openIMIS FHIR R4 Implementation Guide
1.0.0 - ci-build
openIMIS FHIR R4 Implementation Guide
1.0.0 - ci-build
openIMIS FHIR R4 Implementation Guide - Local Development build (v1.0.0). See the Directory of published versions
Contents:
This page provides a list of the FHIR artifacts defined as part of this implementation guide.
The following artifacts define the specific capabilities that different types of systems are expected to have in order to comply with this implementation guide. Systems conforming to this implementation guide are expected to declare conformance to one or more of the following capability statements.
| openIMIS Capability Statement |
These define constraints on FHIR resources for systems conforming to this implementation guide
| openIMIS ActivityDefinition |
Defines a ActivityDefinition for openIMIS which maps to a Medical Service. |
| openIMIS Bill |
Defines an Bill for openIMIS. |
| openIMIS Claim |
Defines a Claim for openIMIS which maps to a Claim. |
| openIMIS Claim Administrator Practitioner |
Defines a Practitioner for openIMIS which maps to a Claim Administrator. |
| openIMIS Claim Administrator Practitioner Role |
Defines a Claim Administrator Practitioner Role for openIMIS. |
| openIMIS Claim Response |
Defines a ClaimResponse for openIMIS which maps to a Claim. The ClaimResponse resource contains the adjudication result of a Claim. |
| openIMIS Communication |
Defines a Communication for openIMIS which maps to the Feedback in openIMIS. |
| openIMIS CommunicationRequest |
Defines a CommunicationRequest for openIMIS which maps to the Claim request for feedback in openIMIS. |
| openIMIS Contract |
Defines a Contract for openIMIS use to enrol a Family/Group. Mapped mostly to Policy and will link Group/Family and Patient/Insurees. |
| openIMIS Coverage |
Defines a Coverage for openIMIS which maps to a Policy. |
| openIMIS CoverageEligibilityRequest |
Defines a CoverageEligibilityRequest for openIMIS to enquire an Insuree. |
| openIMIS CoverageEligibilityResponse |
Defines a CoverageEligibilityResponse for openIMIS to get the enquire information for an Insuree. |
| openIMIS Enrolment Officer Practitioner |
Defines a Practitioner for openIMIS which maps to an Enrolment Officer. |
| openIMIS Enrolment Officer Practitioner Role |
Defines a Enrolment Officer Practitioner Role for openIMIS. |
| openIMIS Group |
Defines a Group for openIMIS which maps to an Family |
| openIMIS Health Facility Organization |
Defines an Organization for openIMIS which maps to a Health Facility |
| openIMIS Insurance Organization |
Defines an Organization for openIMIS which maps to the openIMIS implementation as Insurance. This is required in different resources. |
| openIMIS Insurance Plan |
Defines an Insurance Plan for openIMIS which maps to a Product. |
| openIMIS Invoice |
Defines an Invoice for openIMIS. |
| openIMIS Location |
Defines a Location for openIMIS which maps to a Location |
| openIMIS Medication |
Defines a Medication for openIMIS which maps to a Medical Item. |
| openIMIS Patient |
Defines a Patient for openIMIS which maps to an Insuree |
| openIMIS Payment Notice |
Submit payment notice. |
| openIMIS Policy Holder Organization |
Defines an Organization for openIMIS which maps to a Policy Holder under Formal Sector scheme. |
| openIMIS Subscription |
Allows to subscribe to notification of new or updates entitities. |
These define constraints on FHIR data types for systems conforming to this implementation guide
| Level (ActivityDefinition) |
Indicates the Level for an ActivityDefinition. |
| Location Reference (Address) |
The reference to address’ location for City/Village level. |
| Municipality (Address) |
The location level between District and City/Village. |
| Item Reference (Claim) |
The reference to the Medication or ActivityDefinition for an item within a Claim. |
| Payload Type (CommunicationRequest | Communication) |
Indicates the payload type for a Communication. |
| Premium (Contract) |
Indicates a premium for a Contract. This is a complex extension. |
| Policy Status (Coverage) |
Indicates the policy status for a Coverage. |
| Date (Coverage) |
Indicates a date for a Coverage. |
| Poverty Status (Group) |
Whether the Group has the poverty status. |
| Confirmation (Group) |
Indicates the confirmation for the Group. |
| Poverty Status (Group) |
Whether the Group has the poverty status. |
| Group Type (Group) |
Indicates the type of the Group. Values defined by openIMIS. Can be extended. |
| Conversion Product (InsurancePlan) |
Reference to the product which replaces the current product in case of renewal after the period end. |
| Discount (InsurancePlan) |
Defines the discount to be applied for enrolment and renewal in InsurancePlan. |
| Max Installments (InsurancePlan) |
Maximal number of instalments in which contributions for a policy may be paid. |
| Period (InsurancePlan) |
Defines the number of months a certain period is valid in InsurancePlan. |
| Cycle Start (InsurancePlan) |
Defines the starting date for a new cycle in InsurancePlan. |
| Frequency (Medication) |
The frequency a Medication can be prescribed. |
| Level (Medication) |
Indicates the Level for a Medication. |
| Medication Type (Medication) |
Indicates the Item type for the Medication. |
| UsageContext (Medication) |
The Context a Medication can be prescribed. |
| Health Facility Care Type (Organization) |
Indicates the care type of the Health Facility (Organization). |
| Legal Forms (Organization) |
Indicates the legal forms of the Health Facility Organization. |
| Health Facility Level (Organization) |
Indicates the level of the Health Facility (Organization). |
| Activity (Organization) |
Indicates the activity of the PolicyHolder Organization. Values defined by openIMIS. Can be extended. |
| Legal Forms (Organization) |
Indicates the legal forms of the PolicyHolder Organization. |
| Card Issued (Patient) |
Whether a card was issued to the Patient/Insuree during enrolment. |
| Education Level (Patient) |
Specifies the Patient/Insuree’s education level |
| Group Reference (Patient) |
The reference to the Group/Family the Patient/Insuree is part of. |
| Identification (Patient) |
Specifies the Patient/Insuree official identification and the type of identification document. |
| IsHead (Patient) |
Whether the Patient/Insuree is the Head of the Family. |
| Profession (Patient) |
Specifies the Patient/Insuree’s profession |
| Vulnerability Status (Patient) |
Whether the Patient/Insuree has the vulnerability status. |
| Substitution Reference (PractitionerRole) |
The reference to the Enrolment Officer that will substitute the current one after the period end. |
| Unit Price (Medication|ActivityDefinition) |
The unit price for a Medication or ActivityDefinition. |
These define sets of codes used by systems conforming to this implementation guide
| Level (ActivityDefinition) |
Indicates the Level for an ActivityDefinition. Values defined by openIMIS. Can not be extended. |
| Service Type (ActivityDefinition) |
Indicates the Service Type for an ActivityDefinition. Values defined by openIMIS. Can not be extended. |
| Usage Context Type (ActivityDefinition) |
Indicates the Usage Context Type for an ActivityDefinition. |
| Usage Context for Venue Type (ActivityDefinition) |
Indicates the Usage Context for Venue Type for an ActivityDefinition. |
| Usage Context for Workflow Type (ActivityDefinition) |
Indicates the Usage Context for Workflow Type for an ActivityDefinition. Values defined by openIMIS. Can not be extended. |
| ChargeItem (Bill Invoice) |
Indicates the ChargeItem for a lineItem from a Bill. Values defined by openIMIS. Can not be extended. |
| Type (Bill Invoice) |
Indicates the Type for Bill. Values defined by openIMIS. Can not be extended. |
| Category of the item (Claim) |
Indicates the category for the item under a Claim. Values defined by openIMIS. Can not be extended. |
| Rejection reasons (Claim) |
Indicates the rejection reason of an item from a Claim. Values limited by openIMIS. |
| Status of the claim (Claim|ClaimResponse) |
Indicates the status of the Claim. Values defined by openIMIS. Can not be extended. |
| Category of the supporting info (Claim) |
Indicates the category for the supportiong info under a Claim. Values defined by openIMIS. Can not be extended. |
| Visit Type Codes (Claim) |
Indicates the visit type of the Claim. Values limited by openIMIS. |
| Claim Feedback Status (CommunicationRequest) |
Indicates the status of a feedback (Claim). |
| Premium Category (Contract) |
Indicates the category of the premium for the Contract. Cannot be extended. |
| Premium Payer (Contract) |
Indicates the payer of the premium for the Contract. Can be extended in openIMIS. Need to match openIMIS database payer list. |
| Premium Type (Contract) |
Indicates the type of the premium for the Contract. Cannot be extended. |
| Resource Party Role (Contract) |
Indicates the participant engagement type for the Contract term. |
| Scope (Contract) |
Indicates the scope for the Contract. Values defined by openIMIS. Cannot be extended. |
| Status Codes (Contract) |
Indicates the status of the Contract. Values limited by openIMIS. |
| Type of benefit as amount left (Coverage) |
Indicates the type of benefit under a Coverage. Values defined by openIMIS. Can not be extended. |
| Type of benefit (Coverage) |
Indicates the type of benefit under a Coverage. Values defined by openIMIS. Can not be extended. |
| Type of benefit as total left (Coverage) |
Indicates the type of benefit under a Coverage. Values defined by openIMIS. Can not be extended. |
| Partial categories of the item (Coverage) |
Indicates the category for the item, only for medical items and services, under a Coverage. Values defined by openIMIS. Can not be extended. |
| Category of the item (Coverage) |
Indicates the category for the item under a Coverage. Values defined by openIMIS. Can not be extended. |
| Coverage Status (Coverage) |
Indicates the status of a Coverage (Policy). |
| ICD 10 Level 1 diagnosis |
Example of diagnosis to be used with Claim resource. The actual list is configured in openIMIS. |
| Feedback Payload (CommunicationRequest | Communication) |
Indicates the Feedback Payload code for a CommunicationRequest and Communication. List defined by openIMIS. Can not be extended. |
| Feedback Status (CommunicationRequest) |
Indicates the Feedback Status for a CommunicationRequest. Partial list defined by openIMIS. Can not be extended. |
| Confirmation Types (Group) |
Indicates the confirmation type for the Group. Values defined by openIMIS. Can be extended. |
| Group Type (Group) |
Indicates the type of the Group. Values defined by openIMIS. Can be extended. |
| Coverage Benefit Limit Types (InsurancePlan) |
Indicates the Coverage Benefit Limit Types for an InsurancePlan. Values defined by openIMIS. Can not be extended. |
| Coverage Type (InsurancePlan) |
Indicates the Coverage Type for an InsurancePlan. |
| General Cost Type (InsurancePlan) |
Indicates the General Cost Type for an InsurancePlan. Values defined by openIMIS. Can not be extended. |
| Publication Status (InsurancePlan) |
Indicates the Publication Status for an InsurancePlan. |
| ChargeItem (Invoice) |
Indicates the ChargeItem for a lineItem from an Invoice. Values defined by openIMIS. Can not be extended. |
| PriceComponent Type (Invoice) |
Indicates the Type for a PriceComponent from an Invoice. |
| Status (Invoice) |
Indicates the status for an Invoice. Values limited by openIMIS. Can not be extended. |
| Type (Invoice) |
Indicates the Type for an Invoice. Values defined by openIMIS. Can not be extended. |
| Location Type (Location) |
Indicates the location type. Values defined by openIMIS. Cannot be extended. |
| Item Type (Medication) |
Indicates the Medical Item Type for an Medication. Values defined by openIMIS. Can not be extended. |
| Level (Medication) |
Indicates the Level for a Medication. Values defined by openIMIS. Can not be extended. |
| openIMIS Identifiers Value Set |
Indicates the Identifier type |
| Health Facility Care Type (Organization) |
Indicates the care type of the Health Facility (Organization). Values defined by openIMIS. Cannot be extended. |
| Legal Forms (Organization) |
Indicates the legal forms of the Health Facility Organization. Values defined by openIMIS. Can be extended. |
| Health Facility Level (Organization) |
Indicates the level of the Health Facility (Organization). Values defined by openIMIS. Cannot be extended. |
| Activity (Organization) |
Indicates the activity of the PolicyHolder Organization. Values defined by openIMIS. Can be extended. |
| Legal Forms (Organization) |
Indicates the legal forms of the PolicyHolder Organization. Values defined by openIMIS. Can be extended. |
| Contact Relationship (Patient) |
Indicates the Relationship of a Patient with the Head of the Family. |
| Education Level (Patient) |
Indicates the Education level of a Patient |
| Identification Type (Patient) |
Indicates the type of document the Patient used to identify himself. |
| Marital Status (Patient) |
Indicates the Marital status of a Patient |
| Profession (Patient) |
Indicates the profession of a Patient |
| Practitioner Qualification Type |
Indicates the Qualification Type of a Practitioner. |
| Usage Context for Age Type (ActivityDefinition|Medication) |
Indicates the Usage Context for Age Type for an ActivityDefinition or Medication. |
| Usage Context for Gender Type (ActivityDefinition|Medication) |
Indicates the Usage Context for Gender Type for an ActivityDefinition or Medication. |
These define new code systems used by systems conforming to this implementation guide
| Level (ActivityDefinition) |
Indicates the Level for an ActivityDefinition. Values defined by openIMIS. Can not be extended. |
| Service Type (ActivityDefinition) |
Indicates the Service Type for an ActivityDefinition. Values defined by openIMIS. Can not be extended. |
| Usage Context for Workflow Type (ActivityDefinition) |
Indicates the Usage Context for Workflow Type for an ActivityDefinition. Values defined by openIMIS. Can not be extended. |
| ChargeItem (Bill Invoice) |
Indicates the ChargeItem for a lineItem from a Bill. Values defined by openIMIS. Can not be extended. |
| Type (Bill Invoice) |
Indicates the Type for Bill. Values defined by openIMIS. Can not be extended. |
| Category of the item (Claim) |
Indicates the category for the item under a Claim. Values defined by openIMIS. Can not be extended. |
| Rejection Reasons (Claim) |
Indicates the rejection reason of an item from a Claim. Values limited by openIMIS. |
| Status of the claim (Claim|ClaimResponse) |
Indicates the status of the Claim. Values defined by openIMIS. Can not be extended. |
| Category of the supporting info (Claim) |
Indicates the category for the supportiong info under a Claim. Values defined by openIMIS. Can not be extended. |
| Visit Type (Claim) |
Indicates the visit type of the Claim. Values limited by openIMIS. |
| Premium Category (Contract) |
Indicates the category of the premium for the Contract. Cannot be extended. |
| Premium Payer (Contract) |
Indicates the payer of the premium for the Contract. Can be extended in openIMIS. Need to match openIMIS database payer list. |
| Premium Type (Contract) |
Indicates the type of the premium for the Contract. Cannot be extended. |
| Resource Party Role (Contract) |
Indicates the participant engagement type for the Contract term. |
| Scope (Contract) |
Indicates the scope for the Contract. Values defined by openIMIS. Cannot be extended. |
| Type of benefit (Coverage) |
Indicates the type of benefit under a Coverage. Values defined by openIMIS. Can not be extended. |
| Category of the item (Coverage) |
Indicates the category for the item under a Coverage. Values defined by openIMIS. Can not be extended. |
| ICD 10 Level 1 diagnosis (Claim) |
Example of diagnosis to be used with Claim resource. The actual list is configured in openIMIS. |
| Feedback Payload (CommunicationRequest | Communication) |
Indicates the Feedback Payload code for a CommunicationRequest and Communication. List defined by openIMIS. Can not be extended. |
| Feedback Status (CommunicationRequest) |
Indicates the Feedback Status for a CommunicationRequest. Partial list defined by openIMIS. Can not be extended. |
| Confirmation Types (Group) |
Indicates the confirmation type for the Group. Values defined by openIMIS. Can be extended. |
| Group Type (Group) |
Indicates the type of the Group. Values defined by openIMIS. Can be extended. |
| Coverage Benefit Limit Types (InsurancePlan) |
Indicates the Coverage Benefit Limit Types for an InsurancePlan. Values defined by openIMIS. Can not be extended. |
| General Cost Type (InsurancePlan) |
Indicates the General Cost Type for an InsurancePlan. Values defined by openIMIS. Can not be extended. |
| ChargeItem (Invoice) |
Indicates the ChargeItem for a lineItem from an Invoice. Values defined by openIMIS. Can not be extended. |
| Type (Invoice) |
Indicates the Type for an Invoice. Values defined by openIMIS. Can not be extended. |
| Location Type (Location) |
Indicates the location type. Values defined by openIMIS. Cannot be extended. |
| Item Type (Medication) |
Indicates the Medical Item Type for an Medication. Values defined by openIMIS. Can not be extended. |
| Level (Medication) |
Indicates the Level for a Medication. Values defined by openIMIS. Can not be extended. |
| openIMIS Identifiers (All) |
Identifiers that are specific to openIMIS and could not be found in standard sources. |
| Health Facility Care Type (Organization) |
Indicates the care type of the Health Facility (Organization). Values defined by openIMIS. Cannot be extended. |
| Legal Forms (Organization) |
Indicates the legal forms of the Organization. Values defined by openIMIS. Can be extended. |
| Health Facility Level (Organization) |
Indicates the level of the Health Facility (Organization). Values defined by openIMIS. Cannot be extended. |
| Activity (Organization) |
Indicates the activity of the PolicyHolder Organization. Values defined by openIMIS. Can be extended. |
| Legal Forms (Organization) |
Indicates the legal forms of the PolicyHolder Organization. Values defined by openIMIS. Can be extended. |
| Contact Relationship (Patient) |
Indicates the Relationship of a Patient with the Head of the Family. Values defined by openIMIS. |
| Education Level (Patient) |
Indicates the Education level of a Patient. Values defined by openIMIS. Can be extended. |
| Identification Type (Patient) |
Indicates the type of document the Patient used to identify himself. Values defined by openIMIS. Can be extended. |
| Profession (Patient) |
Indicates the profession of a Patient. Values defined by openIMIS. Can be extended. |
| Qualification Type (Practitioner) |
Indicates the Qualification Type of a Practitioner. |
| Usage Context for Age Type (ActivityDefinition|Medication) |
Indicates the Usage Context for Gender Type for an ActivityDefinition or Medication. Values defined by openIMIS. Can not be extended. |
These are example instances that show what data produced and consumed by systems conforming with this implementation guide might look like
| AspirinMedication |
Example of openIMIS Medication |
| Claim001 |
|
| ClaimResponse001 |
|
| Claim001Communication |
|
| Claim001CommunicationRequest |
|
| ContributionInvoiceSubscription |
Example of openIMIS Subscription request. |
| GeneralConsultationService |
Example of openIMIS ActivityDefinition |
| InformalSectorContract |
|
| InformalSectorContributionInvoice |
Example of an Invoice covering the contribution payment by a family under Informal Sector scheme. |
| Jamu-municipality |
Example of a municipality |
| Jamula-village |
Example of a Village |
| Jimara-district |
Example of a district |
| JoeDoeCoverage |
|
| JoeDoeEnquiring |
|
| JoeDoeEnquiringResponse |
|
| MyTradePolicyHolder |
Example of openIMIS PolicyHolder |
| RX01 |
Example of openIMIS InsurancePlan |
| RX02 |
Example of openIMIS InsurancePlan |
| RaptaDistrictHospital |
Example of openIMIS Health Facility |
| Roberts-Jeb-EO |
Example of openIMIS Practitioner for Enrolment Officer. |
| Rushila-Dani-CA |
Example of openIMIS Practitioner for Claim Administrator. |
| Upper-River-Region |
Example of a Region |
| doe-family |
Example of openIMIS Group |
| jane-doe |
Example of openIMIS Patient |
| john-doe |
Example of openIMIS Patient |
| openIMIS-Implementation |
Example of openIMIS Insurance. |