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openIMIS tblPolicy resource (FHIR Coverage)

openIMIS tblPolicy resource (FHIR Coverage)

List of content:

Description:

The OpenIMIS Policy object (from the openimis-be-policy_py module) was mapped to the FHIR Coverage resource. 

Notes / Assumptions:

  • The endpoint uses the UUID as a primary key

FHIR resources:

Fields mapping:

Table legend:

Color

Description

Color

Description



Mapped - the final choice, the most suitable choice



Need to be found the best place for the field (not mapped currently)



Currently not important - not mapped

Mapping:

OpenIMIS field

DB type

FHIR field

Description

Note

STPH

Mapping status

PolicyID

PK

Identifier





Use only PolicyUUID

This is the Database ID and should be used only internally

PolicyUUID

UniqueIdentifier

Identifier

The unique identifier used as PK for FHIR



Added

mapped

FamilyID

FK(tblFamilies)

policyHolder



We use the policyHolder to represent the reference to the Patient (head of the family). The insurance code is used to point the appropriate Patient.

(was updated by SD) OK

mapped

EnrollDate

date

Extension



The FHIR representation doesn't contain this type of value. If needed we can consider adding the FHIR extension.

Extension



StartDate

date

period





OK

mapped

EffectiveDate

date

Extension



The FHIR representation doesn't contain this type of value. If needed we can consider adding the FHIR extension.

Extension



ExpiryDate

date

period





OK

mapped

PolicyStatus

tinyint

status

Default: 1
1 - Idle
2 - active
4 - suspended
8 - Expired

There are some differences between the Policy and FHIR statuses. List of FHIR coverage statuses:
1) active
2) cancelled
3) draft
4) entered-in-error

ok

mapped

PolicyValue

decimal

contract.valuedItem.net



The FHIR representation doesn't contain this type of value. If needed we can consider adding the FHIR extension.

contract.valuedItem.net



ProdID

FK(tblProduct)

grouping



The FHIR representation doesn't contain exactly the same type of value. The coverage classifications can be contained in the "grouping" field and we can join it with a product using grouping.plan. See example: https://hl7.org/fhir/STU3/coverage-example.json.html

I would suggest to check Contract entity => Coverage.contract 



OfficerID

FK(tblOfficer)

contract.agent.actor



The FHIR representation doesn't contain this type of value. If needed we can consider adding the FHIR extension.

subscriber



PolicyStage

char(1)



Default: N
N - New Policy
R - Renewed Policy

The FHIR representation doesn't contain this type of value. If needed we can consider adding the FHIR extension.



Will be added after when the final approach will be established

ValidityFrom

datetime



Audit information. More information can be found here (on page 113):
https://github.com/openimis/openimis_docs/blob/master/specs/Web%20application%20-%20Functional%20Design%20Specification.pdf

This information are valuable for OpenIMIS but I probably not required by external systems.




Internal field



ValidityTo

datetime





LegacyID

int





AuditUserID

int