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MIS uses the concept of user profiles (roles) that can be associated with users. Some roles are predefined and they are designated as system roles. Their purpose is guarantee compatibility with the previous versions of IMIS.

User roles/profiles administration is restricted to users with the role of openIMIS Administrator.

Navigation

All functionality for use with the administration of user roles can be found under the main menu Administration, sub menu Users Profile.

Clicking on the sub menu Users re-directs the current user to the User roles/profiles control page.

User roles/profiles control page

The User roles/profile control page is the central point for all user roles/profiles administration. By having access to this page, it is possible to add, edit, delete and search users roles/profiles. The page is divided into four panels (Image User roles/profiles control page).

Administration of users’ profile (roles) is not included in any system role. It can be accomplished by the Admin user or by users to which such administration is delegated (by defining a role including an access to Administration/User Profiles) by the Admin user.

Pre-conditions

A new user profile may only be added or thereafter edited, after an approval of the management of the scheme administration. It can be accomplished at the beginning only by the Admin user. The Admin user can define a new user profile incorporating also adding, editing or deleting of user profiles and create new users with this profile. In this way, rights to the register of user profiles can be delegated to other users besides the Admin user.

Navigation

All functionality for use with the administration of user profiles can be found under the main menu ADMINISTRATION, sub menu USER PROFILES

Search Panel

The search panel allows a user to select specific criteria to minimise the search results. The following search options are available which can be used alone or in combination with each other.

Role Name

When set the search will display the roles with a name that start with the content of the filter , % can be used as a wildcard meaning a search with %er will display all the result containing er in the name

System

The system user profiles match the previous roles for compatibility reasons. When set to TRUE the search will display the default roles, when set to FALSE the search will display only the custom roles

Blocked

The blocked user profiles are temporarily not acting in the sense that their access rights are not available to users to whom blocked user profiles were assigned. When set to TRUE the search will display the roles that were blocked, when set to FALSE the search will display only the unblocked roles

Historical

Historical records are displayed in the result with a line through the middle of the text (strikethrough) to clearly define them from current records Click on Historical to see historical records matching the selected criteria. Historical records are displayed in the result with a line through the middle of the text (strikethrough) to clearly define them from current records (Image User roles results panel).

Result Panel

The Result Panel displays a list of all roles/profiles found, matching the selected criteria in the Search Panel. The currently selected record is highlighted with light blue, while hovering over records changes the highlight to yellow (Image User roles results panel). The leftmost record contains a hyperlink which if clicked, re-directs the user to the Change user role/profile Page. A maximum of 15 records are displayed at one time, further records can be viewed by navigating through the pages using the page selector at the bottom of the result Panel

Blue background: Selected recordYellow background: hovered recordsStrikethrough: historical records

A maximum of 15 records are displayed at one time, further records can be viewed by navigating through the pages using the page selector at the bottom of the result Panel (Image User roles/profile control page)

Button Panel

The Add button will add a new role/profile (not available if Historical was checked)The Edit button will edit a role/profile. not available if Historical was checked)The Duplicate bbutton will duplicate a role/profile (not available if Historical was checked)The Delete button will deleting a role/profile (not available if Historical was checked)The Cancel button re-directs to the Home Page.

Information Panel

The Information Panel is used to display messages back to the user. Messages will occur once a user role/profile has been added, updated or deleted or if there was an error at any time during the process of these actions.

User role/profile Page

Data Entry - Role details

Role Name

Enter the name of the role/profile, this name will be used as reference in the User roles/profiles control page and Users page

Alternative language

Translation of the role name for the second language of openIMIS

System

Read-only checkbox indicating whether the user profile is a system one or not.

Blocked

If checked the user profile is blocked

Data Entry - Rights details

Insurees and Policies

list of the right available for the Insurees and Policies module:

CRUD rights (Create, read/search, update/edit and Delete):Family/GroupInsureePolicyContributionBusiness specific rolesRenew policyEnquire insuree

Claims

list of the right available for the Claims module:

CRUD rights (Create, read/search, update/edit and Delete):ClaimsBusiness specific roles:Claims:PrintSubmitReviewFeedbackUpdateProcessClaim Batch:ProcessFilterPreview

Administration

list of the right available for the Administration module:

CRUD rights (Create, read/search, update/edit and Delete):ProductsHealth FacilitiesPricelists – Medical ServicesPricelists – Medical ItemsMedical ServicesMedical ItemsEnrolment OfficersClaim AdministratorsUsersUser roles/profilesPayersLocationsBusiness specific rolesDuplicate ProductsDuplicate Pricelists – Medical ServicesDuplicate Pricelists – Medical ItemsDuplicate User roles/profilesMove Locations

Tools

list of the business rights available for the Tools module

RegisterUpload DiagnosesUpload Health FacilitiesUpload LocationsDownload DiagnosesDownload Health FacilitiesDownload LocationsExtractsDownload Mater-dataCreate Phone ExtractsCreate Offline ExtractUpload ClaimsUpload EnrolmentsUpload FeedbackRun reportPrimary Operational Indicators-policiesPrimary Operational Indicators-claimsDerived Operational IndicatorsContribution CollectionProduct SalesContribution DistributionUser Activity ReportEnrolment Performance IndicatorsStatus of RegistersInsurees without PhotosPayment Category OverviewMatching FundsClaim OverviewPercentage of ReferralsFamilies and insurees OverviewPending InsureesRenewalsCapitation PaymentRejected PhotosUtilities/Email settingBackupRestoreExecute ScriptEmail Setting

Buttons

Save

Once all mandatory data is entered, clicking on the Save button will save the record. The user will be re-directed back to the User Control Page, with the newly saved record displayed and selected in the result panel. A message confirming that the user has been saved will appear on the Information Panel.

Cancel

By clicking on the Cancel button, the user will be re-directed to the User roles/profiles control page.

Mandatory data

If mandatory data is not entered at the time the user clicks the Save button, a message will appear in the Information Panel, and the data fields will take the focus (by an asterisk on the right of the corresponding data field).

Adding a User role/profile

Click on the Add button to re-direct to the User role/profile Page.

When the page opens all entry fields are empty. See the User role/profile Page. for information on the data entry and mandatory fields.

Editing a User role/profile

Click on the Edit button to re-direct to the User role/profile Page.

The page will open with the current information loaded into the data entry fields. See the User role/profile Page. for information on the data entry and mandatory fields.

Duplicating a User role/profile

Click on the Duplicate button to re-direct to the User role/profile Page.

The page will open with all the current rights for the selected user role/profile, (except for theuser role/profile name which should be unique), loaded into the data entry fields. See the User role/profile Page for information on the data entry and mandatory fields. To save the record, enter a unique code before clicking on Save.

Deleting a User role/profile

Click on the Delete button to delete the currently selected record.

Before deleting a confirmation popup (Image User roles/profile delete confirmation) is displayed, this requires the user to confirm if the action should really be carried out.

When a user roles/profile is deleted, the rights that it provide are not available to the users having that role/profile.

Default User roles and rights

The table below shows the default roles in openIMIS.

Tab. 5 Overview of Scheme administrator & district Staff roles

Role

Responsibilities

Available functionality

Enrolment Officer

He/she enrols insurees and submits enrolment forms to a health insurance administration; handles policy modifications; collects feedback from scheme patients and submits to the health insurance administration.

  • Capture a photo of an Insuree.

  • Send a photo

  • Inquiry on an Insuree

  • Collect feedback from an Insuree

Village Executive

Officer (VEO)

He/she collects feedbacks and collects changes on insurees during insurance periods

  • Collect feedback from an Insuree

  • Inquiry on an Insuree

Manager

Oversees operations of the health insurance scheme;runs openIMIS operational reports analyses data generated from the IMIS.

  • Create managerial statistics

  • Authorize issuance of a substitution

  • membership card

Accountant

Transfers data on collected Contributions to an external accounting system. Calculates claim amounts per health facility, runs openIMIS operational reports and presents claims decision overview to management of a health insurance administrator. Processes approved claims to health facility sub-accounts.

  • Transfer of data on Contributions to accounting system

  • Valuation of a claim

  • Transfer of a batch of claims for payment

Clerk

Enters and modifies data on families, insurees, policies and contributions. Enters data on claims if the claims are submitted in a paper form.

  • Creation/ Search/ Modification/ Deletion/ Modification of a household/group, an Insuree, a Policy or a Contribution.

  • Renewal of a policy

  • Entry of a claim

Medical Officer

Provides technical advice on claims verification from a medical standpoint.

  • Checking of a claim for plausibility

  • Review of a claim

  • Authorize a claim for payment

Scheme

Administrator

Administers registers (all except the register of users)

  • Administer registers ( Officers, Payers, Health Facilities, , Medical Services, Medical Items, Medical Item Price Lists, Medical Services Price List, Products)

  • Extract Creation for Off-line Health Facilities

openIMIS

Administrator

Administers operations of the IMIS. Is responsible for backups of data.

  • Administer the register of users, Utilities

  • Manage Backup, Restore and Updates

  • Extract Creation for Off-line Health Facilities

Tab. 6 Overview of Health Facilities staff roles

Role

Responsibilities

Available functionality

Receptionist

Verifies membership and issues to a patient a claim form.

  • Inquiring on a Household/group, Insuree and Policy

Claim

Administrator

Pools claim forms of a health facility, enters and submits claims.

  • Opening of a batch of claims

  • Entry of a claim

HF

Administrator

Off-line HealthFacility administration

  • Off-line extract upload

Offline HF

Administrator

Off-line HealthFacility administration

  • Creation of clerk

  • Creation of offline Extract




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