FAQ List

FAQ - Does openIMIS support other database management systems than PostgreSQL?

With the migration done by BlueSquare the foundation was created to do this kind of DB switch with relative ease. The reason behind this is that SQL is a standard language for querying databases. SQL is supported by all major database management systems, although there are slight differences in how they implemented this standard - the dialects. So in reality we never migrated away from SQL, we just migrated the legacy version of openIMIS from a very specific Microsoft SQL dialect to a more standard way of using SQL, which can in theory work on different DBMS products. Because of the programming library that BlueSquare used to implement the database access form openIMIS, it is relatively easy to just install a specific DB driver and then have openIMIS use the new dialect.

However, there are still differences in what the different DBMS can do. Depending on the driver, it might allow for 90% of compatibility with not all functionalities covered. Even these 90% will only make sure that data is read - when it comes to performance optimisation on high data volumes there is always a certain amount of DBMS specific configuration needed. For this reason the openIMIS Initiative can only support one reference DB system, which is PostgreSQL. We also try to maintain backward combability with MS SQL Server, but there will be most likely be gaps coming up in future versions. For everything else we cannot provide that support as we would have to test a variety of different DBMS with every new version of openIMIS.

FAQ - What is a scheme operator?

A scheme operator is an agency or institution which uses openIMIS to administer a health financing or social protection scheme. Typical scheme operators include regional or national health funds, a ministry of health or social welfare, a national health insurance board, or a government agency tasked with implementing a cash transfer program.

FAQ - What is an implementer?

Implementers are organizations which support scheme operators to install and use openIMIS. They can help to transfer business processes as part of software customization, provide training on use of openIMIS and support the maintenance of the system once it is operational.

FAQ - Does openIMIS support use of Biometrics?

Currently no openIMIS implementation applies the use of Biometric identification cards. The current identification of an individual is done using photos which are stored on the central server (or in form of an offline extract) and can be retrieved through querying by authorized personnel using an individuals unique ID number or corresponding bar code on an individuals card. See more information on current ID mechanism applied through openIMIS here: Identification card

FAQ - What standards does openIMIS follow?

In terms of interoperability with other systems openIMIS follows the HL7FHIR R4 standard. See more here information on the mapping openIMIS FHIR R4 Overview Page

Diagnosis coding in the system is uploaded at the time of configuration of the system. So depending on what standards are applied in a country the scheme operator can upload a diagnosis list of their choice eg. in Tanzania a smaller version of ICD 9 was initially applied which later was shifted to ICD 10. See more information on upload of diagnosis here WA6.1 Bulk uploads from Web Application user interface

FAQ - How can openIMIS link to and help in transition from an existing system of a scheme operator?

It is a reality that all scheme operators have some form of system to manage their operations and information generated within that. This can be either paper forms or digitized files like Excel files or more advanced IT solutions. Depending on how openIMIS is chosen to be used (stand alone system or partial use with existing solutions) in such situations there might be a need to either link openIMIS to existing technological solutions (need for interoperability) or a process and tools to allow transition (data migration) from older system to openIMIS. The latter can at times also mean shifting from paper records to openIMIS.

In situations where paper records are entered in openIMIS leading to a digitization of records for the first time, the data entry process can be cumbersome and requires time and resources. This should therefore already be accounted for during the planning stage. The scheme operator should see this investment of resources and time keeping in mind that some tasks are one time tasks which makes life in future simpler. For example the entry of families data that were enrolled in the past simplify the process and reduce the effort in future during renewals where this data does not have to be captured again if there are no changes and can simplifying even the older paper based renewal process. The investment is hence worth it and should be seen in this light.

In situations where simpler solutions like Excel files were used in the past there are some possibilities to update some bulk data in the system through files organized in specific format. See more information on such bulk uploads here: WA6.1 Bulk uploads from Web Application user interface

In situation where openIMIS needs to function along side an existing system, the first step is to establish a clear division of roles between the two solutions and thereafter accordingly the actual linking of the two softwares. On the openIMIS side a mapping has been undertaken of data captured in openIMIS to the FHIR standards to allow intergration with softwares through a standardized internationally accepted interoperability standard. Please find further information here: openIMIS FHIR R4 Overview Page

FAQ - How does Claims Submission work when a health facility has absolutely no internet?

In scenarios where a health facility does not have any internet, they can continue to use paper claim forms, where they enter all the claims related information. Thereafter based on feasibility a frequency is established in which the forms are physically transferred to a location (example the scheme operators district office) where an authorized user has internet connection and a computer or openIMIS claims mobile app through which they enter the claims in openIMIS.

A second alternative that is used is that the claims app for such a health facility is installed on a phone and its database (drop downs etc.) is updated and configured before hand at a location where there is internet connectivity. Thereafter the health facility claim administrator can use the phone in an offline setting (without internet) to submit claims in the app. Here again then based on feasibility the phone or the folder from the phone with these files can be physically transported to another location and an authorized user can upload these into openIMIS through an upload function. Any subsequent changes in price list or services offered as part of the benefit package need to be reflected in the health facility claims app and hence requires as well close coordination by the scheme operator to ensure database of the claims app at such health facilitieas are update as and when needed.

In either cases a feasible frequency of frequent contact between the scheme operator and the health facility needs to be established because in offline settings there is a need of physical transport of forms or data (in a pen drive or phones memory, etc.). This requires established processes and agreements between all involved actors as this also leads to delays in processing of claims.

FAQ - Can multiple people contribute to one claim?

Yes multiple users can be created within a health facility in the role of Claims Contributor who can contribute to the same claim. So for example a claim admin at a hospital can start a claim and users say in different departments of the hospital (say Laboratory, Pharmacy, etc.) can contribute to the same claim the services rendered to the client as well cost related information. Hence this way multiple users can contribute to the same claim before it is then completed and submitted by the Claim Administrator to the scheme operator for reimbursement.

FAQ - How are QR codes used in openIMIS?

QR codes are currently used in openIMIS as a way to capture (with limited errors) a unique ID of a person. In most implementations a unique ID number is printed on a card along with a QR code (that is essentially the same ID number). Any person enrolled into the insurance programme is given one card that carries this unique ID number and respective QR code. The QR code can then be easily read with the openIMIS mobile apps used either by the Enrolment officer or by a Health Facility staff instead of typing the ID number which reduces error and makes respective processes faster. In case the QR code scanner or camera has an issue on the phone the ID number listed below the QR can also be directly typed in.

You can find more information on the current use of ID cards in openIMIS here: Identification card

FAQ - How are IDs generated in openIMIS?

Current openIMIS release does not generate IDs but only validates the logic of the ID number used in the implementation and ensures there is no duplicate IDs in the instance. In country implementation like Nepal there are use cases where the logic of generation of IDs is programmed in openIMIS and hence generated within the system and thereafter provided to printers to use in printing of cards which carry the unique number and corresponding bar code.

You can find more information on the current use of ID cards in openIMIS here: Identification card

FAQ - What is openIMIS?

openIMIS is a digital public good which powers versatile solutions for the management of health financing and social protection programs. Designed to be interoperable with other information systems, openIMIS draws upon and contributes to Digital Public Infrastructure. 

FAQ - Is the software modifiable/ adaptable?

Yes. The license for openIMIS allows for free modification and adaptation to the software. To ease the modifications process, full technical documentation is provided along with the source code.

FAQ - How can the software be used?

openIMIS was originally developed to facilitate the administration of social health insurance schemes for people in the informal sector in low- and lower-middle income countries. It has subsequently been modified for use in administering health insurance schemes focused on the formal sector, employment injury insurance schemes, cash transfers and voucher schemes. However, the use of the software is not limited to these general use cases! Feel free to explore the software and try out new implementation scenarios.

• Explore the software …

• Getting started …

• Ways to contribute …

FAQ - Who can use the software?

Anyone can download and use openIMIS for free. Whether you are the operator of a health insurance or cash transfer scheme, a university offering courses in health financing, or a company specializing in the implementation of digital health and social protection programs - you are free to make use of openIMIS and to adapt it to your needs.

• Explore the software

• Getting started

• Ways to contribute

FAQ - Can the software be re-sold?

Yes. You can package and re-distribute the software according to the license agreement.

GNU Affero General Public License (AGPL-3) explicitly allows to convey verbatim copies of the software commercially:

You may charge any price or no price for each copy that you convey, and you may offer support or warranty protection for a fee. (AGPL-3, §5)

However, you should be aware of the other statements in the license agreement, especially when distributing modified source versions. AGPL-3 has an in-built copy-left clause. This means that you need to distribute your version under the same license. Also, you are expected to feed back modifications of your distribution to the openIMIS project, even if you offer openIMIS as a Software as a Service (SaaS) using your own server.

Of course we would appreciate being in touch with you when you plan to redistribute the software. This will be of benefit to you and the openIMIS community.

FAQ - Where is my data collected?

As you implement openIMIS, you will need to install and host the software on either a virtual or physical server. This server(s) is where your data will be stored. You have full control over who has access to the data.

FAQ - Is my data safe?

Yes. We take care to ensure that the openIMIS software is free of security-related issues and that all required measures to ensure the safety of data are in place. However, there is an added layer of security that you are responsible for during implementation. As you implement openIMIS, you will need to install and host the software on either a virtual or physical server. You should ensure that the server you choose to host openIMIS on has the required security measures in place.

In terms of access to data, the openIMIS Initiative will never have access to any data from your implementation of openIMIS.

(read more on securing your installation …)

FAQ - What are the additional costs to consider when using openIMIS?

Some examples of additional costs to consider when using openIMIS are given below. The extent of these additional costs will very much depend on the size and scale of the implementation. Examples of cost drivers are:

• Customization costs

• Server hosting costs

• Costs for computer hardware

• Internet connection

• User training

(read more here …)

FAQ - Is openIMIS free?

The openIMIS software, including the source code, is free. It can be freely downloaded without restrictions. When implementing openIMIS, you will incur costs for deploying the software (e.g. server costs) and for required hardware (e.g. at health facilities and the scheme operator). In addition, there will be costs for implementation and roll-out of the software (e.g. user training) and regular maintenance of the installation.

FAQ - What do I need to become an openIMIS user?

There are no pre-defined requirements to use openIMIS. Please feel free to move around this wiki and learn about the software and the community, or try out the software functionalities from the demo, or join the weekly calls of the implementers' committee. If you are a developer and you want to start looking into the code and find ways in which you can build on the existing functionality, please visit the GitHub repository and join the developers' committee. 

FAQ - What is open-source software?

Wikipedia defines open-source software as "a type of computer software in which source code is released under a license in which the copyright holder grants users the rights to study, change, and distribute the software to anyone and for any purpose." In openIMIS's case, the copyright holder is the Swiss Agency for Development and Cooperation (SDC) and they allow anyone  to redistribute it and/or modify it under the terms of the GNU AGPL v3 License.

In addition to the license agreement and the ability to modify and redistribute it freely, open-source software is a collaborative effort among a community of users, implementers, and software developers. These communities share their experiences, discuss new features and functionalities for the software, and ultimately provide direction to the future development of the software. You can find more information about the openIMIS community here.

FAQ - How much does it cost to implement openIMIS

First things first: as an open source software, openIMIS is completely free of charge. You can simply download and use it. There are no license costs attached to it, no matter what the use case is. However, costs will arise for the implementation of openIMIS in your organization. These depend on a variety of factors, including the specifics of your organization and use case.

• Read more here to estimate your specific implementation costs

• Read more here to estimate additional implementation costs

FAQ - When was openIMIS created?

With support from the Swiss Agency for Development Cooperation (SDC) in 2012, the Swiss Tropical and Public Health Institute (Swiss TPH), Microinsurance Academy and Exact Software developed an Insurance Management Information System (IMIS) to operate community health funds (CHF) in several districts of Tanzania.

In 2014, a mutual health insurance scheme in Cameroon adapted the software for their business processes. Since 2015, the German Development Cooperation (GDC) has been providing assistance to customize IMIS for Nepal’s national health insurance scheme. The software has grown organically and has demonstrated potential for easy adaptation to different types of health financing mechanisms needed for UHC.

In 2016, GDC and SDC invested jointly to make IMIS an open-source software. The openIMIS source code has been publicly available since 2018.