OpenBodhik: Open Body of Digital Health Insights and Knowledge, is an Opensource digital health community run by ACCESS Health Digital [AHD], a Division of ACCESS Health International [AHI]. We are a Not-For-Profit think-tank working in public health and digital health. All Code and Documents released on MPL 2.0 License.
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.
The eObjects concept was introduced by ACCESS Health in Theme papers in Nov 2018, that became the Chapter 5 of the book ‘Health Systems for New India’, published by Niti Aayog in Nov 2019. Prof Dennis Streveler and Dr Pankaj Gupta are the Authors of the Chapter 5 in the Health System for New India book. The eObjects concept was again recommended in the ‘NHA-IRDA joint working group report’ to facilitate electronic, codified data exchange between providers and payers. The eObjects concept was then detailed out into Provider and Payer eObjects including the data standards recommended in the National Digital Health Blueprint. ACCESS Health has now released the eObjects design and code in opensource under MPL 2.0 license.
eObjects are evolving, check with us for the latest versions. Reach out to us for any help to understand or implement the eObjects. We can set up a group call with all of you to explain these eObjects in detail or even can set up one to one calls.
Thank You for your continuous association with us.
Digital Health 101 is a basic set of webinar recordings from AHD Academy. Suitable for Doctors/Nurses/Clinicians, Public Health and Healthcare Managers, Government Administrators and Technologists interested in Digital Health. The Courses are spread across Basic, Specialist and Expert Levels.It is a video based learning model and It is free.
Disclaimer:AHD Academy is a Library of Live Webinar Recordings from AHD on various Digital Health topics. It is opensource material meant for learning from experts at your own pace. This is Not an Academic Course material. Please do not confuse these webinar recordings with regular recognized courses run by universities/colleges. You may contact your College, University, Organization for properly moderated Lectures, Trainings, Courses on Digital Health.
Basic Course for Digital Health Enthusiasts: Suitable for Clinicians, Healthcare Managers, Govt Administrators and Technologists interested in Digital Health. Will take approximately 40 Hours to read up the material and listen-in to these 101 webinars.
Reading Material Lesson 1. Note: This is a preparatory Lesson that will open your mind
and help you understand the higher lessons. Reading material for this Lesson is
based on white paper written by Dr Pankaj Gupta on the same topic.
Reading Material for Lesson 2. Note: This is a preparatory Lesson that will open your mind
and help you understand the higher lessons. Reading material for this Lesson is
based on white paper written by Dr Pankaj Gupta on the same topic.
Note: This is a preparatory Lesson that will open your mind
and help you understand the higher lessons. Reading material for this Lesson is
based on white paper written by Dr Pankaj Gupta on the same topic.
Note: This is a preparatory Lesson that will open your mind
and help you understand the higher lessons. Reading material for this Lesson is
based on white paper written by Dr Pankaj Gupta on the same topic.
Specialist Course:Suitable for Healthcare Managers wanting to Specialize in Digital Health. Will take approximately 50 Hours to listen-in to these 101 webinars. Pre-requisite is Basic Course for Digital Health Enthusiasts. Technologists can jump to the Expert level Course.
Expert level Course: Suitable for Technologists aspiring for Expertise in Digital Health. Will take approximately 60 Hours to listen-in to these 101 webinars. Pre-requisite is Basic Course for Digital Health Enthusiasts. Specialist Course is not required for Technologists.
Masters level Course: Suitable for Academic Excellence in Digital Health. Content similar to Basic, Specialist and Expert level course is used in Last semester of the Masters course, but obviously with more in-person teacher-led classroom sessions.
ACCESS Health Digital [AHD] is a a not for profit think tank working on NDHB Digital Health Standards for India. We run a Social Entrepreneurship Accelerator [SEA] for helping Indian HealthTech startups and vendors to implement Open Digital Health Standards that are applicable globally. #AtmaNirbharBharat #VocalForLocal
The
Social Entrepreneurship Accelerator launched by ACCESS Health Digital
has become an official Amazon AWS Activate Provider. AWS Activate works
with accelerators, angel investors, and venture capital firms to provide
startups with free AWS credits, technical support, training, resources,
and more. These exclusive benefits are designed to help startups
quickly get started on AWS and grow their business. Startups associated
with an AWS Activate Provider are able to apply for AWS Activate
Portfolio.
The new partnership with Amazon Web Services will help
the Social Entrepreneurship Accelerator create new opportunities for
its startups, providing them with access to Infrastructure as a service
[IaaS], Platform as a Service [PaaS] and Software as a Service [SaaS].
This gives the startups entry into a Plug-and-Play integrated software
development environment. Just adopt the PaaS and all startups in the
accelerator can turn into SaaS companies.
SEA Objectives
SEA Cohort 1
SEA Cohort 2
In late October 2020, India's National Health Authority' Market ACCESS Program [MAP] put 12 startups under mentorship of ACCESS Health Digital's Social Entrepreneurship Accelerator [SEA] -- the second of three cohorts to join the SEA family, now home to almost 40 startups that range in sector and specialty from primary care delivery and telemedicine to electronic health records and disease management. Like the previous cohort, SEA aims to provide its newest members with mentorship, market access, and a stamp of confidence, among other basic building blocks that will situate them in the digital health landscape. Together, they're working toward a single transformative purpose: building a vibrant national digital health ecosystem.
SEA Cohort 3
Parallelly Cohort 3 has also started to take shape, mostly on reference from Cohort 1 and requests from Partner organizations.
SEA Silver Club
Silver Club has implemented the Standards and achieved our Stamp of Confidence.
SEA is an Exponential Organization (ExO) whose impact will be disproportionally large as compared to its peers because it leverages exponential technologies.
ACCESS Health Digital 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. ACCESS Health Digital runs a Social Entrepreneurship Accelerator to accelerate the implementation of the NDHB Standards through these building blocks.
The eObjects were designed for interoperability across the healthcare ecosystem on a federated architecture. eEncounter, eDischarge Summary Objects are for Provider-to-Provider interoperability; such that the data can flow across healthcare facilities, State HIE and National Data Lake. Whereas the eClaims Object creates a Financial Lever for the market. If the providers submit the claims in standard eClaims Object format then the turnaround time for their payments can be expected to be faster. Clearly eObjects are an innovative breakthrough.
This is very similar to what happened in the FinTech revolution in India where Government of India created the Unified Payment Interface UPI platform and then created the BHIM App and released the related Application Programming Interface APIs to the market. Later the Market used the API’s and built the hugely successful Paytm, Googlepay, Phonepe wallets. In 3 years the UPI transactions went from negligible to 1 Billion transactions per month.
Financial lever and strong governance for digital health transformation, plays a vital role in ensuring successful outcomes of such undertakings. India would do well to heed this truth.
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 semantic interoperability may remain a challenge. For example – all applications must have the same Facility master. When Application A sends the ANC data for Facility 123, the receiving Application B should understand ANC and uniquely identify Facility 123. Another example is if a hospital application sends the insurance reimbursement bill to the insurance company/government, the recipient application should be able to understand and re-present the same meaning of bill information.
Interoperability among e-Governance applications for the health sector requires exchange of information across applications. There is a need for commonly accepted data definitions for the various data elements used in e-Governance systems in Healthcare. Hence, standardization of data elements is the prerequisite for systematic development of e-Governance applications in the health sector.
The old HIS and EMR systems or even the new breed Digital Health Apps lack credible Global Digital Health Standards. Hence, they exist in silos and don’t interact with each other or the larger Healthcare ecosystem. The data cannot be referred for any meaningful analysis. For example, we still don’t know clearly the size, scale and depth of the Dengue, Chikungunya and H1N1, Flu epidemics that strike us every year. Hence, we are always left gasping for breath when the seasonal spike starts.
India is already the Diabetes capital of the world with 70 million cases and counting. We still don’t have standard protocols based on the Digital Disease Management Platform.
The HMIS/HIS/EMR market in India requires Digital Health Standards based FHIR/JSON eObjects that can help the existing systems to communicate with the external world in a Standardized format.
These Provider eObjects were first published in Health Systems for New India book by Niti Aayog and comply with NDHB, EHR and Meta Data standards, guidelines provided by Medical Council of India, Clinic Establishment Act and as per the latest Telemedicine guidelines released by the Government of India.
We have published the details of the eObjects on the openbodhik.in. To facilitate standard value sets for the entire ecosystem, we have also provided all the required value sets/code directories/master in an excel format.
eEncounter Note
ePrescription and
eDischarge Summary
Please follow the link provided here to access the e-provider objects and related documents:
Sample JSON Format eObject: https://drive.google.com/file/d/1MKOkOIsjdIJHyTSS-FcKCGy0jXeyHZEh/view?usp=sharing
Your respective Healthcare Delivery Systems should be able to generate the Provider eObjects formats. You can use the eObjects as input forms i.e. if you are building a new system. Legacy systems will use eObjects as Standard Output format.
The provider e-object can also facilitate capturing of signs, symptoms, vitals and procedures data during an active surveillance, which would in turn be useful in studying and analysing a disease outbreak.
We request you to kindly use these eObjects to collect data in your respective health delivery systems, that we can together facilitate Government with valuable clinical data for analysis and planning.
eObjects are evolving, check with us for the latest versions. Reach out to us for any help to understand or implement the e-objects. We can set up a group call with all of you to explain these eObjects in detail or even can set up one to one calls.
Thank You for your continuous association with us.
