When Erik Cardenas was little, he constantly had ear infections. But his family often couldn’t get time off to take him to the doctor.
“I remember my parents, they lived paycheck to paycheck. So I remember having my mom and dad kind of think about who could afford to stay home with me,” he told Business Insider.
At 10, Cardenas, newly insured through his mom’s commercial health plan after she got a job on the assembly line at Alcon Laboratories, took his first trip to a pediatrician’s office. While he stared at the aquarium and toys, his mom took out her purse to buy coffee from the lobby setup, not knowing it was free.
Now 38, Cardenas is one of two technology leaders at Amazon Care, Amazon’s health service that provides online and in-person visits for Amazon employees. There, he’s building out the app that powers Amazon Care and working on problems like making sure the clinics are synced up with the outside health system.
In February, Amazon rolled out the pilot program for employees in the Seattle area, where Cardenas lives. In September, it expanded to all eligible employees in Washington, an Amazon spokesperson confirmed to Business Insider. Stat News initially reported the statewide expansion of the program.
The Washington rollout includes only Amazon Care’s virtual services, like video appointments and messaging features, the spokesperson said.
Amazon Care is the latest sign of the tech giant’s healthcare ambitions. Amazon stands to be a formidable competitor to traditional healthcare companies. The $1.57 trillion tech giant has tens of billions in cash, 112 million Prime members, and the ability to roll out health pilots on its 1.2 million workers.
Its 2018 acquisition of the online pharmacy PillPack sent shockwaves through the industry, as did its announcement that it’s joining up with JPMorgan and Berkshire Hathaway to form Haven, a joint venture that’s geared toward lowering healthcare costs for the companies’ employees and improving the quality of their care.
Read more: How tech titans like Amazon, Google, and Microsoft are taking on the $3.6 trillion healthcare industry
Cardenas is using Amazon Care himself. When Cardenas’ 8-year-old son, Santiago, who’s also prone to ear infections, gets sick, he gets an online consultation with Amazon Care doctors through the click of a button or two.
After the last earache a couple of months ago, Santiago got an exam in their home from a registered nurse, followed by a delivered prescription for the infection. It took hours, not days.
Seattle workers, unlike those in the rest of the state, can get in-person care.
“So when I compare the Amazon Care service that I helped build, it’s drastically improved from the experiences that I dealt with as an 8-year-old, even at the pediatrician’s office,” he said.
Learning healthcare technology on the job
Cardenas was one of 50 people in his high-school graduating class of about 440 to go to a four-year college. He attended Texas A&M University but realized he wasn’t ready to excel in that environment and left after his first year.
Cardenas learned on the job, first as a patient-registration coordinator for a radiology clinic. His first exposure to healthcare software came when the clinic implemented a new system for sending moving images online to other medical professionals.
In 2005, Cardenas had to use those IT skills in a catastrophe. While he was implementing electronic medical records for clinics in Austin, Texas, Hurricane Katrina hit New Orleans. He was asked to set up digital records for people displaced by flooding.
“The individuals that were seeking care, some of them didn’t have identification,” Cardenas said. “Some of them didn’t have any details about their medication history or problems.”
After that, Cardenas took more medical-imaging jobs and became the IT director at Tenet Healthcare. In 2014, he started a venture for cancer navigation that didn’t work out. He joined Everlywell, a testing startup, as a founding employee in 2016.
Amazon poached him from WellnessFX, another testing group, two years later. He said that with Amazon’s mission to be Earth’s most customer-centric company in mind, he said yes.
Everything important in the health-tech world has happened over the past 10 years, and Cardenas had a front-row seat, he said.
Cardenas made a promise to himself to finish his college degree and became a full-time student while working at Amazon. He graduated in September from the University of the Incarnate Word in San Antonio.
“I’ve always been a student of healthcare, right, never stopped learning,” he said.
Cardenas is hammering out Amazon Care’s digital strategy
Cardenas is one of the key contributors to Amazon Care’s overall strategy and feeds ideas to a team of engineers. One of his priorities lately is making labs, imaging centers, and doctors in the network more coordinated through the exchange of patients’ health information.
Such coordination will be important as the semivirtual service expands to a wider variety of people. It works with a mobile app and a private practice, Care Medical. For now, the care team does in-person and telehealth visits for people with basic health issues like coughs and fevers, Cardenas said.
When needed, Amazon employees can get referred to specialists. But Cardenas wants the whole system to talk to each other, saving patients from tracking down appointments and results.
“For me, that’s just the cornerstone for improved patient experiences, for improved patient safety, for cost reduction, and for better care coordination,” Cardenas said.
He’s also played a role in Amazon’s testing of essential employees.
Amazon Care is getting bigger
There are early signs that Amazon Care will roll out to consumers at some point too. One new job posting for a “business development manager” is looking for someone to “build and grow relationships with commercial and public sector enterprises.”
Cardenas declined to talk about the pilot’s expansion plans.
Amazon Care is one of a number of healthcare ventures for Amazon that kicked off in earnest with the 2018 acquisition of PillPack. Its voice assistant, Alexa, is increasingly directing users to urgent-care centers, and Amazon Web Services, the largest cloud provider, has signed on big healthcare clients like the health IT giant Cerner. The tech giant also made a huge bet on a health-monitoring device called Halo in August.