...
As a software for managing health/social protection processes, openIMIS helps digitising the link between beneficiaries, providers and payers for healthcare and social protection. The technical solution is supported by a community of developers, users and implementers, with the joint mission to increase and improve universal health coverage (UHC) and Universal Social Protection (USP).
The business processes (workflows) covered by openIMIS
• Beneficiary management (enrolment, contributions, policy assignment, renewals)
• Service utilisation
• Claims management, *AI claims adjudication module (AI decision support)
• Monitoring and reporting
...
In his explanation on the governance structure, Saurav Bhattarai makes transparent, in what roles partners engage e.g. as part of the Technical Advisory Group, the Implementers or Developers Committee and how the global community is linked with local implementations also through regional hubs. Also the overview on the tasks of the openIMIS coordination desk shows on what aspects partners can join in e.g. in new software development, the promotion of use and further development of openIMIS, implementation support (at the stages of feasibility studies and formulating requirements for potential implementation) as well as capacity development (through the regional hubs in Asia and Africa, on-the job trainings and ad-hoc support).
The three introduced use cases and implementations in Tanzania, Cameroon and Nepal show the specifics in implementation and functionality requirements, but also the flexibility of openIMIS in addressing them in terms of a modular solution, interoperability with the existing digital environment, and easy to scale-tool.
Presentation slides (PDF)
Further reading on Healthy DEvelopments platform by BMZ
openIMIS: Co-creating a global good (June, 2020)
openIMIS: Health and social protection’s digital backbone (June, 2020)
Open source software for social health insurance (March, 2017)