Date: 13.05.2020
Objective: Align scope and roadmap for Formal Sector Integration
Participants:
Umesh Prasad Bhusal
Topic Proposals:
Date | Topic | Presenter | Comments |
|---|---|---|---|
13.05.2020 | Overview of Formal Sector requirements from Nepal | GIZ Nepal | |
20.05.2020 | Gap analysis and conception for core modules | SwissTPH | |
27.05.2020 | Gap analysis and conception for APIs | Healthix | |
03.05.2020 | Overview of the Product Roadmap for the openIMIS modular re-architecture | BlueSquare | |
Align the Product Roadmap |
Changing the claim flow (add the admin checks for the claims) was supported by the workflow package that was not accepted by DS
workpackage budget for formal sector in Notice D1 does not cover generic workflow engine
contribution is paid by employer directly
Nepali Developer / Beneficiary Management System (SOSYS) will remain and needs interoperability
Beneficiary can claim directly for treatment in hospitals without MoU with SSF - not in scope for this formal sector work package, will be needed with accident insurance, is in issue queue and waiting for other funds
Reimboursement of cash payment (HF W/O MoU) are important for the Nepali but they are not covered by the RfA answers.
Beneficiary / employer is responsible to update basic salary.
Interface standard: FHIR, SOSYS will be able to adapt to that
The maternity, sick pays are handled by SOSYS, therefore they are not is scope
invite representatives from Social Security Fund (technical & business staff) for more detailed analysis - focus on specific topics at a later stage, also involving representatives from other scheme operators
SOSYS Developers ()
share SOP document of SOSYS processes (GIZ Nepal)
presentation from last weeks call (Formal Sector Beneficiary API in Nepal )
clearly map out entities (beneficiary, employer etc.) workflows (claiming, enrollment etc) and system components (enrollment system, claiming system, payment system etc..) - SwissTPH & GIZ Nepal
need detailed view on workflows and needed FHIR APIs: rely on existing openIMIS FHIR ressources and map out gaps (Healthix & SwissTPH)
dependencies: database, FHIR APIs
product management will not be migrated in time (items, services)
Support for formal sector schemes - Incubator page in this wiki
http://hl7.org/fhir/financial-module.html - FHIR R4 objects (financial Module)
