02 Potentials & Problems

Persona: Fatima Mwanga

• Location: Tanzania

• Age: 32

• Gender: Female

• Background:

  • Fatima has a degree in social sciences and has been working in health services for 5 years.

  • She has experience in community outreach and public health initiatives.

• Role & Responsibilities:

  • Enrolls insurees and submits enrollment forms to health insurance administration.

  • Handles policy modifications.

  • Collects feedback from scheme patients and submits it to the health insurance administration.

• Available Functionality:

  • Capture a photo of an insuree.

  • Send a photo.

  • Inquiry on an insuree.

  • Collect feedback from an insuree.

• Goals:

  • To ensure maximum enrollment of eligible beneficiaries.

  • To improve community understanding of health insurance benefits.

• Challenges:

  • Limited access to technology in remote areas.

  • Language barriers with some community members.

• Technology Proficiency: Basic to intermediate; comfortable with mobile devices but needs training for advanced software.

Persona: Ramesh Gurung

• Location: Nepal

• Age: 28

• Gender: Male

• Background:

  • Ramesh has a diploma in office management and has been a clerk for 4 years.

  • He has experience working with local government offices.

• Role & Responsibilities:

  • Enters and modifies data on families, insurees, policies, and contributions.

  • Enters data on claims if the claims are submitted in a paper form.

• Available Functionality:

  • Creation, search, modification, deletion, and modification of a household/group, an insuree, a policy, or a contribution.

  • Renewal of a policy.

  • Entry of a claim.

• Goals:

  • To maintain accurate and up-to-date records.

  • To streamline application processing for better efficiency.

• Challenges:

  • High volume of applications leading to backlog.

  • Frequent changes in regulations affecting documentation requirements.

• Technology Proficiency: Intermediate; familiar with database management but struggles with complex software features.

Persona: Jean-Paul Ngome

• Location: Cameroon

• Age: 40

• Gender: Male

• Background:

  • Jean-Paul has a Bachelor’s degree in Accounting and has 10 years of experience in financial management.

  • He has worked in both the public and private sectors.

• Role & Responsibilities:

  • Transfers data on collected contributions to an external accounting system.

  • Calculates claim amounts per health facility.

  • Runs openIMIS operational reports and presents claims decision overview to management.

  • Processes approved claims to health facility sub-accounts.

• Available Functionality:

  • Transfer of data on contributions to accounting system.

  • Valuation of a claim.

  • Transfer of a batch of claims for payment.

• Goals:

  • To maintain accurate financial records for the organization.

  • To ensure timely and accurate reporting for stakeholders.

• Challenges:

  • Difficulty in reconciling data from different sources.

  • Limited resources for financial training and development.

• Technology Proficiency: Advanced; skilled in financial software and data analysis tools.

Persona: Aisha Thapa

• Location: Nepal

• Age: 35

• Gender: Female

• Background:

  • Aisha has a degree in healthcare management and has 6 years of experience in patient services and claims processing.

  • She has previously worked in a hospital setting, assisting patients with insurance claims.

• Role & Responsibilities:

  • Verifies membership and issues claim forms to patients.

• Available Functionality:

  • Inquiring on a household/group, insuree, and policy.

• Goals:

  • To ensure all patients have access to the necessary claim forms and information.

  • To facilitate a smooth claims process for patients.

• Challenges:

  • Managing high patient volumes during peak hours.

  • Ensuring accurate information is communicated to patients regarding their claims.

• Technology Proficiency: Intermediate; comfortable with patient management systems but needs training on new software.

Persona: Ramesh Gurung

• Location: Nepal

• Age: 28

• Gender: Male

• Background:

  • Ramesh has a diploma in office management and has been a claims administrator for 4 years, focusing on health facilities.

• Role & Responsibilities:

  • Pools claim forms from health facilities and enters and submits claims.

• Available Functionality:

  • Opening a batch of claims.

  • Entry of a claim.

• Goals:

  • To ensure timely and accurate submission of claims from health facilities.

  • To improve communication with healthcare providers regarding claims processing.

• Challenges:

  • High volume of claims leading to potential errors or delays.

  • Difficulty tracking the status of multiple claims at once.

• Technology Proficiency: Intermediate; experienced with claims processing software but can benefit from additional training on openIMIS.

Persona: Dr. Lila Acharya

• Location: Nepal

• Age: 45

• Gender: Female

• Background:

  • Dr. Acharya has a medical degree and has been practicing for over 15 years.

  • She has experience in public health and claims verification.

• Role & Responsibilities:

  • Provides technical advice on claims verification from a medical standpoint.

• Available Functionality:

  • Checking of a claim for plausibility.

  • Review of a claim.

  • Authorize a claim for payment.

• Goals:

  • To ensure the accuracy and legitimacy of claims.

  • To enhance collaboration between healthcare providers and insurers.

• Challenges:

  • Inconsistent information from different healthcare facilities.

  • High-pressure environment with tight deadlines.

• Technology Proficiency: Advanced; experienced with medical software and claims processing systems.Users Feedback Questionaire:

Persona: Pascal Nguene

• Location: Cameroon

• Age: 38

• Gender: Male

• Background:

  • Pascal has a degree in public administration and has worked in health scheme administration for 8 years.

• Role & Responsibilities:

  • Administers registers (all except the register of users).

• Available Functionality:

  • Administer registers (officers, payers, health facilities, medical services, medical items, medical item price lists, medical services price list, products).

  • Extract creation for off-line health facilities.

• Goals:

  • To ensure the smooth operation of the health insurance scheme.

  • To provide accurate data for decision-making.

• Challenges:

  • Managing multiple registers can be cumbersome.

  • Ensuring data accuracy and integrity.

• Technology Proficiency: Intermediate; comfortable with administrative software but needs training on advanced features.

Persona: Sara Mbuyu

• Location: Tanzania

• Age: 30

• Gender: Female

• Background:

  • Sara has a background in information technology and has worked in system administration for 5 years.

• Role & Responsibilities:

  • Administers operations of the IMIS.

  • Responsible for backups of data.

• Available Functionality:

  • Administer the register of users and utilities.

  • Manage backup, restore, and updates.

  • Extract creation for off-line health facilities.

• Goals:

  • To ensure data security and system reliability.

  • To maintain seamless operations of the openIMIS system.

• Challenges:

  • Handling system updates can disrupt operations.

  • Ensuring user access control while maintaining security.

• Technology Proficiency: Advanced; highly skilled in system administration and database management.

Heuristic Evaluation

openIMIS

1. Add/Update/Delete Family/Group:

   Evaluator: Marvin M
   Date : 20.10.2024
   Task : Add/Update/Delete Family/Group

• Visibility:

  • Issues:

    • Date-Picker info missing for birthday input field / photo date

    • Search existing insuree as head of Family does not respond in a resonable time. No Spinner or Search button + No information if nothing was found

    • After clicking save button the screen does not change. It just turns gray.

    • Reload button has no warning if you really want to reload

    • If a entry is deleted it will be displayed as gray stripped row. The list itself will not get refreshed afterwards.

  • Recommendations:

    • Add DatePicker icon

    • Add feedback notification for search

    • Add feedback information "nothing found" etc.

    • Add forwarding or other response after adding family

    • Refresh the Family-List at a certain point (either if notification arrived or after X seconds)

• Matching real-world

  • Issues:

    • Only seven inputs needed but 28 input-fields are shown to get answered.

    • After changing from one page to another there is no information shown what type of interaction is happening. If you change from Family to “Add Policy” then you get to the “Policy” Page. But there is no information that you now can add information to the Policy.
      -> Add Policy looks exactly the same as “Read” Policy

    • User hast to scroll through all lists even though he just wants to add/change one information (ex. Policies)

  • Recommendations:

    • Add any information that the user is aware of which action he is doing.

    • Displaying the “menus” only as header or card without records to easily choose the wanted menu

• User Control and Freedom

  • Issues:

    • Undo and Redo are not fully supported

    • Reload button does not clear all values

    • Poverty State is shown in Family List as checkbox. There is no visual effect which shows that the checkbox cannot be changed.

  • Recommendations:

    • Add a visual indication which shows, that those checkboxes are read only

• Consistency and Standards

  • Issues:

    • Add Family/Group is possible to do directly from Navigation. All other entries can only be generated from the regarding list. Double entry of Family/Group in Navigation is also bit confusing.

  • Recommendations:

• Error Prevention

  • Issues:

    • Missing information if you really want to reload the page if data was already entered.

    • No Validation of input fields given

  • Recommendations:

    • Add warning if user wants to reload

    • Add validation to input fields

• Recognition Rather
  Than Recall

  • Issues:

  • Recommendations:

• Flexibility and
  Efficiency of Use

  • Issues:

    • Search for Village or Health Facility instead of going through the different fields of information
      Recommendations:

• Aesthetic and
  Minimalist Design

  • Issues:

    • Field "Status" is shown but cannot be changed or does not give any appended information

    • A lot of information is shown double times. Family head is shown in header, Family Details and Insurees

  • Recommendations:

• Help Users Recognize,
  Diagnose, and Recover
  from Errors

  • Issues:

    • Missing tooltips for some buttons.

    • Documentation of some processes is really Comprehensive but no direct information panels are used inside the system

  • Recommendations:

• Help and Documentation

  • Issues:

  • Recommendations:

Heuristic Evaluation

openIMIS

1. Add/Update/Delete Insuree

   Evaluator: Marvin M
   Date : 20.10.2024
   Task : Add/Update/Delete Insuree

• Visibility:

  • Issues:

    • After adding an insuree to a existing family and changing his/her Address, the next time if you open the insuree, the Checkbox “Same Address” is ticked and the entry “Address” hidden. Same for “Village”

  • Recommendations:

    • Show the differentAddress, Village details.

• Matching real-world

  • Issues:

    • If you want to add a insuree from the list of all insurees then it randomly picks a existing family/group for you. The insuree will therefore be added to the wrong family.

  • Recommendations:

    • Asking the User to which family he wants to add the insuree to. Give the possibility to create a new one if its not existing.

• User Control and Freedom

  • Issues:

    • Once a Photo Officer was inserted and afterwards removed, then the list of Officers is not going to be provided anymore. The Search needs then a manual input.

  • Recommendations:

    • Make the Photo Officer Search the same component as “Health Facility Search”. This component is much more user friendly

• Consistency and Standards

  • Issues:

  • Recommendations:

• Error Prevention

  • Issues:

    • After adding a insuree you can go and update the user status. For the status “inactive” as well as “dead”. The User can therefore the no longer change the user status.

  • Recommendations:

    • Add Reasons for inactivity or dead.

• Recognition Rather
  Than Recall

  • Issues:

  • Recommendations:

• Flexibility and
  Efficiency of Use

  • Issues:

  • Recommendations:

• Aesthetic and
  Minimalist Design

  • Issues:

    • After choosing a Relationship in the add insuree, the field adds a magnifying glass to the result. This indicates it would act as a search. Same for Profession, Education.

  • Recommendations:

    • Remove the magnifying glass from the result

• Help Users Recognize,
  Diagnose, and Recover
  from Errors

  • Issues:

  • Recommendations:

• Help and Documentation

  • Issues:

  • Recommendations:

Heuristic Evaluation

openIMIS

1. Add/Update/Delete Policies

   Evaluator: Marvin M
   Date : 20.10.2024
   Task : Add/Update/Delete Policies

• Visibility:

  • Issues:

    • During entering the policy only 3 fields are needed to complete. There are a lot more information that cannot be changed or used for the creation of the policy

  • Recommendations:

    • Hide the overload of information which are not needed.

• Matching real-world

  • Issues:

  • Recommendations:

• User Control and Freedom

  • Issues:

    • Needed double click for choosing an element in the list.

  • Recommendations:

    • Add One-Click Elements to List

• Consistency and Standards

  • Issues:

    • Policy can only be added from Family-Page and not as usual from the list of Policies

    • In Policy details the “Open Family” Button is displayed on the other side than all other buttons as usually.

  • Recommendations:

    • Add create Policy Button to the list of Policies

• Error Prevention

  • Issues:

    • Update and Read Policy look exactly the same. Not clear what a user can do with the entry.

  • Recommendations:

    • Clarify the possible interactions.

• Recognition Rather
  Than Recall

  • Issues:

  • Recommendations:

• Flexibility and
  Efficiency of Use

  • Issues:

  • Recommendations:

• Aesthetic and
  Minimalist Design

  • Issues:

  • Recommendations:

• Help Users Recognize,
  Diagnose, and Recover
  from Errors

  • Issues:

    • Notifications after the asynchronous job are hard to find/recognize. The Notifications do not have links to the elements or a detailed error description.

  • Recommendations:

    • Add Links and error description to the Notifications. If its an error, add all inserted data back again, so that the user only needs to change the failure.

• Help and Documentation

  • Issues:

  • Recommendations:

Heuristic Evaluation

openIMIS

1. Add/Update/Delete Claims

   Evaluator: Marvin M
   Date : 20.10.2024
   Task : Add/Update/Delete Claims

• Visibility:

  • Issues:

    • Search Form for Claims is too intense. There are too many possible fields without a distribution into several “search topics” or similar. Preset search filters are getting lost by the mass of fields (example “Claim Status”).

  • Recommendations:

    • Divide Search Form into “search” and “advanced search”

• Matching real-world

  • Issues:

  • Recommendations:

• User Control and Freedom

  • Issues:

    • User can not select a Claim from the list by double click everywhere in the row. If you click on a control nothing happens.

  • Recommendations:

    • Change control fields to clickable labels

• Consistency and Standards

  • Issues:

  • Recommendations:

• Error Prevention

  • Issues:

  • Recommendations:

• Recognition Rather
  Than Recall

  • Issues:

  • Recommendations:

• Flexibility and
  Efficiency of Use

  • Issues:

    • Why does the Health Facility and Admin need to be entered before its even possible to enter a claim?

  • Recommendations:

• Aesthetic and
  Minimalist Design

  • Issues:

  • Recommendations:

• Help Users Recognize,
  Diagnose, and Recover
  from Errors

  • Issues:

    • Policy information in Claims are Red if inactive. This Text is the only “negative indicated” text in openIMIS with a red font color. The red color differ from the one in the status notification bar.

  • Recommendations:

    • Highlight the information differently. The red is nowhere else used and with the blue background not good readable.

• Help and Documentation

  • Issues:

  • Recommendations: