The openIMIS software powers the health and social protection services that support millions of people around the world, by supporting healthcare insurance schemes to provide rapid, responsive, accurate, and fair services to their beneficiaries.
openIMIS enables healthcare and social protection providers to manage all aspects of their schemes including: registering members, storing beneficiary information, managing policies, submitting claims, and tracking outcomes. Initially developed for use in low- and middle-income countries, it has since been modified to suit health insurance and social protection schemes in all circumstances. The following are some of the key characteristics of openIMIS:

Free and Open-Source

Unlike commercial software packages that charge expensive license fees, openIMIS is completely free to use by any scheme, operating at any scale. The code itself is published as open-source, which means it can be adapted, built-upon, and shared without restrictions.

Community of Practice

At the heart of openIMIS is a vibrant community of users, partners, health insurance managers, developers, and academic institutions. This is a highly-active and very engaged community of practice that shares a commitment and passion for improving social protection systems. They meet every two weeks to share learning, exchange experiences, and support one another.

Advantages and Opportunities

The advantages of openIMIS include:
Open access. The source code for openIMIS is published openly for anyone to modify or adapt according to their specific needs. This encourages innovation and collaboration between developers; helping to drive rapid evolution and address emerging issues. This is a royalty free software, with an GNU AGPL v3 license, making it available for use by health insurance providers in even the poorest countries.
Paper-free processing. Healthcare insurance schemes rely on streamlined archiving and document-sharing processes to ensure efficient and effective membership and claims management. The openIMIS software allows for the creation of entirely digital healthcare insurance schemes, accessible remotely.
Secure personal data. Members can access their personal records stored on openIMIS, which helps to increase transparency and improve the performance of the healthcare service.
Streamlined management. From the initial registration of those eligible for social security healthcare through to membership renewal and beyond, openIMIS is there at every step to increase the effectiveness and efficiency of the healthcare scheme. Key features include:

• Individual beneficiaries can be dynamically linked (with family members or employers) helping to manage bespoke insurance schemes such as employee healthcare benefits.

• Photographs of beneficiaries can be taken using the mobile app, transmitted to the main database, and linked with a membership file.

• QR codes create unique links between membership cards and beneficiary accounts.

• Contributions are recorded directly in the openIMIS system providing beneficiaries with payment receipts and updated information on their benefits.

• Medical services and medicines provided to beneficiaries are recorded within openIMIS, thereby initiating a claim process and triggering a reimbursement request to the insurer.

• openIMIS includes predefined criteria to review claims submitted and deploys artificial intelligence to quickly and accurately verify applications that pass initial checks.

Challenges and Limitations

The openIMIS software was created to support healthcare systems in developing countries, however, a lack of adequate infrastructure can cause some challenges. The following are particularly important areas for consideration:
Internet access. openIMIS can be operated offline but must be brought online regularly to synchronize with, and relay data to, the server. In response, some schemes have opted to use the mobile version of openIMIS (using tablets and smartphones) for key processes including membership registration, data access, and claim submission.
Electricity supply. A reliable power source is crucial when running openIMIS on desktop computers and laptops. Using generators and power banks for mobile devices has helped to alleviate this issue for some service providers.
Technical know-how. Healthcare staff and administrators need support and training in using openIMIS to ensure optimal performance and maximum efficiency. Training programmes that include regular refresher training, together with user manuals and ongoing technical support (in-person, virtual or by telephone), help to ensure gaps in technical knowledge are quickly addressed.