IMIS - Insurance Management Information System

IMIS - Insurance Management Information System

 

A successful insurance scheme is based on strong data management. The previous system for managing CHF data was CHF Track, which is based on Microsoft Excel. While Excel is useful for certain types of data management it is not an appropriate platform to manage a national insurance scheme. CHF Track does not account for member drop-out or membership expirations, nor does it allow the names of the health facilities to be altered, not to mention addition challenges related to managing large client databases and appropriate client identification mechanisms.

  • IMIS 1
Furthermore, none of the CHF coordinators visited initially in the 3 districts of Dodoma were actually using CHF Track. CHF Track was considered cumbersome enough that CHF stakeholders were using manual methods of data collection and filing.

Limited access to a computer at the district and health facility level is an additional hurdle for data collection and use of an effective Insurance IT solution.


Poor data collection has prevented organizations working on CHFs to make use of all of the data provided to them. This created problems conducting cost studies and other measures for structural improvement because records from health facilities often deemed unreliable.
The reformed CHF approach is supported by a robust, tailor-made IT system. The Insurance Management Information System (IMIS) was designed to support the business processes of the reformed CHF scheme, to ensure availability and precision of information, to accelerate operations, and to reduce fraud. The centralized IMIS makes CHF membership portable—members can access their health benefits at any health facility. Although the CHF schemes are backed by one central IMIS server, districts retain the ability to define their own insurance products, pricing options and service packages. The IMIS can accommodate these district-specific parameters, even when reimbursing cross-district service provision.

  • IMIS 2
The IMIS is:

    • Comprehensive system for managing a health insurance scheme (enrolment, renewal, claims management, feedback, reporting)
    • Provides a way to standardize scheme operations while starting up and subsequently for scaling up across multiple sites
    • Uses easily accessible technology (android mobile phones) – easy to implement, scale and further innovate
    • Targets specifically challenges of informal sector schemes – takes processing closer to clients (cuts down transaction time), cost effective mechanism for establishing identity and eligibility, supports an ‘active’ enrolment structure
    • Flexible – multiple products, multiple insurance models, multiple structures, multiple business rules, etc.
    • On line and offline capability (both computer and mobile phone) to adjust to available infrastructure
    • System managed through central server which can allow for gradual roll out (geographically or feature wise) in a modular way; and centralized or decentralized management of schemes
    • System allows “portability” for clients (i.e. clients from district A claiming in District B)