Overview

Date: 07.10.2020

Objective: Weekly Co-ordination call of the Formal Sector developers

Participants:

• @Uwe Wahser

• @Maguette T. NDONG

• @Luciana Rajula

• @Patrick Delcroix

• @Eric Darchis

Topic Proposals:

Presentations / Attachments

Minutes

Entities

• contract: Contract Module

• coverage: FHIR R4 - Coveragearchived

Workflows

• SOSYS:

  • eligibility request openIMIS → SOSYS

    • if failed, openIMIS will manage

  • automated claims management (openIMIS)

  • invoice notice (openIMIS → SOSYS)

APIs

• need definition/documentation of SOSYS openIMIS API

  • “c#”- Integration

Dependencies

Questions - Challenges - Issues

Healthix (update from Mondays' call with Nepali S4P, SOSYS tech, Healthix):

• SOSYS wants to use their system over openIMIS for employer management

• SOSYS wishes only to send the “enrollment“ (insuree + dependent) data to openIMIS, the name of the employer could be included, all the insurance product are the same, → batch registration

• SOSYS will provide a service that could be called automatically (every day)

• SSF want still to be able to add manually data on openIMIS

• SOSYS needs API need to replace an Excel file (content unknown), apparently from IMIS (Maybe excel reports for claims valuation)

•  

Issues:

• How openIMIS will know how to update the removed insuree

• How openIMIS will keep the manual entry (not being erase by every day update)

• Which kind of data will be sent every day, only the changes or full dump (clear performance risks)

• SPTH formal sector will be useless, quick fix should be enough

• funding function of openIMIS will be useless (relative pricing, matching funds, …)

OpenHIE workflow

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

• Enrollment should use the contract resource (From the FHIR page, enrollment is used the amend a contract by adding insuree)

• Lacks the formal sector flows:

  • enroll company

  • group contract/enrollment including multiple offer (insurance product)

  • payments

• @Daniel Futerman How can propose updates ?

  • sign up to the openHIE wiki

  • join the monthly UHC call of openHIE (next one: Thursday at 16:00 CET):

    • https://iu.zoom.us/j/154938887?pwd=WEtHK0llaWZmTWtmTnhPUlVqRmlGUT09

    • https://wiki.ohie.org/display/resources/Health+Financing+towards+UHC+Call

SwissTPH

• 3 shell back end module delivered on github

• Calculation module will use a function to manage the event error

  • Django signal are not run in parallel, meaning that the sender of the signal can check the result for the signal processing.

Next meeting (14.10.2020):

• Healthix: mapping tables (SOSYS → FHIR → openIMIS) : FHIR4 fields mapping.xlsx

Additional Resources

• Formal Sector Modules