Bridging the Gap: How Kyruus Health Transforms Healthcare Navigation with AI

An Overview of Challenges and Innovations in Health Plan Member Care

Solution Overview: Transforming Healthcare Provider Search

Building with Tribe AI: Accelerating AI Transformation

Implementation Insights: Learnings from Kyruus Health’s Journey

Guide Member Experience in Action: Real-World Applications

Conclusion: The Future of Healthcare Navigation with Generative AI

About the Authors: Meet the Minds Behind the Innovation

Bridging the Gap in Healthcare Access: How Kyruus Health is Transforming Member Experience

This post was written with Zach Heath of Kyruus Health.

When health plan members seek care, they shouldn’t have to navigate a complex medical lexicon. Yet, millions do just that, struggling to articulate their symptoms in everyday language while being confronted with clinical terminology. This often forces members to play the role of amateur medical translators, trying to convert statements like "my knee hurts when I climb stairs" into more technical terms such as orthopedics or physical medicine. The challenge escalates with traditional provider directories, which are laden with overwhelming options and medical jargon, leading to frustration, delayed care access, and ultimately, increased costs for both individuals and health plans.

Introducing Kyruus Health

Kyruus Health, a leader in care access solutions, simplifies this complex scenario by connecting over 1,400 hospitals, 550 medical groups, and 100 health plan brands. Each year, they facilitate over 1 million appointments, ensuring that members find the care they need efficiently. To combat the difficulties of healthcare navigation, Kyruus has introduced Guide, an AI-powered solution that understands natural language, enabling members to express health concerns in their own words and receive tailored provider recommendations.

The Role of AWS Services in Guide

In this post, we will delve into how Kyruus Health leverages Amazon Web Services (AWS) to build Guide, focusing on tools like Amazon Bedrock and Amazon OpenSearch Service that help facilitate seamless communication.

Solution Overview

Guide revolutionizes the healthcare provider search process by translating natural language health concerns into precise provider recommendations. Here’s how it works:

1. Natural Language Processing: When a member enters a query like, “I’ve been having shooting pain down my leg for two weeks,” Amazon API Gateway securely receives this request.
2. Conversion and Translation: This request is routed to Guide’s conversation service, powered by Amazon Elastic Container Service (Amazon ECS). Here, the AI model, using Amazon Bedrock with Anthropic’s Claude 3.5 Sonnet, processes the input, recognizing potential conditions like sciatica and translating the everyday description into structured medical parameters.
3. Provider Matching: The structured parameters are then sent to the Provider Search Service, which queries OpenSearch Service for applicable providers based on specialties, clinical focus, locations, and insurance networks.

This robust structure allows members to express their health needs in plain language while ensuring that the provider matches meet clinical requirements—all under the umbrella of HIPAA compliance through end-to-end encryption.

Insights from Implementations

Kyruus Health’s experience offers valuable insights for organizations looking to implement AI in healthcare:

• Focus on Healthcare-Specific Testing: By prioritizing realistic healthcare scenarios from the onset, Kyruus ensured that Guide accurately translates everyday descriptions into provider specialties, crucial for health outcomes and costs.

• User-Centric Design: Prioritizing member needs over technical capabilities led to significant satisfaction improvements and reduced search abandonment rates, underscoring that AI should focus on human requirements.

• Strategic Model Deployment: Instead of relying on a single AI model for all tasks, Kyruus discovered the effectiveness of deploying specialized models for various healthcare navigation aspects. This targeted approach enhanced match accuracy and optimized both performance and cost.

The Guide Member Experience in Action

Picture a member entering their symptoms along with their location preference. Guide utilizes natural language processing through AWS to identify specialists, delivering relevant recommendations. This streamlined approach results in higher match rates and significantly increases appointment completions for health plans.

Conclusion

Guide exemplifies how generative AI, powered by AWS, is redefining healthcare navigation, transforming complex medical jargon into accessible language. The innovative architecture, which combines Amazon Bedrock and OpenSearch Service, enables members to find healthcare providers with ease, all while improving member satisfaction and conversion rates.

For health plans looking to enhance their digital initiatives, Guide serves as a robust blueprint for tackling healthcare complexities. To further explore generative AI solutions, consider leveraging Amazon Bedrock for managed access to foundational models. Additionally, check out the AWS Healthcare Industry Lens for more resources related to implementation and use cases.

About the Authors

Zach Heath is a Senior Staff Software Engineer at Kyruus Health, specializing in creating scalable software solutions that connect patients with appropriate care through innovative technology.

Anil Chinnam is a Solutions Architect at AWS, passionate about translating cutting-edge technologies into practical business value for healthcare customers, facilitating cloud adoption, and driving transformation outcomes.

By reshaping the healthcare experience, Kyruus Health is spearheading an era where access to care becomes intuitive and efficient, bridging the gap between everyday concerns and medical resolutions.