| # | Assessment Elements | Answer Options | What looks immature | What looks mature | Evidence Type |
| | Do you have API management solutions enabling the organization to securely interoperate with the external ecosystem? (MoH, NPHIES, CNHI, NHIC, Saudi Payments, Healthcare private sector, etc.) | -Yes
-No | Unavailable | API management solutions are developed and provide features to develop, assemble, publish APIs from existing applications to external stakeholders | Please provide a screen sample of the API management solution |
| | Which of the following protocols does your MFT support? | - FTP
- SFTP
- FTPS
- HTTP
- HTTPs
- SMTP
- AS2
- Databases connectivity
- None | Unavailable | MFT supports Support common file transfer protocol i.e. FTP, SFTP, FTPS, HTTP, HTTPs, SMTP, AS2, Databases connectivity | Please provide a screen sample that proves the adoption of the selected protocols for file transfers |
| | Does the organization have e-Claims integrated with its IT architecture enabling the payers and CNHI to digitize claims processing; detect and notify frauds in claim processes? | -Yes
-No | Unavailable | The organization has e-Claims integrated in its IT architecture enabling the payers and CNHI to digitize claims processing; detect and notify frauds in claim processes. | Please provide a screen sample of the integration results through the implemented APIs |
| | Do you follow the claims processing services e-Claims as part of NPHIES? | -Yes
-No | Unavailable | The organization has e-Claims integrated in its IT architecture enabling the payers and CNHI to digitize claims processing; detect and notify frauds in claim processes. | Please provide a sample of a successful claim |
| | Do you follow the e-Claims interoperability standards for messaging (FHIR HL7 v4)? | -Yes
-No | Unavailable | The organization follows messaging (FHIR HL7 v4), communication (REST API (HTTPS / JSON)), and authentication standards (OAuth 2.0 & OpenID) for e-Claims | Please provide a screen sample from the HIS/RCM system of the code used |
| | Do you follow the e-Claims interoperability standards for communication (REST API (HTTPS / JSON))? | -Yes
-No | e-Claims interoperability standards for communication (REST API (HTTPS / JSON) is not followed | e-Claims interoperability standards for communication (REST API (HTTPS / JSON) is followed | Please provide a screen sample from the system that shows the compliance (A sample file can be provided) |
| | Do you follow the e-Claims interoperability standards for authentication standards (OAuth 2.0 & OpenID)? | -Yes
-No | e-Claims interoperability standards for authentication standards (OAuth 2.0 & OpenID) is not followed | e-Claims interoperability standards for authentication standards (OAuth 2.0 & OpenID) is followed | Please provide a screen sample from the system that shows the compliance (A sample file can be provided) |
| | Do you use terminology registry to perform On-line query of national standard terminology to be used by health informatics SMEs.? | -Yes
-No | Unavailable | The organization uses the registry to perform On-line query of national standard terminology to be used by health informatics SMEs. | Please provide a screen sample from the system that shows the compliance (A sample file can be provided) |
| | Which of the following do your NPHIES clinical services use cases are you integrated with? | - Clinical notes and summaries
- Imaging and teleradiology
- e-Dispense and e-Prescription
- e-Transfer and e-Referral
- Immunization service
- None | Unavailable | - Sharing of coded laboratory orders and laboratory test results
- Doctors, nurses, pharmacists, other health care providers, and patients access and securely share a patient's vital medical information electronically
Healthcare providers submit teleradiology orders to remote teleradiology services via NPHIES (Uniplat) platform and publish/retrieve imaging reports and images
- Physicians, pharmacists and other medical practitioners use e-Dispense and e-Prescription manage medications between healthcare facilities and participating pharmacies electronically
- e-Transfer and e-Referral used to enable healthcare providers and facilities to electronically refer and/or transfer patients to other healthcare facilities
- Immunization service used to enable collection and reporting of immunizations to the public health system, along with support for the associated vaccination monitoring. | Please provide a screen sample that shows the efforts placed in adopting NPHIES clinical use cases (email communication or policies and procedures documents)
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