AeHIN openIMIS Community of Practice in Asia

The open-source Insurance Management Information System (openIMIS) is the first open-source software that manages social (health) protection schemes by linking beneficiary, provider, and payer data. With a modular structure, openIMIS can be modified according to country-specific needs.

The initiative aims to contribute to the "gradual inclusion of hitherto excluded populations into social (health) protection schemes by improving the schemes' data and information management capacities through openIMIS." Part of its objectives is to complement ICT infrastructure for insurance and other finance mechanisms with openIMIS or specific modules.

One of the expected outputs of the initiative is establishing a Community of Practice (CoP) for existing users and interested groups to inform the direction and development of openIMIS. Currently being implemented in Tanzania, Nepal, and select countries, the openIMIS initiative collaborated with the Asia eHealth Information Network (AeHIN) to expand its reach in Asia. 

AeHIN is a collaboration of digital health advocates created by the World Health Organization in 2011 to help Asian countries with digital health development. It has helped build capacity in the region by laying down national health information foundations: (1) governance; (1) architecture, (3) program management; and (4) standards, and interoperability.

In 2019, AeHIN established an openIMIS regional hub (Philippines, Indonesia, and Sri Lanka) in Asia to provide country-input on challenges, priorities, and user requirements for openIMIS, especially in the academic setting. 

Since then, partner universities and groups have started using openIMIS to demonstrate a health information system's core functionalities and a social health insurance scheme's critical business processes.


Management of social health insurance and other health protection schemes to achieve universal health coverage (UHC) through openIMIS


Position openIMIS as a  global good that can support the application of concepts and skills on social health protection and health informatics


Strengthen the openIMIS community in Asia by localizing capacity-building strategies and supplementary knowledge materials with the reality of concrete country cases


  1. Continue facilitating regional knowledge sharing and networking around openIMIS;

  2. Develop a regional capacity-building program on health financing and digital heath with openIMIS as the laboratory component; and

  3. Expand the openIMIS community of practice in Asia by supporting open source ecosystems for national and subnational schemes.

Contact Persons:

Dr Alvin Marcelo 

Executive Director


Kristin Chloe Pascual

Operations and CoP Management


Charisse Orjalo

Online Community Management



AeHIN 7th General Meeting

AeHIN held its seventh AeHIN General Meeting virtually last January 7, 14, 21, and 28, 2021. This year’s theme discussed ‘Strengthening Regional Health Systems Response to COVID-19 focusing on digital health experiences in Asia.’ A total of 328 participants from 42 countries in and outside of the Asian region attended the conference. 

During the opening ceremony, AeHIN partners shared messages carrying the importance of the Governance, Architecture, Project Management, and Standards and Interoperability (GAPS) Framework in digital health to set the context of the whole conference.

Mr. Saurav Bhattarai, GIZ Advisor, discussed using standards-based tools and leveraging what is already available to avoid duplication of efforts. He stressed that “we needed digital health tools running on open and standards-based architectures that facilitate interoperability to ensure that we can effectively fight the COVID-19 pandemic.”

Saurav Bhattarai welcoming participants to the 7th AeHIN General Meeting

On the third day of the conference, AeHIN facilitated a parallel community meeting for the openIMIS Regional Hub Asia (Philippines, Indonesia, and Sri Lanka) to gather their ideas on best moving forward with the community of practice. 

One of the suggestions in the meeting was to use a standard learning management system for learning openIMIS and to scale up the visibility of openIMIS in policy-oriented discussions in respective countries. Participants also suggested using openIMIS as a bridge to strengthen the collaboration between the ministry of finance and the ministry of health.

The AeHIN Partner Share session followed the parallel community meeting, wherein Saurav Bhattarai gave updates on the openIMIS initiative. He shared about their continued support in existing openIMIS implementations that manage the data of over five million beneficiaries.  

The initiative has also been working on new implementations and functionalities and expanding openIMIS for other social protection schemes. openIMIS is also strengthening its focus on interoperability. Saurav Bhattarai discussed that they have been “mapping openIMIS data model to be FHIR-compliant as well as working on direct interoperability with our other global goods such as DHIS2, OpenMRS, and Bahmni.”

Another important update from the openIMIS Initiative was the openIMIS Catalytic Implementation Fund that intends to “provide support to scheme operators that want to use openIMIS to manage their various social health protection schemes or beyond.”

AeHIN Hour - openIMIS Webinars 2021

Since 2019, AeHIN and the openIMIS have organized webinars to help bring information, updates, and discussions about openIMIS between the initiative and its communities of practice in Asia.

Saurav Bhattarai and Konstanz Lange, Advisors from the openIMIS Coordination Desk in GIZ, were the speakers at the first AeHIN-openIMIS webinar for 2021 held on March 9.

In this webinar, they introduced the openIMIS Catalytic Implementation Fund, a “mechanism to allow resources to be made available for getting started with openIMIS implementations.” 

The speakers also explained the various use cases where it can be applied and provided details on the procedures related to getting access to the fund.

The webinar recording is available at .

Other openIMIS webinars are available at .

openIMIS Enrollment App Testing

In mid-March, the AeHIN secretariat team contributed to testing the openIMIS enrollment application.

AeHIN focused on testing the openIMIS enrollment application via Android. The team used the openIMIS test link in documenting the test results. 

openIMIS Virtual Meetings

On March 17, 25, and 31, AeHIN participated in the openIMIS virtual community meetings spearheaded by the openIMIS coordination desk. On the first day, AeHIN co-facilitated the session on ‘Community-driven openIMIS 5th Anniversary Campaign.’ The session collated ideas from the implementers to further promote openIMIS’ anniversary.

openIMIS Discussion with MoH Lao PDR

On March 30, 2021, Dr. Bikash Devkota (Director of Quality Standards and Regulation Division from the Ministry of Health and Population Nepal) and Dr. Damodar Basaula (Executive Director of Health Insurance Board Nepal) presented at the Lao PDR Digital Health Convergence Workshop to discuss the experience of Nepal in implementing openIMIS.

As a follow-up action to the Lao PDR Digital Health Convergence Workshop, AeHIN facilitated a virtual meeting with Dr. Thepphouthone Sorsavanh (Head of Health Information Division, Ministry of Health Lao PDR) and Dr. Viravong Viengxay (National Health Insurance Board) last August 20, 2021. Dr. Sorsavanh also invited Kevin Billavarn (ADB Consultant) and Roland Dilipkumar Hensman (WHO Consultant) to the meeting.


The discussion from the meeting is summarized below:

  • Invite Lao IT staff to join the AeHIN community/mailing list

    • Currently 1 IT specialist working with NHIB

    • Currently around 5 IT staff working with Health Information Division, MOH Lao

  • MOH departments to meet again for the development of Lao's Digital Health Strategy (for the next five years); convergence workshop report to be published soon

  • openIMIS can provide support through the following channels:

    • Through networking facilitated by AeHIN: support discussions in defining the functionalities required by NHIB for their health insurance management system

    • Through knowledge resources: openIMIS wiki page, openIMIS videos

    • Through the openIMIS implementation catalytic fund: technical assistance for implementation including customization, user training, etc.; more details are available here

    • Through ILO

  • Suggested next steps based on the meeting:

    • At the country level, the Lao team defines system requirements for health insurance management

    • At the regional level, AeHIN facilitates inter-country discussion in defining minimum requirements for a generic health insurance information system

    • Meeting with Dr. Alvin and Saurav to discuss refined system requirements (wait for further details from NHIB)

    • openIMIS demo

    • Meet as a group on how to move forward

As of December 2021, MoH Lao PDR and NHIB Lao PDR did not yet give feedback on the systems requirements for their national health insurance.

Lao PDR Convergence Workshop - Use of openIMIS in Nepal

The Ministry of Health Lao PDR hosted a digital health convergence workshop last March 30-31, 2021. The workshop aims to help strengthen the digital health sector of Lao with the help of experts from the Asia eHealth Information Network, development partners, and other government agencies in the country.

The workshop's expected outcome is to develop a digital health architecture blueprint and a digital health strategy for the Lao PDR health sector. These outcomes will help improve stakeholder coordination and harmonization towards a sustainable and interoperable health information system.

AeHIN presented the AeHIN Mind the GAPS (Governance, Architecture, Program Management, and Standards, and Interoperability) Framework, which was the basis of strategy development sessions during the workshop. 

Neighboring countries also shared their experiences in the Digital Health Strategy Development session. Since its first digital health convergence workshop, Dr. Bikash Devkota, Director of Quality Standards and Regulation Division from the Ministry of Health and Population Nepal, shared Nepal's digital health journey.

According to Dr. Devkota, one of the lessons they learned is that digitalization is a significant component of quality care as it makes service easier and efficient. With this regard, Nepal prioritized digitalization in health. 

Dr. Damodar Basaula, Executive Director of Health Insurance Board Nepal, discussed how openIMIS played a big part in the country’s health digitalization, especially in managing Nepal’s national health insurance scheme. 

The Health Insurance Scheme of Nepal is a contribution-based Security Health Insurance (SHI) scheme with subsidies for the ultra-poor, poor, and the marginalized. The Nepal Health Insurance Board (HIB) manages it entirely. It is currently implemented in 69 districts and has a total of 3.7 million beneficiaries.

openIMIS supports the management of the core business processes of the Nepal HIB from the enrollment to verification of beneficiaries, claims generation, claims review, and data analysis. At present, there are 375 hospitals using openIMIS to send claims digitally, and there are 7,335 openIMIS users.

Since 2016, the Nepal HIB has been part of the openIMIS community of practice. They report bugs and issues, request new features, and discuss various technical topics with the community. The openIMIS community has provided them with a platform for exchange and regular updates, especially new features.

Dr. Basaulaa shared that the use of openIMIS in Nepal expedited the implementation of the Management Information System (MIS) for health insurance in Nepal. They also received support from the community of practice when needed, and the new versions of the openIMIS software are available regularly.

Nepal has learned that they need local capacities to manage and maintain software. Local teams have to lead implementations, and the openIMIS global community is available to support their local efforts.

AeHIN x APMC-SN M.D.igital 2021: National Telehealth Convention


AeHIN has co-presented this year’s M.D.igital Telehealth Convention with the theme “The Role of Medical Students in the Global Digital Health Strategy 2020-2025” last April 24-25, 2021.

The online conference, initiated by the Association of Philippine Medical Colleges Student Network (APMC-SN), served as a venue to discuss the role of medical students in the Global Digital Health Strategy 2020-2025. Four hundred sixty-one attendees attended the event.

In the international session, Saurav Bhattarai, Advisor from GIZ, introduced openIMIS, an open-source information system for managing insurance schemes and other related use cases. Saurav also discussed how systems can interoperate with openIMIS. openIMIS is being implemented in Nepal, Cameroon, Tanzania, Chad, and DRC. 

The conference proceedings and the MDigital Paper will also be shared once available.

Contribution to the openIMIS eLearning Course

In July 2021, AeHIN contributed to the development of the openIMIS eLearning course, particularly the second module on ‘openIMIS and National eHealth Landscape.’

In this module, AeHIN contributed slides on digital health challenges, AeHIN’s Mind the GAPS (Governance, Architecture, Program Management, and Standards) and Fill the GAPS Framework and some activities of the openIMIS community of practice in Asia.

Dr. Alvin Marcelo, AeHIN’s Executive Director, provided a voice recording of AeHIN's part in the module, corresponding to the contributed slides.

Convening the openIMIS Regional Hub Asia (Every First Tuesday of the Month)

The openIMIS Regional Hub Asia held its first internal meeting via Zoom with the country hub representatives for the year 2021 last August 3. Dr. Alvin Marcelo welcomed discussed the overview of the openIMIS community of practice in Asia as well as past activities from 2019 to 2020. He then explained the openIMIS regional hub work plan for 2021 to 2022, including the tentative schedule of activities. Lastly, the regional hub agreed to meet every first Tuesday of the month to discuss announcements and updates.

The succeeding meeting via Zoom took place on September 7. The regional hub discussed the upcoming testing activity for the openIMIS October 2021 release version, the openIMIS e-learning course to be cascaded in each country hub, proposed schedule of webinars, and some deliverable reminders for other consultants. The meeting also announced openIMIS related events as well as brainstorming for the regional hub’s abstract submission for the Global Digital Health Forum 2021.

In lieu of the monthly meetings for October and December 2021, the regional hub gathered for the openIMIS testing orientation held last September 29, 2021, and the openIMIS community of practice in Asia’s pre-formed panel at the GDHF held last December 7, 2021, respectively.

openIMIS Training with Metropolitan Medical Center

AeHIN shared its curriculum for ‘openIMIS training for medical schools in the Philippines’ with the Metropolitan Medical Center last August 2021. This initiative aimed to address Metropolitan Medical Center-College of Arts, Science, and Technology’s request to learn more about the field of health informatics. 

On August 14, Dr. Alvin Marcelo, AeHIN Executive Director, presented the overview of the curriculum and facilitated the module discussion on ‘Health Informatics’ via zoom to the faculty of Metropolitan Medical Center-College of Arts, Science. The session was attended by 16 participants.

Dr. Alvin Marcelo with Dr. Sonny Matias Habacon, Dean of Metropolitan Medical Center College of Medicine, talking about health informatics curricula, how faculty and students can teach and learn how to encode health data into a free open source software (openIMIS), and how Metropolitan can start their community of practice.


The succeeding modules were offered as self-paced educational video resources, namely:

openIMIS Testing for October 2021 Release Version

In support of the openIMIS October 2021 release version, the openIMIS Regional Hub Asia gathered testers who could contribute to completing the test case scenarios for the openIMIS modular release instance (174 test cases), openIMIS legacy release instance (74 test cases), and the openIMIS claims AI instance (12 test cases). 

On September 29, the openIMIS Regional Hub Asia facilitated an orientation and quick training on the testing activity with the identified testers from various country hubs.  The number of identified testers per group were outlined below.

  • Philippines-St Luke’s College of Medicine Quezon City - 8 testers

  • Philippines-San Beda College of Medicine - 5 testers

  • Sri Lanka - 5 testers

  • Cambodia - 5 testers

  • Nepal-Kathmandu University - 2 testers

The testing is ongoing for the openIMIS instances assigned to the regional hub and is expected to be completed by the second week of October 2021.

Focus Group Discussion on Free and Open Source Software

The openIMIS Regional Hub in Asia aims to promote a demand-supply ecosystem that will support the adoption of Free and Open Source Software (FOSS) applied in healthcare, such as openIMIS.

To understand the needs and perspectives of stakeholders in the ecosystem, AeHIN hosted a Focus Group Discussion on Free and Open Source Software for Healthcare last 25 August 2021 at 5:00-6:00 PM GMT+8. AeHIN administered real-time questionnaires (via complemented with open discussion to surface the participants’ perceived benefits and risks of adopting FOSS like openIMIS.

The 23 participants from the Philippines, Germany, Sri Lanka, Malaysia, Nepal, Bangladesh, New Zealand, Switzerland, and the United States represented various sectors. The majority of the participants work in the private sector (34.8%), primarily electronic medical record providers and insurance companies. Other sectors represented are the academe, international development agency, government, and non-government agency (figure below).

Sectoral Representation of the Participants 


Overall, the focus group discussion showed that the participants are familiar with examples of FOSS in healthcare. Participants also identified advantages and disadvantages of FOSS in healthcare as summarized below:

  • Costs: FOSS is considered an affordable solution that can help low-resource countries manage their healthcare system. However, it can have a high impact on countries if it fails. While FOSS is known to be cost-effective with its free license, some participants believe that it may have unclear upfront costs.

  • Community/Support: Some participants appreciate that FOSS has a thriving community of developers and users, allowing easy onboarding of local experts. On another note, some participants perceive the community as weak, lacking local technical experts who can provide a high quality of support (troubleshooting, core development, enterprise support).

  • Features: FOSS allows implementers to have complete control of the source code. Thus, they can easily modify, customize, and localize software development. Other benefits highlighted are cross-platform deployment and easy interoperability with other information systems. With the degree of flexibility in FOSS, some are concerned with issues on security, deployment stability, and data privacy that may come with it.

  • Overall Implementation: As it is vendor-independent, FOSS promotes ownership, sustainability, and fast implementation. However, some participants noted that FOSS implementation is prone to hiatus due to the unavailability of experts. Disadvantages include unclear licensing types and service level agreements as well as poor marketing.

For small and medium enterprises (SMEs) to invest in FOSS, they need support configuring the product to address clients’ needs. Thus, they are seeking a training program and budget to create a highly competent pool of developers who are well versed in FOSS development. To sustain the implementation, they want to ensure value for FOSS investment by reassuring product continuity, especially in its ability to provide stable and certified solutions. Thus, FOSS development should be well-secured by a funded program. They also want to guarantee a market for FOSS solutions to generate demand for the product. Lastly, they need government commitment to FOSS and its SME vendors. 

For the ministry of health (MoH) to adopt FOSS, implementers should avoid adverse lobbying (‘selling’ FOSS for FOSS’s sake). It is crucial to emphasize the specific features of FOSS that contribute to cost-effective innovation and address specific needs in managing health information. MoH should also understand that they have full control when adopting FOSS. Since most decision-makers do not have an IT background, networking is one of the ways for government staff to connect with FOSS experts. MoH would also need to develop an enterprise roadmap for FOSS implementation and, at the same time, strengthen and empower their technical team to ensure high quality of service and fast development in FOSS.

Lastly, the discussion also shows a need to develop a framework or model defining the role of SMEs and MoHs for FOSS implementations in highly regulated domains, such as healthcare. Demand for FOSS in national healthcare can only be generated if MoH adopts a clear governance framework in implementing and evaluating HIS solutions including FOSS. Supply for FOSS solutions can only be sustained if a local community of experts from the private sector is available.


AeHIN Webinar on DRGs

DRG 101

On October 14, 2021, Prof. Supasit Pannarunothai, Chair of the Center for Health Equity Monitoring Foundation, presented a webinar titled "DRG 101: What is the Diagnosis Related Group? Why is it important for UHC in Thailand?"

The Universal Health Coverage (UHC) has been unanimously endorsed by major multilateral policy organizations since 2000.

The Health Systems Research Institute, launched in 1993, funded research on diagnosis-related groups (DRG) in Thailand to promote a payment method for less evenly distributed events among populations like hospitalizations.

This webinar (Figure 1) provided frameworks of successful implementation of DRG inpatient payment policy after UHC law was enacted in 2002.


In this webinar, Prof. Supasit Pannarunothai explained the general principle of DRGs and also shared lessons learned on how to adapt the policy processes to fit with different political contexts among limited-resource countries (Figure 2).

The webinar recording is available at

Other openIMIS webinars are available at


DRG Information Systems

On October 26, 2021, Dr. Boonchai Kijsanayotin, Chair of the Asia eHealth Information Network, presented a webinar titled “DRG Information Systems: Thailand Experiences."


Thai diagnosis-related groups (TDRGs) have contributed to Thai UHC provider payment since Thailand implemented universal health insurance in 2002.

The development of TDRG goes hand in hand with the development of hospital and health information systems in Thailand.

This webinar (Figure 3) provided insights about the data needed for patient grouping and the calculation of DRG's cost weight (or relative weight), and how Thailand develops health information systems and data standards to be utilized by the TDRG system.

In this webinar, Dr. Boonchai Kijsanayotin explained also the essential building blocks of setting up a DRG system based on Thailand’s experience (Figure 4).

The webinar recording is available at

Other openIMIS webinars are available at .

openIMIS Community of Practice in Asia Pre-formed Panel at the Global Digital Health Forum 2021


On December 7, 2021, the openIMIS Regional Hub Asia conducted a pre-formed panel session at the Global Digital Health Forum (GDHF) 2021 with the title, “Strengthening a Community of Practice for openIMIS in Asia”.

Dr. Alvin Marcelo, AeHIN Executive Director, moderated the panel session. Country hub representatives from the Philippines (Dr. Julius Migriño), Sri Lanka (Dr. Chamika Senanayake), and Nepal (Mr. Nirmal Dhakal) shared their experiences on how they adopted openIMIS in their respective institutions.


1. Philippines (Dr. Julius Migriño, Associate Professor, San Beda University College of Medicine)

Dr. Julius Migriño started his presentation by giving a brief background of health financing in the Philippines. He explained that health financing in the Philippines can be categorized into general tax revenue, out-of-pocket, private insurance, and Philippine Health Insurance. He also introduced the primary electronic medical records (EMR) systems used in the country.

Dr. Julius Migriño’s focused on the use and plans for openIMIS at the San Beda College of Medicine, which offers a four-year medical degree program with a traditional subject-based curriculum and outcomes-based education formats. Based on the current directive from the Universal Health Care (UHC) Law in the country, the college has been implementing changes in curricular content to integrate public health concepts, including health financing and health informatics.

In February 2020, select students and faculty members of San Beda College of Medicine have undergone an openIMIS training tailored for medical students. Through this training, the college was able to discuss potential uses of openIMIS and also reflect on the limitation of the college’s curriculum rollout in the areas of health financing and health informatics.

Now as a member of the openIMIS community of practice in Asia, Dr. Julius Migriño presented the short, medium, and long-term goals of the San Beda University College of Medicine to adopt openIMIS (Figure 5).

As a short-term goal, the college aims to use the openIMIS manual for medical students as a reference in introducing ‘Health Financing’ as part of the ‘Health Management’ elective for the third and fourth-year levels.

As a medium-term goal, the college aims to demonstrate openIMIS as a tool for health financing. In this endeavor, the college has involved student volunteers in the user testing activities of openIMIS. The college is also planning to include the forthcoming openIMIS eLearning course as part of the ‘Health Management’ elective.

Lastly, for the long-term goal, the college aims to use openIMIS as a tool for patient enrolment in the community health station (for outpatient setting) that is currently being constructed in the university.

2. Sri Lanka (Dr. Chamika Senanayake, Medical Officer, Ministry of Health Sri Lanka)

Dr. Chamika Senanayake introduced the two types of insurance in Sri Lanka, namely life insurance and general insurance. There are also 28 private insurance companies in the country and another one used for the state sector, a national insurance trust fund for all government employees. Insurance in Sri Lanka is regulated by the Insurance Regulatory Commission of Sri Lanka. Other bodies included in the insurance mechanisms are the Sri Lanka Insurance Ombudsman, the Insurance Association of Sri Lanka, and the Sri Lanka Insurance Institute.

In Sri Lanka, health financing is usually from the out-of-pocket expenditure. According to Dr. Chamika Senanayake, one of the reasons why there is low insurance penetration in the country is that technology is not used to its full potential.

In terms of digital health ecosystem maturation, the National eHealth Steering Committee is governing digital health efforts in the country. Numerous health information systems are being used as well including the use of DHIS2 for COVID-19 surveillance.

Siloed systems, less coordination, less flexibility, ‘pilotitis’, and lack of alignment to national priorities are among the digital health challenges encountered in the country.

For openIMIS activities in Sri Lanka, Dr. Chamika Senanayake approached the Sri Lanka Institute of Insurance, which is composed of chief executive officers of insurance companies in Sri Lanka, to give an overview of openIMIS and its benefits (Figure 6). Some of the concerns raised by the representatives in the discussion include the visibility of medical records in the event of a claim, implication from the data protection act, customer consent, trends of various epidemics, and timeline on the national rollout of the country’s main Health Information Management System (HIMS). As part of awareness-building activities on openIMIS, Dr. Chamika Senanayake also held openIMIS webinars via AeHIN Hour.

Today, the health ministry is developing its national eHealth architecture and still figuring out how to implement the architecture’s middleware. In this initiative, the ministry is looking into how openIMIS can fit the architecture.


Dr. Chamika Senanayake also mentioned that they gathered health informatics graduate students in the user testing of openIMIS. Other potential opportunities for openIMIS as explained by Dr. Chamika Senanayake include:

  • Academic commitment towards digital health innovation (M.D.  program in Health Informatics), specifically interest in health data utilization and prevention of fake claims

  • Research project on health information management in the private health insurance industry of Sri Lanka, including a systematic review on health insurance information management

  • Incorporation of openIMIS LMS module for postgraduate trainees at the University of Colombo

  • Using openIMIS as a health insurance training platform for postgraduate trainees

  • Implementation of domains such as health financing and health insurance in medical undergraduate and postgraduate

3. Nepal (Mr. Nirmal Dhakal, Senior Technical Advisor, GIZ Nepal)

Mr. Nirmal Dhakal gave an overview of openIMIS implementations in Nepal (Figure 7). As of now, openIMIS has been supporting the Health Insurance Board (HIB) and the Social Security Fund (SS) in Nepal in managing their respective insurance schemes.

  • For the HIB, openIMIS supports the management of a voluntary social health insurance scheme for the informal sector. Since 2016, openIMIS has been implemented already in 76 districts in the country. openIMIS supports the management of core business processes at HIB which includes enrolment, verification, claims submission, claims review, and data analysis. To date, about 7,000 users actively rely on openIMIS for this scheme.

  • For the SSS, openIMIS support the management of various insurance schemes, such as the mandatory health and maternal scheme, accident injury insurance scheme for formal sector employees, benefits for dependent family members, and old-age benefit.

As a community, the openIMIS implementers in Nepal have been at the forefront of sharing on-the-ground experiences and knowledge in deploying openIMIS. The country has already hosted study tours for potential openIMIS users, such as Cambodia, Pakistan, Cameroon, Nigeria, and recently, Bangladesh. In addition, the Executive Director of the HIB is also a member of the larger openIMIS steering committee, which defines the overall strategic orientation of the openIMIS initiative.

As of now, major EMR system developers are working to make their respective systems compliant to Fast Healthcare Interoperability Resources (FHIR) for data exchange with openIMIS.

Mr. Nirmal Dhakal ended his presentation by discussing the lessons learned in implementing openIMIS in Nepal. He shared that openIMIS enabled quick implementation of management information systems for health insurance in Nepal. This implementation is supported by a community of practice with implementers from other parts of the world. Furthermore, new versions of the software are also released regularly. Mr. Nirmal Dhakal added that local teams need to lead the openIMIS implementation to manage and maintain the software.

After the presentations from the Philippines, Sri Lanka, and Nepal, Dr. Alvin Marcelo moderated the question and answer session with the audience. Mr. Saurav Bhattarai from the openIMIS coordination desk also joined and shared briefly about implementations in Africa, wherein openIMIS is used for multiple financing schemes.

The session recording is available until early March 2022 at the on-demand section of GDHF 2021’s platform via this link.

openIMIS Community Connect

On October 21, 2021, AeHIN participated in the openIMIS community connect spearheaded by the openIMIS coordination desk. In the openIMIS introductory e-learning course sub-session, the country hub representatives from the community participated in the online brainstorming activity on how to promote or market the openIMIS e-learning course.

Review of the openIMIS eLearning Course

Since November 17, 2021, the openIMIS regional hub in Asia, through country hub representatives, has started giving feedback to the tentative openIMIS eLearning course hosted through the SwissTPH moodle platform. The feedback was sent through the feedback box inside the moodle platform.

AeHIN introduces openIMIS and the CoP in Asia at PMAC 2022

On January 23, 2022, AeHIN hosted a side meeting with the theme “Digital Health for UHC and Primary Care” at the virtual Prince Mahidol Award 2022. Over one hundred participants joined from Thailand, Indonesia, the Philippines, South Africa, Sri Lanka, Bangladesh, Vietnam, India, Pakistan, Malaysia, Japan, Cambodia, Australia, Myanmar, and the United States of America. Dr. Alvin Marcelo, Executive Director of AeHIN, introduced the openIMIS Community of Practice in Asia as part of their Mind the GAPS presentation. He also shared that academics and MOH members of the CoP talk about doing interoperability at the business layer manifested through the openIMIS platform.


openIMIS Webinar on the Health Equity Fund in Cambodia

On January 31, 2022, Ms. Suong Sovathana, Vice Chief of Payment Certification Bureau (PCA) in Cambodia, presented a webinar titled, ‘Health Equity Fund in Cambodia’ on AeHIN Hour. In this session, she shared an overview of the basic structure of the health system, health insurance schemes, health equity fund implementation, and claim reimbursement process in Cambodia. Ms. Sovathana also explained the role of the Payment Certification Agency in certifying invoices submitted by the health facilities to the Ministry of Health. This process is observed before reimbursements are made to facilities via bank -to-bank transfer.


The recording of the webinar is available at

Ms. Sovathana Suong will be presenting her second webinar in April 2022.

openIMIS Webinar on a Study on Health Insurance Information Management in the Private Health Insurance Industry of Sri Lanka

Last February 22, Dr. Chamika Senanayake, lead of the openIMIS country hub in Sri Lanka, presented their study on health insurance in Sri Lanka. In the webinar, he presented their study which identified the life insurance and health insurance information management systems of Sri Lanka and their patterns of claims and utilization, evaluated the effects of health insurance data collection, processing, exchanging by use of conventional electronic-health insurance management systems, and explored the implications of data protection laws towards patient information safety while interacting with health insurance information systems.

The link to the recording will be made available once the paper of Dr. Chamika’s team has been published.


openIMIS Webinar - OpenIMIS: Case Study and its Implementation Status in Nepal

On March 8, two engineering students from the class of Dr. Rabindra namely Supriya Khadka and Rohan Chhetry presented their case study which includes the technicalities in which OpenIMIS was built. They talked about the implementation of OpenIMIS in Nepal, and how it can be implemented in the Institute of Engineering, Pulchowk Campus, Tribhuvan University, Nepal.

Interesting information were shared by the students and opened opportunities for engagement with the students. The webinar recording may be accessed at .

openIMIS Webinar - Why and How Thailand became a SNOMED CT Member Country

Dr. Boonchai Kijsanayotin, Chair of the Asia eHealth Information Network, shared why and how Thailand became a SNOMED CT member country.

In the webinar, he shared what the Thai Health Information Standard Development Center (THIS) has learned, researched, pursued, and endured to introduce SNOMED CT to the health IT and digital health community in Thailand, and the plan to adopt and implement SNOMED CT in Thailand for both administrative information systems (Thai DRG and health insurance information system e.g., OpenIMIS) and clinical care information system.

View the recording here:

openIMIS Webinar - Social Protection Focusing on HEF Implementation in Cambodia

On April 5, 2022, Dr. Chhun Eang Ros, Deputy Director of the Payment Certification Agency (PCA) at the Ministry of Health Cambodia presented the specific roles of Patient Management and Registration System at relevant stakeholders at each level of Health Equity Fund Implementation, its process and coverage, and how it is being expanded nationwide.

The webinar recording may be viewed at

Open Source Health Information Systems: Opportunities and Challenges (Part 1)

In this session, Dr. Luis Ruiz talked about the aspects related to the design and development of open-source health IT infrastructures that guarantee the scalability and availability of data for health delivery, research, and policy making. Aspects such data ownership, data accessibility, and FAIR (Findable, Accessible, Interoperable, Reusable) principles were covered. The webinar also focused on how these aspects should be approached at procurement and development stages from a free open-source software (FOSS) perspective.

To view the recording, please visit .

The second part of the webinar will be held on May 13 at 3 PM Manila time.

DRG Webinar Series 2022

The webinar series aims at building up knowledge and learning experiences to participants from countries that want to pursue the universal health coverage policy with payment to acute inpatient care with diagnosis related group tools.

The core course materials target the whole range of stakeholders from policy levels to operational levels.

Sub-modules segmentally target individual groups from researchers and developers of the tools; hospitals; funders; and academic professional bodies such as health care accreditation assessors and medical associations and health IT association.

Webinar recordings:

openIMIS eLearning Course Launch

On May 6, the openIMIS eLearning Course was launched through a webinar.

In the first part of the session, Konstanze Lang provided a short introduction to the openIMIS initiative, the rationale behind, an overview on use cases and countries where openIMIS is implemented as well as on the community. It was followed by Daniella Majakari who gave the the introduction to the the new openIMIS e-Learning course, including the target audience, the learning objectives and different modules, and a short demo on how to navigate the course. A total of 60 participants joined the session.

To check the webinar recording, visit

As of June 15, 2022, the openIMIS eLearning Course titled “Introduction to openIMIS” has 200 participants. Country hubs from the openIMIS Community of Practice in Asia have been organizing feedback and reflection sections based on their experience in completing the self-paced openIMIS eLearning course.

Current Status and Future Perspectives of OpenIMIS Implementation in Nepal

Dr. Rabindra Bista, Associate Professor at the Department of Computer Science and Engineering in Kathmandu University Nepal, gave a webinar on May 16, 2022.

In his presentation, he covered the current state-of-the-art of openIMIS implementation in Nepal, patients' perspectives of using openIMIS in Nepal, and how they can integrate openIMIS in an academic curriculum. Thirty-four attendees joined the webinar.

To view the recording, please visit .


FOSS Webinars 2022

Dr. Luis Marco Ruiz, Chair of the openEHR Education Program, presented a two-part webinar about opportunities and challenges in Open Source Health Information Systems for governments and software implementers on April 8 and May 13. Forty-one attendees participated in the first webinar and 81 attendees joined the second webinar.

Both webinars covered aspects related to the design and development of open-source health IT infrastructures that guarantee the scalability and availability of data for health delivery, research, and policy making, as well as data ownership, data accessibility, and FAIR (Findable, Accessible, Interoperable, Reusable) principles. The webinar focused on how these aspects should be approached at procurement and development stages from a free open-source software (FOSS) perspective.

On June 10, Mr. Uwe Wahser from GIZ and Dr. Oliver Hummel from the University of Mannheim gave presentations on FOSS and Academia. Dr. Christoph Geiss, also from the University of Mannheim, joined the Q&A portion. A total of 24 participants attended the session.

Documentation and materials from the session may be accessed here.


Webinar recordings:

Open Source Health Information Systems: Opportunities and Challenges (for Governments)

Open Source Health Information Systems: Opportunities and Challenges (for Software Implementers)

FOSS and Academia: How to integrate openIMIS in your Curriculum

openIMIS Guest Lecture from Nepal

Mr. Nirmal Dhakal and Mr. Purushottam Sapkit gave a guest lecture to engineering students of the Institute of Engineering at Tribhuvan University on May 23, 2022. They gave a brief overview of openIMIS and Digital Health in Nepal. The students were mainly interested in status configuration, installation, as well as the existing countries implementing openIMIS and what they can learn from them.

openIMIS-DRG Datathon 2022

The Center for Applied Research and Development (CARD) of the Institute of Engineering at Tribhuvan University, in collaboration with the openIMIS initiative, Standards and Interoperability Lab Thailand (SIL-TH), and the Asia eHealth Information Network (AeHIN), organized the openIMIS-DRG Datathon held on June 3-5.

A two-hour orientation was held on the first day of the datathon. Dragos Dobre and Eric Darchis gave an introduction to openIMIS and data models, and Dr. Boonchai Kijsanayotin, Chair of the Asia eHealth Information Network gave an introduction to DRGs and the Thai Data Model.

Thirteen out of the 14 participating teams successfully finished and submitted their output.

On June 6, virtual badges were awarded to the students via Badgr.

Images are by Center for Applied Research and Development (CARD), Institute of Engineering, Tribhuvan University. Retrieved from , .

openIMIS-DRG Datathon Awarding Ceremony 2022

On July 4, an awarding ceremony was held at Pulchowk Campus to recognize the students who won the openIMIS-DRG Datathon held from June 3 to 5, 2022.

The criteria used to score the performance and output of the groups were based on accuracy. The three winning teams namely Cartographers, Hufflepuff, and Trinity were awarded with certificates and prize money from the Institute of Engineering, Pulchowk Campus, Tribhuvan University.

Prof. Sangeeta Singh, Director of CARD-IOE; Prof. Shashidhar Ram Joshi, Dean of IOE; and Dr. Basanta Joshi, Deputy Director of CARD-IOE were present in the awarding ceremony, while Dr. Alvin Marcelo, Executive Director of AeHIN, joined the awarding virtually via Zoom.

Prof. Basanta Joshi shared the results of the Datathon and Gaps Analysis in openIMIS and the Thai Diagnosis Related Groups (DRGs) through a webinar on July 18.




openIMIS talks about Opportunities on AI for Health Insurance at the AeHIN GM 2023

To discuss the potentials and challenges of using Artificial Intelligence (AI) as a tool in managing health insurance schemes, the openIMIS Initiative together with the Badan Penyelenggara Jaminan Kesehatan (BPJS -K) or Social Security Agency on Health Indonesia, openIMIS Initiative, Joint Learning Network, and World Bank, held a joint session on ‘AI for Health Insurance’ at the Asia eHealth Information Network (AeHIN) General Meeting (GM) 2023 on November 6, 2023, at JS Luwansa Hotel and Convention Center, Jakarta, Indonesia. The AeHIN GM discussed various digital health topics under the overall theme,  “Ensuring Digital Health for Better Outcomes: Putting Blueprints into Practice.” 

Around 50 delegates representing the government, academe, development partners, civil society, and professional societies within and beyond South and South-East Asia participated in the ‘AI for Health Insurance’ session, which explored the aspects AI can and cannot solve in the health insurance sector. Karlina Octaviany, AI Specialist at the ‘FAIR Forward – Artificial Intelligence for All’ initiative at GIZ Indonesia, moderated the two-hour knowledge-sharing session, which discussed examples of applying AI for health insurance; presented opportunities on how AI could work with existing (health) insurance management information systems; and shared BPJS-K’s experience in adopting AI for health insurance.

Opportunities for AI in Health Insurance

Saurav Bhattarai, Advisor and lead for the openIMIS initiative at GIZ, presented opportunities for AI in health insurance in the context of claims adjudication. He started his presentation with an example of a typical insurance claims workflow:

  1. Claims submission: It starts with claims submission which could be done manually or digitally by health facilities. 

  2. Rules engine: A typical IT system has some rules programmed in, which generally contain simple checks to see if the health insurance policy is active, if the person is insured or not if the services are covered and applicable in the policy, and the frequency limits. Bhattarai further explained that the rules engine is classified as part of AI, even if it is rudimentary, as the computer is taking a decision about claims getting approved or rejected. 

  3. Manual evaluation: After passing the checks from the rules engine, it will undergo manual evaluation.

  4. Payment: After claims are verified from the manual evaluation, payment will be approved. If not, a health facility will receive a response.

As an implementation example, Bhattarai showed the number of claims coming in per day to the National Health Insurance in Nepal –– from around hundreds of claims per day in 2016 to around 15,000 claims per day in 2021. The trend shows an exponential increase even up to now. Bhattarai mentioned that digital health is one of the contributing factors to this increase, which began when the National Health Insurance mandated the use of Fast Healthcare Interoperability Resource (FHIR) standards for electronic health records. This meant that more electronic health record systems (EHR) in hospitals are now compatible with the IT system used for the submission of digital claims in health insurance. Digitalization is making it easier for health facilities to submit claims; however, health insurers are finding it difficult to review the increasing number of claims. As a result, there is a huge gap between the number of claims received and the number of claims reviewed.

Bhattarai reiterated that the bottleneck lies in adjudication. The number of claims per day increases every year, while the human intervention capacity remains limited. In 2019, only 16 officers were hired to review claims. On a good day, one officer can review up to 100 claims per day. Theoretically, all available officers combined can only review up to 1, 600 claims per day out of around 15,000 claims received per day. This situation hurts healthcare delivery because when health facilities are not being paid, they cannot provide services to the population that needs them. At the moment, 30,000 claims are projected to be received per day, which means around 300 officers would be needed to manage this daily demand. Thus, automated claim categorization through AI models is needed to reduce time between claims submission and claims payment and, therefore, to increase access to health.

By adding machine learning to the same claims submission workflow, claims can now be automatically categorized. In this context, an AI engine was created for automatic classification based on manual review and the ability to flag rejected claims. If the AI engine starts rejecting claims, it will go through a manual quality assurance process so human reviewers can check if the AI is rejecting claims properly. The manual quality assurance helps the AI engine learn more, as human action is what makes the AI engine better and better. Bhattarai explained the steps followed to incorporate machine learning in the claims submission workflow:


  1. Data gathering and preparation: Creation of an AI input data model, including sanity check on the database, processing of categorical data, and normalizing data. 

  2. Implementation of the AI algorithm: Design AI methods, model outputs, and evaluation metrics, then programming the AI model itself. 

  3. Software development: Development of the AI modules as well as program interfaces using the FHIR standard. Claims that come in the AI module are FHIR claims.

  4. User acceptance testing: Testing of the AI modules.


On challenges encountered, Bhattarai shared that during data gathering, the challenge was that there was not a lot of data to learn from initially and that the few ‘rejected data’ did not indicate reasons for rejection. In the database, it was also observed that text fields were not standardized. During algorithm development, one of the challenges Bhattarai shared was the lack of non-numerical data. As most data were categorical, rejections were based on different types of data and visit types. Very few AI models were suited to the type of data that was present. Thus, the resulting AI model was based on extreme gradient boosting. For the development of the claims module, two data streams were used – offline and online data. Offline historical data were used for gathering data, cleaning data, and data analysis for training the AI model. The model was then applied to online data where claims were coming in before finally executing the AI model for actual analysis and execution of AI in accepting and flagging claims.

The whole research and development of the AI module presented by Bhattarai was implemented on openIMIS, an interoperable, versatile open-source software for managing health insurance systems. Not only is the software available for download, but all the logic and thought process that went into developing the AI module is free to use and modify. As openIMIS is a global good, the openIMIS Claim-AI module can be integrated into any management information system (MIS). Organizations can adopt the AI module and continue using their own MIS without needing to use the whole openIMIS technology suite. With a readily available AI module for claims, interested implementers will only need to conduct data preparation, customize, deploy and test. Bhattarai encouraged everyone to take advantage of this global public good, “In typical AeHIN fashion, when we help friends, friends will help us; this is us helping friends.” 

The openIMIS AI module resources are open-source and freely available with a wider community available for support. Model design details are available here. Codes are also available via GitHub.


Questions addressed and answered by the openIMIS Initiative during Open Forum:

  1. AI will flag anomalies and so on, has there been a regular human intervention to see whether it’s correct? 

  • Saurav Bhattarai: Quality assurance is one of the steps presented. After there is an AI intervention, let’s say an AI flags the claims, there is a provision for a manual review of the AI action. That’s basically where the learning also happens if there is a mistake from the AI. As we go on, we still have a lot more data to process but from the data that we have, the accuracy is increasing as we go along. It takes about a year to gain half of a percentage, but that’s basically how it improves. The manual quality assurance is recommended and very much used.

  1. Since it is an open system, what kind of dataset have you used for training? What is the FPI for this algorithm? It’s good to review them and see whether they fall under the rection category, but what about the claims that are false-positive and selected as legitimate claims?

  • Saurav Bhattarai: For the data, the software is available as a digital public good, when we developed it, it had to be developed for a certain use case because there is no global dataset available. The initial solving of the problem, even the model development, was done based on the dataset that we had in the implementation in Nepal - the National Health Insurance in Nepal. That data was used to develop the model, training, and everything. Right now, what is available as a digital public good is everything about that data. But, you can train the (AI) model using your own data. Right now, we’re trying to see if we can get access to some publicly available data, but that’s quite difficult. There are some developer teams that are artificially generating data. Of course, it’s not the same as real data but just for our testing purposes and showcasing purposes. But, the model itself is there. For the false positives, I am not an AI expert, but I can refer you to the resources, and I can send you the links. We did have performance issues on version 1, so this is version 2 already.

  1. So, we have to shift gears. (For example), if a minister would be interested in AI either in MoH or insurance agency, what might be an advice you can give the minister? One or two priority things you can start with, knowing that AI might be very complex and might be difficult for them to do many things all at the same time.

  • Saurav Bhattarai: I don’t think we want the minister saying, ‘We should have AI.’ The minister should be saying, ‘Let’s reduce fraudulent claims.’ If the minister starts saying, ‘Let’s have AI,’ then we’re gonna have everyone running around buying anything that has the word, ‘AI’. It’s more of, ‘Let’s build capacities within the advisory team of the minister so that the minister isn't saying let's use AI.’ He’s talking about the problems in the health sector and asking for solutions to that problem. That means the digital health and the technical teams will decide how, what, and when you can use AI, or maybe 5 years later, we’ll be talking about a different technology – it won't be AI because these technologies will definitely change. 

Presentation slides at the session are available here.


openIMIS presents at the AeHIN Marketplace in Jakarta, Indonesia

AeHIN’s marketplace session made a successful comeback in this year’s AeHIN General Meeting held in Jakarta, Indonesia. The marketplace session is one of the unique parts of the AeHIN General Meeting. NGOs, international development agencies, the academe, and government partners showcase their digital health solutions implemented in collaboration with the Government/Ministry of Health, highlighting the national/provincial digital health programs in countries. openIMIS was among the 34 booth presenters at the event. Saurav Bhattarai and Nirmal Dhakal represented openIMIS and shared about openIMIS being a digital public good that supports the digital management of various processes within multiple types of health financing mechanisms.


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