This page presents the analysis of AI algorithm’s input data model. First, we analyse the openIMIS data structure and fields representing the information used by the Medical Officer to adjudicate a claim. Second, we look at the openIMIS-FHIR mapping and extract the required FHIR resources to feed the AI algorithm during the learning, development and test processes. Because the openIMIS FHIR module do not map all openIMIS fields to FHIR resources, we are limited by the current FHIR-openIMIS R4 mapping.
openIMIS Claim Review Web Page
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openIMIS Database Tables
The following database diagram displays openIMIS tables and their relations. The analysis is centered on Claim and identifies other entities in relation to a Claim and used in the adjudication process.
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FHIR Resources Definition
From all the fields that the Medical Officers are using when reviewing claims, we mainly need to identify entities in relation to the Claim. From some entities (Diagnosis, HF), we might not require more than the identification fields.
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