openIMIS is a free and open-source software developed to accelerate Universal Health Coverage in low and middle income countries. The tool provides a modular open source platform supporting health financing and social protection schemes.
OpenIMIS was originally created using proprietary technologies. The OpenIMIS community decided in 2016 to rebuild the tool in a modular architecture, using open source technologies. The challenge of this reconstruction was to build a new software, while keeping the old OpenIMIS active in places like Nepal where it supports the national health insurance.
Since 2018, Bluesquare has been leading the architectural migration of openIMIS. The chosen approach is iterative and each iteration delivers a production-ready (partially migrated) software. While much more complex and time consuming, this approach reduces the migration risks of existing implementations to its minimum.
The new modular architecture is based on open source technologies: each country is able to choose the parts relevant to its context, adapt or even replace the ones that don’t fully match its needs… and develop (and eventually share) its own extensions.
openIMIS before Bluesquare
The history of openIMIS started in Tanzania in 2012 when the Swiss Development Cooperation (SDC) was supporting the management of the Community Health Funds’ (CHF) financing programmes. IMIS, the ancestor of openIMIS, was the result of the collaboration of the technical expertise of 3 different organisations: Swiss Tropical and Public Health Institute (Swiss TPH), the Micro Insurance Academy (MIA), and Exact Software.
While the software was primarily developed to be used only in Tanzania, it was soon clear that many other countries/organisations could benefit from it and, together with the German Development Cooperation (GIZ), the tool was brought open source. The objective was clear: build a large community of users, implementers and developers helping each other improve their shared tool. Cameroon and Nepal were the first to join the community by choosing openIMIS for their health financing and social protection programmes. Soon openIMIS was also set up in DRC, Tchad,…
At this point, the (Microsoft-licensed) technology stack and the (monolithic) initial design were identified as major drawbacks for further extensions and a full redesign and rewriting of openIMIS was decided.
Bluesquare as the leader of the architectural design
GIZ hired Bluesquare to define and settle the new architecture for openIMIS with 3 major objectives:
- Based on open sourced technologies
- Modular to ease (country specific) customisations and extensions
- Integrated in OpenHIE landscape
Bluesquare suggested an iterative roadmap, where each iteration would deliver a production-ready (partially migrated) software. In such an approach, each existing openIMIS implementation has a very limited transition risk. Furthermore, the first planned iterations (migrating claim processing and beneficiary enrollment processes) were undertaken in a “fallback by design” strategy: migrated modules are fully backward compatible with legacy application, and reverting to previous versions is a matter of url activation.
In full awareness of the induced complexity of such an approach, the openIMIS community decided in February 2019 to embrace the journey all together.
The redevelopment of openIMIS
Although this (very technical) step had no added value (no new feature,…) for users, its impact on the development community was salvaging: not only its deeply integrated modularity provided the necessary mechanisms to further dismantle the legacy software piece by piece… but also, and nonetheless, it immediately facilitated the contributions of distinct teams with distinct focus to the software.
And indeed, by October 2019, SwissTPH/Soldevelo team delivered a FHIR API module, highlighting the commitment of the OpenIMIS community to integrate the OpenHIE landscape. So far, the FHIR module has been used to prototype integrations with OpenMRS but also DHIS2 and Bahmni.
In parallel to this new extension, Bluesquare migrated the claim processing as well as locations & health facilities registrations from the legacy software to the new platform.
By December 2019, the new architecture had fully proven its value both for migrating existing features and for its easy flexibility/extensibility.
In 2020, the development roadmap has been amended to integrate new objectives: the primary focus remains the legacy software migration to be continued where Bluesquare is currently proceeding with beneficiary enrollment migration, but other teams are also working in parallel on two new modules:
- AI-based claim fraud detection
- formal sector social insurance features
This current phase of work will be released around April 2021.
Bluesquare and openIMIS in the future
The complete migration of openIMIS to the new platform is not finished, and the chosen approach, minimizing risks undertaken by current implementations, leads us to a horizon 2022-2023. Still, openIMIS new architecture has proven to be extensible, customizable and easily integrable with other systems and, as such, is now ready to deliver its value in new context.