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Open Source Insurance System

openIMIS is an open source Insurance Management Information System built to improve health financing schemes effectiveness in LMIC (low- and middle-income countries)

General solution overview

openIMIS produces operational reports to track all activities and the performance of insurance schemes according to specified criteria. Additionally, the system encompasses a data warehouse based on a multidimensional model where aggregated data is extracted regularly from the central database for dynamic analysis and reporting. openIMIS is a fully functional, licensed open-source application compatible with other technologies catering to Universal Health Coverage, such as the national HMIS (DHIS 2) in Tanzania. The software source code is publicly available creating a global community of developers and users around IMIS, which will be able to further enhance and evolve the system functionality according to upcoming requirements from its application sites. This will ensure better modularity and continuous system growth driven by implementation needs and technology advances.

Current openIMIS implementations

Key features of openIMIS system

openIMIS is a comprehensive system for managing and standardizing crucial performance operations of Health Insurance. Starting from enrolment and renewal of membership, the system is ready to process claims and provider payment as well as all other management tasks. The system distinguishes itself through the use of easily accessible and implementable mobile applications taking processes closer to clients and making health insurance more inclusive, particularly for the informal sector. The system reduces bureaucracy and cuts down transaction time. openIMIS distinguishes itself with its innovative features: 

  • User friendly, and easy to access
  • Lower processing costs and time 
  • Centralized web-based, paperless application for enrolment, renewals, identification enquiry, contribution collection, claiming, provider payment and feedback collection features 
  • Cost effective patient identification using QR codes
  • Off-line installation synchronized with the central database whenever internet is available or manually through data storage devices 
  • Applicability to different types of health insurance schemes (community-based, district, regional or national schemes), encompassing different enrolment modalities, benefit packages and provider payment mechanisms 
  • Technical basis for implementing portability of benefits across different insurance schemes and locations 
  • Unique feedback app for increasing social accountability 
  • Support of different languages (e. g. English Kiswahili, Nepali, French). New languages could be easily added
  • License-free software and continuous development by the global open-source community 

Sources:
1. Swiss-Tanzania Cooperation: Achieving Universal Health Coverage (UHC)

Different types of Health Insurance Schemes

Support of many languages

Claims review

Digital transmission of claims

Open-source software

User friendly

Online/Offline functionality

Patient recognition with QR codes

Lower processing costs and time

Analyze data using DHIS2 connection

Insurance system workflow

Who is it for?

The users of openIMIS are institutions paying for health care, e.g. health insurance funds or ministries of health.
The software helps to manage:

  • Membership/ patient registry
  • Benefit package (services and prices)
  • Contracted providers
  • Service claims and reimbursement
  • Client feedback
  • Monitoring and reporting

“Last year I underwent a surgery at Kondoa Hospital. Seeing CHF covering the whole cost of surgery was an unforgettable situation in my life. I wish to see all these CHF services extended to national coverage even if the contribution has to increase.”

Jaa Issa Waziri, 51 years, Wisikwantisi Village, CHF member since 2014

Partnership

The openIMIS project is an example of outstanding collaboration and partnership. We develop this global impact solution side by side with our longtime partner – The Swiss Tropical and Public Health Institute (Swiss TPH). We have created a truly international remote Scrum team consisting of 9 team members from 4 countries:

  • Product Owner (Swiss TPH)
  • System Architect (Swiss TPH)
  • Team Leader Developer (SolDevelo)
  • Project Manager (SolDevelo)
  • Scrum Master (SolDevelo)
  • 4 developers (Swiss TPH + SolDevelo)

The Swiss Tropical and Public Health Institute (Swiss TPH) is a world-leading institute in global health with a particular focus on LMIC (low- and middle income countries). Associated with the University of Basel, Swiss TPH combines research, education and services at local, national and international levels. Over 800 people from 80 nations work at Swiss TPH focusing on infectious and non-communicable diseases (NCDs), environment, society and health as well as health systems and interventions.

All openIMIS initiative partners

openimis initiative partners

Case Studies