Overview

Date: 20.05.2020

Objective: Align scope and roadmap for Formal Sector Integration

Participants:

Topic Proposals:

Date	Topic	Presenter	Comments
13.05.2020	Overview of Formal Sector requirements from Nepal	GIZ Nepal	Formal Sector Workshop Series (I)
20.05.2020	Gap analysis and conception for core modules	SwissTPH
27.05.2020	Gap analysis and conception for APIs	Healthix
03.06.2020	Overview of the Product Roadmap for the openIMIS modular re-architecture	BlueSquare
	Align the Product Roadmap	Developers Committee

Presentation

Contribution plan instead of regime (is that what FHIR calls insurance plan?: http://hl7.org/fhir/insuranceplan.html)
Policy (= contract http://hl7.org/fhir/contract.html)
Policy holder (=Employer)
Insuree (also Group of Insurees = Families)
Contribution (= Premium) , Contribution collection → list of employees & their parameters

Enrolment:
- Employer can directly add an insuree. → FHIR interface required from familly ? not required in NEPAL.
- How to deal Employee without ID, should we document dummy insuree ?
- Bulk upload of the employee list might be required (Which format ?)
- other countries / schemes: employee registers himself at a branch office of the scheme operator
adding insuree in openIMIS
- No change is foreseen in that concept but if there is a portal to add the insuree (checking process might be required)
Premium collection

FHIR coverage: list of employees
FHIR paymentNotice: is this the same as claim payment?
- PaymentNotice: "This same resource may be used by employers and insurance exchanges to advise payers that premium payments have been issued and settled."
FHIR contract: contribution collection
FHIR organisation: policy holder

add your question & thoughts here
need to plan which openIMIS components/modules/DB-tables need to be touched when
create wiki pages as soon as possible on formal sector entities & workflows to allow cross-linking (e.g. to JLN, FHIR, glossary, modules etc)