Overview

Date: 03.06.2020

Objective: Align scope and roadmap for Formal Sector Intergration

Participants:

Fourie, Carl

Uwe Wahser

Xavier Gillmann (Unlicensed)

Purushottam Sapkota

Neema Massawe

Doreen G. Wamiti

Nirmal Dhakal

Topic Proposals:

Presentation

Minutes

Entities

Workflows

Workflows: verify with https://wiki.ohie.org/display/SUB/Health+Financing+Workflows

• registration of employer

• registration of employee & family

• eligibility checks

  • currently eligibility checks in SOSYS, but have to be done in openIMIS (to be verified from Nepali side)

  • can/should an eligibility check be possible to be passed through openIMIS to 3rd party system?

    • should be possible in the new architecture, would need to register to openIMIS events

    • current quick fix: product switch / event interception

  • Version 1 solution: verification in openIMIS, needed information comes from SOSYS

  • Version 2 (sometime 2021): pass through mechanism,

• presentation on claiming will come next week

APIs

• existing FHIR API can be changed: The OpenIMIS API FHIR module (currently R3, moving to R4)

• Can attributes be added to the official FHIR documentation? (currently on R4)

• Also work with extensions & codeable concepts.

• FHIRBox: Is that an existing product or would that be something that could be done through OpenHIM?

  • Not an existing product, just a project codename, but an existing service in Kenyan context

  • Implementation must work in the OpenHIE context (e.g OpenHIM)

Dependencies

Questions - Challenges - Issues

• Were there discussions with the KE NHIF?

  • meta data information from LindaMama project.

• Do you have all the needed documents from Social Security Fund in Nepal?

  • by the end of this week - still needs translations

Next week:

• presentation on claims (Healthix)

• discussion on timeline

Additional Resources

• Support for formal sector schemes - Incubator page in this wiki

• http://hl7.org/fhir/financial-module.html - FHIR R4 objects (financial Module)

  • The OpenIMIS API FHIR module

• OpenHIE Health Financing Group: https://wiki.ohie.org/display/SUB/Health+Financing+towards+UHC+Subcommunity

  • Workflows: https://wiki.ohie.org/display/SUB/Health+Financing+Workflows

• JLN Processes Background - Joint Learning Network for UHC

  • Glossary: Glossary

• Product Roadmap

  • Beneficiary Enrollment

  • Persons & Families module scope

  • Policies module scope

  • Contributions module scope