Cambia Health Solutions Builds Integrated, Human-Centered Healthcare Solution on AWS

Total health solutions company Cambia Health Solutions (Cambia) has a commitment to give individuals access to critical healthcare information so that they can make informed decisions affecting their health and well-being. In recent decades, the company has observed that health technology mostly serves large organizations, with sophisticated electronic health record systems essentially acting as efficient billing systems for insurance companies rather than providing useful, insightful information for individuals.

In its drive to make healthcare technology better serve individuals, Cambia used Amazon Web Services (AWS) to develop Journi, a digital all-in-one health solution guided by data-driven intelligence and human expertise that helps health plan members and their families make the most of their health benefits. Cambia used multiple AWS services, including Amazon Comprehend Medical, a natural language processing service that uses machine learning (ML) to extract relevant medical information from unstructured text, and Amazon SageMaker, a fully managed service that provides developers and data scientists the ability to build, train, and deploy ML models quickly.

Cambia is the parent company of six regional health plans serving more than three million people in Oregon, Idaho, Utah, and Washington. Cambia aims to make the healthcare system more economically sustainable and efficient for people and their families, with an emphasis on personalized, compassionate solutions and services.

With Journi, Cambia seeks to transform technology’s role in healthcare. “People don’t only exist when they have an acute health event or episode,” says Laurent Rotival, Cambia’s senior vice president of strategic technology solutions and chief information officer. “We have a real shot at changing the way people experience healthcare and the way the healthcare industry delivers care and services to those people.”

Built using best practices in human-centered design, Journi brings together health plan benefits, digital care tools, well-being and clinical expertise, and human support to combat healthcare complexity and create a better experience. “People today have access to more digital solutions than ever before, but many of these fall short,” says Aadam Hussain, general manager of Journi. “By combining both hard data and human support in one solution, Journi makes it easier for people to understand and make good use of their health benefits.”

“Considering the unprecedented availability of data across the industry, we’re at a stage where we need to design solutions—not for hospitals, health plans, or employers but for individuals, their families, and the people they care for,” says Rotival. “So we’ve built a service on AWS that enables us not only to build products that create an intuitive experience but also to integrate third parties that are not built on our stack.” Based on an individual’s health profile, claims history, and past actions, Journi can provide users with relevant insights and personalized recommendations.

One of the key elements of Journi is a team of concierges and clinical specialists that answers health questions by chat, email, or phone. “We’ve built a series of models based on Amazon SageMaker to interpret the unstructured data that results from either chat-based conversations or phone calls with our members,” says Rotival. “That data is interpreted and contrasted to our service levels and the specs that we’ve defined. That’s been a tremendous use case for us—to provide quality control for these concierge services.”

Another challenge that Cambia faces is getting the data from clinical systems and hospitals and adding it to individuals’ overall health profiles. Traditionally, this data comes in fax or PDF format, which can be time consuming to integrate into the service manually. Cambia is using Amazon Comprehend Medical to develop proofs of concept to address this challenge. Also involved in these proofs of concept is Amazon Textract, a fully managed ML service that automatically extracts printed text, handwriting, and other data from scanned documents. It goes beyond simple optical character recognition to identify, understand, and extract data from forms and tables. “In these proofs of concept, we concluded that these services proved very promising in reducing human intervention from the bulk of the administrative tasks and bringing efficiency to time-consuming processes,” says Rotival. What’s more, Amazon Textract and Amazon Comprehend Medical facilitate HIPAA compliance, helping Cambia safeguard the privacy of sensitive medical information.

Since Cambia embarked on its ML journey, it’s seen a shift in the way it addresses technology problems. “AWS helped us attract different kinds of talent and embrace a lean startup culture of innovation,” says Rotival. “On AWS, the low-cost threshold, the scalability, and the ability to stage solutions very quickly helped us adopt a game-changing culture of speed and innovation.”

Previously, Cambia’s artificial intelligence and data science team’s capacity was consumed with managing the base infrastructure and building tools from scratch. “Using Amazon Comprehend Medical and Amazon SageMaker has helped us shift 30–40 percent of our data science resources from supporting operations to developing solutions that directly impact business and consumer outcomes,” says Rotival.

Using managed services from AWS, Cambia has created a robust solution through which individuals can access critical data and insights about their health. Cambia plans to build on its success and use individuals’ own health information to proactively send recommendations before health concerns lead to more serious problems. Rotival puts it best: “The holy grail is to use prescriptive analytics to offer actionable insights to individuals through their devices, encouraging behavior change and offering advice that’s deeply personal to them rather than generic recommendations for the whole population.”