This is an exclusive BHB+ story

There was a time when tech companies thought they could solve every problem in the world with an app.

And that applied to health care, too. I couldn’t help but chuckle when the “unfortunate” friend in the new HBO movie Mountainhead was seeking funding for his meditation platform.

I reported exclusively on digital health from 2017 to 2022, during an era when money was cheap and non-traditional players were entering the health care arena daily. But with most gladiators entering the arena, there’s a good chance they don’t make it out alive.

Don’t get me wrong, I’m still the last one standing on the BHB team drinking the promise of digital health Kool-Aid. However, with many non-traditional players pulling back on their health care efforts, it got me really thinking: Some of these companies have incredible skills in certain areas, so where could they be useful to the behavioral health industry?

It’s true, Amazon closed its Amazon Care’s division, which included behavioral health. However, it’s important to note that Amazon remains involved in direct care through its acquisition of One Medical, which does offer behavioral health services. What’s more, Google Health closed up shop in 2021.

And while I would cringe to see Amazon roll out another version of its now-discontinued Halo band with behavioral health functions, big tech could still have a trick or two up its sleeve to help the behavioral health space.

In this BHB+ Update, I will explore:

– Why Amazon probably shouldn’t offer therapy but could help with medication management

– How Google could be a leader in AI for behavioral health

– Why Apple’s health records could be difficult to apply to behavioral health

Analyzing Amazon’s behavioral health potential

Let’s talk about Amazon. When Amazon launched its virtual health care offering, I was skeptical. Patients place a great deal of trust in their doctors and health care providers. And many didn’t want to shop at the same place where they went to therapy.

But Amazon does have its strengths. My Pavlovian response when the Amazon truck rolls up to my house is that I’m about to receive something exciting that I impulsively purchased online. And as a new parent, it’s turned slightly to, “Oh great, the diapers are in, and I don’t have to go to Costco.”

But that might be the magic of where Amazon falls into health care. Amazon is about convenience. And for anyone who has stood in line at the pharmacy trying to get in there before it closes, an Amazon alternative is a good deal.

In 2018, Amazon acquired PillPack, a virtual pharmacy, for nearly $1 billion. This launched it into the pharmacy space. Recently, a behavioral health provider recognized the potential of this offering. At the end of May, telemental health provider Talkspace (Nasdaq: TALK) announced a new integration with Amazon Pharmacy. As part of the arrangement, Talkspace providers can now send prescriptions directly to Amazon with one click.

Talkspace initially inked a deal in September to sell its services through Amazon Health Services’ Health Conditions Program. This partnership also made sense for Amazon because at the end of the day Amazon is best known for selling products and services. It makes sense for Amazon to sell its services rather than offer them.

The promise of analytics

While a centralized Google Health offering may be a thing of the past, let’s face it: Google does data well. With everyone in behavioral health interested in the future of artificial intelligence, this could be a place where Google can take the lead and even be a valuable partner for traditional providers.

Last year, I sat down with Dr. Megan Jones Bell, the clinical director of consumer and mental health at Google, to discuss the use cases for AI in behavioral health. She outlined three main themes: reducing clinical burnout, improving nonclinical training programs and boosting measurement-based care.

“Leveraging this technology has enormous potential to improve some of the intractable problems we’ve had in the mental health sector, such as provider shortages and quality access problems,” Bell told me. “It’s a great time for providers or clinicians to be educating themselves about generative AI, specifically to understand what’s different about generative AI from AI that has existed and was leveraged previously, and to start playing around with this, not using patient data, not using it in a clinical capacity, unless their organization is using, a HIPAA-compliant solution.”

Bell noted that Google was working with health care providers on billing, note summarization, and predictive models. Specifically, the tech titan collaborated with the state of Illinois through its cloud public sector team to develop a new portal that enables patients to access mental health care. AI is a component of this effort because it helps route and match patients to clinicians by understanding their needs and facilitating triage.

I think Google’s foray into behavioral health with AI and data analytics makes a great deal of sense. Google is known for helping people find the information they need quickly – why not apply these skills in behavioral health?

Apple’s recordkeeping ambitions

I think one of the most ambitious initiatives that Apple rolled out around health care was its launch of Apple Health Records. The effort enabled patients to store their encrypted health records on their phones. The program launched out of beta in 2018, with 39 health systems participating.

It aimed to address the electronic health record (EHR) interoperability issue, which frequently hinders the sharing of health records among multiple providers.

Within behavioral health care, it’s hard enough getting therapists and psychiatrists to collaborate. Sharing records between physical health and behavioral health providers – imagine! I would love to see Apple Health Records solve some of these issues in behavioral health, especially as we know that behavioral health impacts physical health. In general, providers must understand the medications patients are taking.

Yet one hiccup in bringing this kind of technology to the behavioral health space is that behavioral health providers are notoriously tech-averse. It’s not exactly their fault; behavioral health providers were left out of the 2009 HITECH Act, which allotted funding to encourage the use of EHRs.

The lack of funding for these technologies led to slow EHR adoption among behavioral health providers. This was especially true of small mom-and-pop providers who have slim margins.

Still, we are seeing some of the larger providers, such as Acadia, prioritizing strategic investments in EHRs. As more providers begin to adopt these technologies, there could be an opportunity to ink a deal with Apple and finally give patients the ability to share their information more easily.

Final thoughts

I love the enthusiasm of technologists. And since I don’t talk to tech folks as much, I miss their optimism when it comes to health care.

But I also don’t think tech can solve everything – and I really don’t think MAMMA can solve the broken health system. For the most part, I think that it’s probably best if they move out of the way and let the real providers do the clinical care.

However, I do think some of the largest companies in the country possess special abilities that could help improve health care – one hopes for the better. I think Amazon could and should go all in on its retail functions to make medication and access to behavioral health services easier.

Google should leverage its data analytics capabilities to simplify the lives of providers and patients. And Apple, well, Apple should do what it does best: use really interesting functions on its phone to help put patients in the driver’s seat to care.

Don’t get me wrong, I think there are still a lot of potential pitfalls for big tech in behavioral health (I could write a whole other Update on this!), but for the most part, if these companies stay in their lane, there’s a chance we could see some good.