...
FHIR Resource
...
OpenIMIS database table
...
notes
...
mapping status
...
Claim
...
Api Root
http://localhost:8000/api_fhir/ for version FHIR STU3
http://localhost:8000/api_fhir_R4/ for version FHIR R4 version
Mapping Overview Table
FHIR STU3 resource | openIMIS database tables | Notes | Status |
|---|---|---|---|
| Request properties are mapped to Claim | mostly mapped | |
ClaimResponse |
| Response properties are mapped to Claim | mostly mapped |
tblPolicy | not mapped | ||
Patient | tblInsuree | mostly mapped | |
Practitioner | tblClaimAdmin | used to represent base fields of Claim Administrator (without relation with health facility- FHIR Location) | mapped |
PractitionerRole | tblClaimAdmin | used to represent a relation between base ClaimAdmin (FHIR Practitioner) and Health facility (FHIR Location) | mapped |
Location |
| FHIR location.mode field is used to switch between mapping from tblHF and tblLocations | mostly mapped |
EligibilityRequest | EligibilityRequest | mapped, EligibilityRespone not fully mapped | |
CommunicationRequest | tblFeedback |
Claim
FHIR field | OpenIMIS field | notes | mapping status | ||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Identifier | tblClaim.ClaimID / tblClaim.ClaimUUID / tblClaim.ClaimCode | Claim can have multiple identifiers. The most important one is mapped from ClaimCode | |||||||||||||||||||||||||||||||
patientPaymentNotice | tblClaim.InsureeID | billablePeriod | tblClaim.DateFrom / tblClaim.DateTo | date from and date to are mapped to a period of time between them | diagnosis | tblClaim.ICDID / tblClaim.ICDID1 / tblClaim.ICDID2 / tblClaim.ICDID3 / tblClaim.ICDID4 | ICDID values are mapped to a list of diagnosis | outcome | tblClaim.ClaimStatus | provider | tblClaim.Adjuster | total | tblClaim.Claimed | created | tblClaim.DateClaimed | information | tblClaim.Explanation / tblClaim.GuaranteeId / tblClaimItems.Availability / tblClaimItems.Explanation / tblClaimServices.Explanation | information category is distinguishing the type of information | facility | tblClaim.HFID | enterer | tblClaim.ClaimAdminId | type | tblClaim.VisitType | item.service | tblClaimItems.ItemId / tblClaimServices.ServiceID | claim.item.category.text is distinguishing whether mapping is done from tblClaimsServices or tblClaimItems | item.quantity | tblClaimItems.QtyProvided / tblClaimServices.QtyProvided | claim.item.category.text is distinguishing whether mapping is done from tblClaimsServices or tblClaimItems | item.unitPrice | tblClaimItems.PriceAsked / tblClaimServices.PriceAsked | claim.item.category.text is distinguishing whether mapping is done from tblClaimsServices or tblClaimItems |
ClaimResponse
...
FHIR field
...
OpenIMIS field
...
notes
...
mapping status
...
outcome
...
tblClaim.ClaimStatus
...
payment.adjustmentReason
...
tblClaim.Adjustment
...
totalBenefit
...
tblClaim.Approved
...
payment.date
...
tblClaimed.DateProcessed
...
communicationRequest
...
tblClaim.feedbackId
...
error
...
tblClaim.rejectionReason
...
item.adjudication.reason
...
tblClaimItems.ClaimItemStatus / tblClaimItems.RejectionReason / tblClaimServices.RejectionReason
...
adjudication.reason contains the rejection code
(with adjudication.category = "rejected_reason")
...
item.adjudication.value
...
tblClaimItems.QtyApproved
...
item.adjudication.amount
...
tblClaimItems.PriceAdjusted / tblClaimItems.PriceApproved / tblClaimitems.PriceValuated / tblClaimItems.LimitationValue / tblClaimItems.RemuneratedAmount / tblClaimItems.DeductableAmount / tblClaimItems.ExceedCeilingAmount / tblClaimServices.PriceAdjusted / tblClaimServices.PriceApproved / tblClaimServices.PriceValuated / tblClaimServices.LimitationValue / tblClaimServices.RemunratedAmount / tblClaimServices.DeductableAmount / tblClaimServices.ExceededCeilingAmount
...
processNote
...
tblClaimItems.Justification / tblClaimItems.PriceOrigin / tblClaimServices.Justification / tblClaimServices.Limitation / tblClaimServices.PriceOrigin
...
claimResponse.item.noteNumber can be used to join information about the mapped field and claim item
Coverage
...
FHIR field
...
OpenIMIS field
...
notes
...
mapping status
...
Identifier
...
PolicyID / PolicyUUID
...
policyHolder
...
FamilyID
...
period
...
StartDate / ExpiryDate
...
start date and expiry date are mapped to a period of time between them
...
status
...
PolicyStatus
...
contract.valuedItem.net
...
PolicyValue
...
grouping
...
ProdID
...
contract.agent.actor
...
OfficerID
Patient
...
FHIR field
...
OpenIMIS field
...
notes
...
mapping status
...
Identifier
...
InsureeID / CHFID / passport / TypeOfId
...
RelatedPerson
...
FamilyID
...
name
...
LastName / OtherNames
...
birthDate
...
DOB
...
gender
...
Gender
...
maritalStatus
...
Marital
...
RelatedPerson.Relationship
...
IsHead
...
telecom
...
Phone / Email
...
photo
...
PhotoID
...
photo.creation
...
PhotoDate
...
managingOrganization
...
HFID
...
address
...
CurrentAddress / GeoLocation
Practitioner
...
FHIR field
...
OpenIMIS field
...
notes
...
mapping status
...
identifier
...
claimAdminID / claimAdminCode
...
name
...
LastName / OtherNames
...
birthDate
...
DOB
...
telecom
...
Phone / EmailId
Location
...
FHIR field
...
OpenIMIS field
...
notes
...
mapping status
...
Identifier
...
tblHF.HfId / tblHF.HFCode / tblLocations.LocationId / tblLocations.LocationCode
...
name
...
tblHF.HFName / tblLocatons.LocationName
...
type
...
tblHF.HFLevel / tblLocations.LocationType
...
Address
...
tblHF.HFAddress
...
partOfReference
...
tblHF.LocationId / tblLocations.ParentLocationId
...
telecom
...
tblHF.Phone / tblHF.Fax / tblHF.eMail
EligibilityRequest
...
FHIR field
...
OpenIMIS field
...
notes
...
mapping status
...
patient
...
CHFID
...
benefitCategory
...
ServiceCode
...
benefitSubCategory
...
ItemCode
EligibilityResponse
...
FHIR field
...
OpenIMIS field
...
notes
...
mapping status
...
patient
...
eligibility_request
...
insurance.benefitBalance.financial.allowedUnsignedInt
...
prod_id / total_admissions_left / total_visits_left / total-consultations_left / total_surgeries_left / total_deliveries_left / total_antenatals_left / service_left / item_left
...
insurance.benefitBalance.financial.allowedMoney
...
consultation_amount_left / surgery_amount_left / delivery_amount_left / hospitalization_amount_left / antenatal_amount_left
...
insurance.benefitBalance.excluded
...
is_item_ok / is_service_ok
CommunicationRequest
FHIR field | OpenIMIS field | notes | mapping status | ||||
|---|---|---|---|---|---|---|---|
identifier | feedbackId | reasonCode | CareRendered / PaymentAsked / DrugPrescribed / DrugReceived / Assessment | occurrenceDateTime | feedBackDatetblpayment | not mapped |
Resources for the FHIR R4 mapping
Contributors
SolDevelo/SwissTPH - openIMIS - OpenMRS integration – Digital Square C1 project