared with the same period a year earlier. A lot more employers were using the term to find new employees, too, with a 229% increase.

“React is becoming something that’s more crucial to the job search,” said Indeed economist Daniel Culbertson, who spearheaded the research. The JavaScript library is managed primarily by social media site Facebook, which he said bolsters its popularity. “It’s becoming a part of the job for more and more companies.”

A distant No. 2 was the term Amazon Web Services — the top-selling cloud infrastructure service — showing a 98% increase in interest among job seekers and a 40% jump among employers. No. 3 was Microsoft’s cloud service, Azure, with the number of job hunters using the term to search for tech positions rising 51% and employers 62%.

Search terms equal IT skills

Despite the gap between No. 1 React and the runners-up, AWS and Azure still grew by “leaps and bounds,” the report read, and the high rankings show the importance of cloud computing in the job market today.

“Cloud is gaining because businesses of all stripes are boosting their use of off-site computing and storage — and that’s making experienced cloud developers a must-have for many employers,” the report continued.

Other search terms on the list were Angular — or properly AngularJS, a Google-managed open source web application framework — Tableau, data visualization software; Spark, a data analytics engine; and programming language Python.

Culbertson based the report on search terms because the names of the numerous platforms and programming languages in technology can be easily classified as skills since “they’re very integral to jobs.” When users visit Indeed, they type in search terms that describe the skills they want to take with them to a new job.  

For the research, Culbertson looked at the activity of people searching for tech positions, then examined the searches that got them to the search results page. Then he whittled down the list of terms and classified them as skills.

“We wanted to see which of these tech skills are becoming more important to the job search, based on job search activity,” Culbertson said. “We thought this could serve as a barometer for how important these skills are becoming in general in the tech industry.”

Indeed doesn’t give out exact numbers of searches on terms or jobs people subsequently click on, Culbertson said. But with the site bringing in 200 million visitors a month, breaking down to millions of searches each day — and with technology becoming a more important part of the labor market — searches for tech positions is “a rather high volume,” he said.

The new language of tech?

One unexpected item in the list of tech job search terms was Mandarin, as in the primary language spoken in China, Culbertson said. There was a 49% increase in job-hunter interest in the use of the term.

“This isn’t necessarily a tech skill, but you could classify a language as a skill,” Culbertson said. “And I think it speaks to the fact that China is the second-biggest economy in the world.”

And it represents the impact China and its citizens, who are studying at U.S. universities in high numbers, are having on the U.S. technology industry, he said. Popular job postings people clicked on after searching on Mandarin as a keyword were product developers, language analysts and customer support specialists, the report read.

But employer interest in Mandarin as a search term was down 39%. It’s too early to determine a reason for the dip, Culbertson said, but it’s worth keeping an eye on in the future.

“My assumption is that this would be employers who are looking for people with Mandarin skills because of the amount of business that they do with China,” he said. “But it’s tough to say what would be behind the decline from this year to last year.”

AWS cloud platform will share cloud computing heights, CEO Jassy says

ORLANDO, Fla. — Andy Jassy is confident that Amazon Web Services, Amazon’s cloud computing division, will remain the world’s top-selling cloud infrastructure provider. The word the CEO gave is optimistic.

But AWS won’t be the world’s only cloud provider, Jassy said.

“There’s not going to be only one successful company,” Jassy said at the Gartner Symposium/ITxpo here Monday. He predicts companies moving applications and data to the cloud will go with two or more of a cluster of large providers, which include Microsoft, Google and IBM.

But for most companies, Jassy said, multicloud won’t mean splitting workloads evenly among different providers. Many CIOs and IT leaders start off thinking they’ll do that, but “very few end up going that route.”

For one thing, multiple cloud platforms means multiple systems for cloud teams to learn and keep straight, he said. And cloud providers offer volume discounts to companies — the more cloud they use, the better the price. If companies divvy up their workloads, they lose their buying power.

Instead, most companies pick one provider and then put a small percentage of their workloads in a second one. They do this to avoid vendor lock-in and give them the option to switch if the first vendor raises its prices or goes out of business, Jassy said.

The AWS cloud platform will be the primary cloud for many companies, he said, because the company has “so much more functionality than anybody else, a much larger and more mature ecosystem and then a much more mature platform.”

AWS was launched in 2006, and rivals have struggled to keep up with its fast growth and pace of innovation. But in August, AWS tied Microsoft’s Azure for best cloud platform in Gartner’s annual ranking of cloud providers.

Focus on customer needs

Gartner analyst Daryl Plummer interviewed Jassy onstage in front of thousands of CIOs and IT leaders, and asked Jassy about the factors that helped AWS grow so big so fast.

About 90% of what we build is driven by what customers tell us matters to them. The other 10% is listening to customers really carefully about what they’re trying to solve.
Andy JassyCEO, Amazon Web Services

“About 90% of what we build is driven by what customers tell us matters to them. The other 10% is listening to customers really carefully about what they’re trying to solve,” Jassy said. AWS puts this to practice in its product development. Once it launches a new product or service, it examines customer feedback, makes adjustments and tries again.

Another way AWS distinguishes itself, Jassy said, is through its customer support function called Trusted Advisor, which surveys how customers are using AWS and then alerts them if they’re using it in a “suboptimal way.”

If, for example, a customer has a lot of virtual machines in the AWS cloud but isn’t using them, “we’ll send out a note saying, ‘Hey, maybe you want to stop spending money with us, and you can resume spending money when you need it.'”

AWS has sent millions of such notices out to customers over the last few years and as a result has saved them $500 million a year, Jassy said.

But AWS gets dinged by customers, too. In an unofficial survey of about 75 people, Plummer found that people were frustrated by the deluge of AWS cloud platform features — and how they’re accounted for in infamously confusing bills.

“Nobody knows what they’re paying for,” he said.

Jassy said that for some companies keeping up with the number of new features and services is “sometimes daunting” — there were more than 1,000 in 2016 and 1,250 are expected by the end of the year. Customers are happy with the cost savings and innovation they afford them, he said. But they’ve also told AWS it needs to simplify things.

“I think we’ve made a lot of progress there, but we still have work to do,” Jassy said.

A call to cloud

Jassy would find an ally in Sasi Pillay, who was in the audience. Now vice president of IT services and CIO at Washington State University, Pillay is a longtime advocate of cloud computing.

Pillay moved external websites to AWS as CTO at space agency NASA, and now he’s trying to do the same at WSU, where websites are hosted on premises.

“My long-term vision is to own as little IT assets as possible and instead focus on delivering solutions for our customers,” he said.

To determine what faculty, staff and students need from technology, Pillay has worked to streamline the governance structure through which IT discusses projects with working groups, deans and the university cabinet. Also in the works are a student survey, an interactive list of IT projects students can vote on and a hackathon in which they can develop mobile applications that IT can later deploy.

Pillay saw a clear parallel between the partnership he’s forming with WSU constituents and the one AWS has made with its customers.

“I think that’s what AWS is trying to do with its customers. Instead of being just a service provider, it’s becoming a strategic partner,” he said.