Creating powerful member experiences: Cigna’s AWS HealthLake journey (HLS220)

Overview of Signa's Journey on AWS Health Lake

Signa's Business Objectives and Challenges

• Signa Healthcare is a global healthcare company providing benefits to over 170 million members across 30 countries.
• Evera Health Services, a division of Signa Group, provides solutions ranging from pharmacy, care, medication management, and behavioral services.
• Signa's mission is to improve the health and vitality of the members they serve, which is primarily data-driven.
• Key challenges faced by Signa include:
  • Regulatory requirements from federal and state governments that are complex, demanding, and continuously evolving.
  • Improving member experiences through clinical and claims data exchange platforms, such as prior authorization workflows and care delivery measures.
  • Building a secure, available, operationally efficient, and performant data platform to handle terabytes of data from various sources and standards.
  • Managing the cost of ownership, including third-party licensing, infrastructure, and deployment costs.
  • Ensuring scalability and performance to meet strict SLAs for regulatory organizations.
  • Enabling data reusability to avoid building multiple purpose-specific data layers.

AWS Health Lake Overview

• AWS Health Lake is a managed service that provides a HIPAA-eligible, RESTful FHIR API endpoint and analytics capabilities.
• The FHIR API endpoint allows for the ingestion and real-time transactional access of data, with sub-100 millisecond response times for reads and CRUD operations.
• The analytics capabilities transform the ingested FHIR data into a tabular format, preserving the underlying FHIR schema, enabling SQL-based analytical queries.
• Health Lake also integrates with Amazon Comprehend Medical for natural language processing of unstructured data, such as progress notes, to extract structured data like observations, medications, and conditions.

Signa's Experience with AWS Health Lake

• Signa started small with Health Lake and identified must-have features, such as performance, projected costs, and API responses, which were all positively surprising.
• Signa has one workflow already in production using Health Lake, after successful quality and security testing.
• Signa worked closely with AWS to bring Health Lake into production and continues to explore further use cases.

Key Outcomes and Features of AWS Health Lake

• Significantly reduced total cost of ownership (TCO) compared to building and maintaining a similar solution in-house, with some customers seeing 40-50% savings.
• Ability to scale and maintain performance, even with massive data volumes, without sacrificing response times.
• Adherence to strict SLAs for data ingestion, particularly important for high-volume data like Explanation of Benefits.
• Data reusability, avoiding the need to build multiple purpose-specific data layers.
• Undifferentiated heavy lifting, allowing Signa to focus on building business value rather than managing infrastructure.
• Cell-based architecture, enabling targeted optimizations for specific data types and use cases.
• Integrated natural language processing (NLP) capabilities through Amazon Comprehend Medical.
• Continued feature additions, such as multi-tenancy, FHIR profile support, event management, and pre-built solutions from the AWS sample library.
• Ongoing expansion of Health Lake to additional regions, such as India and international markets, to support global customers.

Next Steps

• Scaling to support petabyte-scale data volumes.
• Providing compliance-ready data stores to address regulatory requirements like CMS 0057 and TEFCA.
• Allowing customers to define their own analytical schemas, in addition to the default FHIR-based schema.
• Integrating advanced NLP capabilities from Health Scribe to further enrich structured data from unstructured sources.