#Opensource Healthcare Community for #DigitalHealth #Ecosystem [OpenHealthCODE]

This document presents the design specifications for electronic claim  objects and associated standard processes for their exchange between  Payers and Providers, through a Health Claim Platform that was  recommended in the report “Common IT Infrastructure  for Health Insurance Claims management” by IRDA-NHA joint  working group.  The health claim platform is intended to improve current  claim processes, enforce transparency and facilitate on time provider  payments for Health insurance Claims in India. Usage of Standard  Electronic Claim related objects will facilitate auto adjudication of  claims by both Public and Private Health Insurance Payers with reduced  operational costs. eClaims Objects - Health Claims Platform Payer eObjects Specifications: eClaims Object, Claims Response etc. eDischarge Summary Object : Pick the eDischarge Object from Provider eObjects v2 Standard Value Sets for eClaims Objects Standard Value Sets for eD...

eObjects were first written by Prof Dennis Streveler and Dr Pankaj Gupta in a white paper in Nov 2018 that was published by Niti Aayog in the book Health Systems for New India, Chapter 5 - Reimagining India's Digital Health Landscape Wiring the Indian Health Sector in Nov 2019. OpenHealthCODE Strategy Council defined the details of the National Digital Health Blueprint building blocks - Minimum viable products including the eObjects and microservices architecture to comply with the NDHB Standards.  OpenHealthCODE  runs a Social Entrepreneurship Accelerator to accelerate the implementation of the NDHB Standards through these building blocks.  The eObjects have now been adopted by Joint working Group of National Health Authority NHA and Insurance Regulatory Development Authority IRDAI Sub group on common IT infrastructure, in its report published on 11 Sep 2019 and will be built into the India’s national Health Claims platform. [ NHA IRDA Press Release ] The eObjects were...

Immediate usecases:  ePrescription and eEncounter FHIR based Objects for Telemedicine interoperability.  The same eObjects can also be used for Referral across Primary, Secondary and Tertiary care. Epidemiological Surveillance is the next big thing. We will need eEncounter, ePrescription and eDischarge Objects to fetch the data from disparate OPD/IPD HIS/EMR systems. eObjects act as a Standard Output Format in these use cases. The need for the eObjects arose because most of the Healthcare-IT applications are being developed without any standards by different agencies and vendors in the public and private sector in India. Each application is developed for standalone use without much attention to semantic interoperability. Later when the thought of interoperability emerges – it becomes difficult to connect the systems and make them talk to each other because they were never designed for that purpose.   Even if technical and organizational interoperability is done the semant...