OpenIMIS

Establishing a functioning national health insurance scheme is high on many countries’ agenda. Health financing as well as healthcare provision are gradually being integrated into coherent and coordinated comprehensive systems designed to overcome fragmentation. Monitoring these data-intensive systems effectively and transparently despite their complexity is of high importance.

The open source Insurance Management Information System (openIMIS) constitutes an IT solution suitable for the effective management of different types of health insurance and other approaches to health financing in low- and middle-income countries moving towards UHC. It is an innovative and cost-effective open source software, which is adaptable to the needs of different types of schemes and their specific business process designs.

openIMIS was designed by the Swiss Tropical and Public Health Institute (Swiss TPH) and was first implemented in 2012 as the IT backbone for operating the community health funds (CHF) – a district-based pre-payment health insurance scheme in Tanzania. The system was then adopted for a mutual health insurance scheme in Cameroon and then in 2013 for operating Nepal’s national health insurance scheme. There have been subsequent pilots in CHAD and Democratic Republic of Congo and since 2016 a global Initiative was set up by Swiss Agency for Development and Cooperation (SDC), Switzerland and the Federal Ministry for Economic Cooperation and Development (BMZ), Germany with the aim to develop an open source, modular and interoperable application for managing health financing schemes.

The open source Insurance Management Information System (openIMIS) has had many new developments during the past few years. Mainly, it has been migrated to a free of charge modular version based on modern technologies.Swiss TPH has leveraged this innovation to further fulfilling users’ needs, with:

• Artificial Intelligence to support medical auditing of claims
• Payments Layer to reduce fraud and improve cash availability in health facilities and for vulnerable people
• Formal Sector management to support small enterprises, cooperatives and farmers