This page presents the analysis of AI algorithm’s input data model. First, we analyse the openIMIS data structure and extract the minimal required openIMIS entities 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 minimal required FHIR resources and fields to feed the AI algorithm during the learning, development and test processes.

Minimal required openIMIS entities and fields

As are looking on the openIMIS claim adjudication process, we are interested to identify the entities/tables and their fields that are used by the Medical Officers to review and categorise the items and services present in a claim.

openIMIS Claim Review Web Page

openIMIS Database Tables

Diagram

The following database diagram displays openIMIS tables and their relations. The analysis is centred on Claim and identifies other entities in relation to a Claim and used in the adjudication process.

Fields definition