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On the 13th a smaller group of participants from Swiss TPH, GIZ, Digital Square + consultants discussed jointly the work plan of Swiss TPH for the “Maintenance of openIMIS in 2018”. Further details of the work plan for 2018 Q1-Q4 have been discussed and defined. Focus was laid on (a) community tools and their set up,(b) the demo version and the main requirements it needs to serve, (c) Implementation Starter Kit and the usefulness of an interaktiv Moodle installation to host corresponding training materials as well as the Release Cycle Management for the Master Version of openIMIS.
OpenIMIS system architecture
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SwissTPH as well as Jiric Neme presented the actual system architecture of MS IMIS as well as opportunities and challenges for opening the system under the following topics: (a) possibilities to use external DWHs;(b) HL7 FHIR use case for OpenIMIS and (c) import/export functionalities.Full presentations available here and here.
Day 2 (Feb 14): Common information basis
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Alicia Spengler (GIZ) opened the second workshop day by reminding that there is a functioning IMIS implemented in Tanzania, which has been replicated and adapted in Cameroon and Nepal. Swiss and German Development Cooperation respectively, being present in different countries, perceived IMIS as a possible basis for a global system building upon national experiences and expertise. Based on synergies in this thematic area, Germany and Switzerland pushed for a joint initiative aiming at the implementation of such systems in various countries and meeting the high demand for information systems for health insurance and other financing mechanism. The initiatives’ vision is that all countries will have the insurance data they need to effectively manage their social insurance schemes, therefore contributing to Universal Social Protection. As, for now, the project is planned and budgeted for three years and setting up the platform until 2019 will be quite a challenge, the initiative is currently looking for additional funds and business models to be able to extend the time frame.
openIMIS update
Speakers: Alex and Jiri (Swiss TPH, full presentation here)
- Work plan for 2018 for the transition of IMIS to openIMIS and maintainance of the openIMIS product is developed
- Tools selected: Github (data storage), Jira (issue tracking), Confluence (documentation management); should be available soon; Readthedocs hasn’t been picked in the procurement process, but should be easily integratable into Confluence
- Demo server setup (being procured); will make use of live examples
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Nepal, IMIS implementation
Speaker: Sarauv Bhattarai (GIZ Nepal, full presentation here)
- 2013-2014 – introduction of social insurance policy; requirements analysis
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- Nepal is willing to do so; want to use opportunity for upgrade and take first steps to get prepared
- Documenting all modifications they’ve made so they can be made in the master version
- Developing test scenarios
- VPS test server secured
- Launch will need to coincide with enrolment cycles. Nepali calendar is constant challenges/requirement; difficulty to fix it in the system.
Window into the future
Where do you see openIMIS in… | |||
1 year? | 3 years? | 5 years? | |
Regarding country implementation | 5- 10 countries, including the existing ones; having stable master version and release plans; countries part of decision-making process of initiative 3 countries; country adaptations recorded; e-payment solutions and SMS notification system implemented | 10-30 countries using an adapted master version; increased uptake within and outside countries; more microinsurances on board Members feedback system established; 2 additional users contributing to the development | 15-50 countries; strengthening local capacity; openIMIS becoming a standard system for health insurance; local implementation agents are in place Constant growth in number of users, more than 6 countries implementing |
Standards and interoperability | Linkages to FHIR, API, SMS Gateways; education for stakeholders on IMIS functionalities RestAPI; integration between openIMIS, Epicor and OpenHIE; countries share knowledge and best practices; dialogue on interoperability initiated; discussion with governments on internat. standards | Linkage to civil register; FHIR, electronic medical records; Epicord, AMQP; establishment of universal openIMIS standards Standardized exchange mechanism; open standards are in place; governments understand and use internat. Standards for data transactions; Standards for claims reimbursement in place | Integration with government systems; broad stakeholder understanding openIMIS as (golden) standard; other partners/systems build apps to work with openIMIS |
Impact on health system | Transparency 24/7 availability | Use of insurance data beyond insurance managers Research activities implemented; quality of health insurance data improved significantly | All insurances covered; PPP; helps in policy decision making UHC (+USP); maternal mortality reduced; increased life expectancy |
Collaboration and participation | COP established with JLN; data exchange with OpenHIE Local universities contribute to capacity building and skill development; JLN, global networks, openHIE community established | Outreach into HISP local nodes; diverse donors for software development; standards for claims transactions are defined and deployed by the CoP Network of implementing partners; Sustainable funding model; international donor community around OpenIMIS | OpenIMIS recognized as a standard product by governments and donors; long-term business model established; collaboration with WHO, ADB, EU; IMIS version for micro insurance available |
openIMIS governance structure
Speaker: Carl Leitner (overview available here)
Other successful open source mechanisms:
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The importance of global networks
Speaker: Caren Althaeuser (Path, full presentation here)
- Joint Learning Network
- Composed of 23 member countries and country core teams
- Steering Committee decides on annual goals
- Supported by Rockefeller, Gates, Wipro
- IT Team is facilitated by Path
- Existing Tools
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- Vendor/software tool neutral
- Could be used for further developing requirements to feed into release cycles of openIMIS
Speaker: Franz von Roenne (GIZ)
- Providing 4 Health (P4H)
- Exits for 10 years, active on the country level & part of a network working towards UHC2030 as a specific form of health coverage foreseen in the SDGs; there are contact persons located in the countries and staff is going to be deployed to the World Bank as well
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- supporting 10 health facilities in each of 4 counties
- Did a health facility assessment
- Sophisticated curricula and many local implementers
- Has 2015-2030 eHealth Strategy
- Facilities have donor driven implementations
- Very diverse b/c of donor and health verticals - multiple systems in same hospital which are not connected.
- Have guidelines for eHealth interoperability
- NHIF is national provider for health insurance. Current mandate is for in-hospital, out-patient and informal sector
- NHIF has mandate for insuring every Kenyan in next 4-5 year; NHIF shall become a law
- NHIF has centralized database (IBM) w/
- thin application layer for UI,
- reports.
- DB is accessible from all NHIF branches
- Powerful but needs better structure
- Hospitals can do eligibility verification
- Allow mobile payment of insurance fees
- Have biometric identification
- Have ID cards
- Looking at how they can better use high volume of data
- Updating eClaims process?
- Trying to automate all their systems
- Mandate:
- Registration
- Receiving of fees - already automated (mobile, online)
- Filing Claims - hospitals can file
- Payment of claims - current work for mPayment
- Have issues with member retention, especially after receiving the funds
- There is also a National Hospital Insurance plan (not integrated yet with the MOH’s strategic plan)
OpenHIE & Digital Square
Speaker: Carl Leitner (Digital Square); complete slides are here.
- OpenHIE is a blue print, an initial sketch to make systems interoperable (component layer, services layer and external systems)
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Digital Square: in the midst of its current funding phase (funded by Gates Foundation & USAID); when openIMIS gets to a point where it can be applied to different countries, it is more available for financing.
Technical Roadmap
Speaker: Patrick Ernst (Consultant, GIZ)
To-dos as follow-Up to roadmap discussion:
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