LHIMS streamlined patient management in all health facilities in the health sector. This included both insured and non-insured patients and consisted of the following:

• The networking of all core activities related to patient registration, service management, claims management, and data reporting in the health sector at the health facility level. It also covered the electronic management of medical records, outpatient and inpatient services, all diagnostic services, and pharmacy services, including services such as mortuary services and all ancillary services related to patient care.

• Each service point was linked to the revenue and claims system. This enabled claims to be processed automatically on a patient-by- patient basis. Claims were compiled automatically at specified periods.

• The system had built-in checks to facilitate claims management and prompted the NHIA when there were deviations from the standards.

• The system was configured to calculate selected indicators automatically to provide indications of performance and to help with continuous monitoring (e.g., how much antibiotics were prescribed in response to laboratory diagnoses of infections or changes in claims per patient as a measure of NHIS spending, etc.).

• A platform for data reporting and analysis was created to enable the setup of an early warning system for disease surveillance by:

a) Establishing platforms for collation, analysis, and reporting in each District Health Administration and each Regional Health Administration. These platforms were linked to all health facilities at the district level, all NHIS registration points, and all healthcare outlets identified by the Ministry of Health as reporting entities in the provision of health services.

b) Data analysis on all platforms was automated based on the national reporting requirements, where possible. Data analysis was automated to the extent that when specified disease thresholds were approached or abnormal trends were observed, these were reported automatically.

• Data was received directly from all registration points and claims from each facility after verification at the District Health Administration. Most parameters for verification were automated to check wrong entries, non-realistic claims, and fraud at the source. The district platform was also configured to provide a second-level verification before claims were submitted.