In collaboration with the Ministry of Health in Rwanda, MSH is seeking to hire an international consultant who will work together with a local Rwandan consultant to carry out the tasks described in the following terms of reference.
Over the past decade, the Rwandan health system has strengthened various health care demand- and supply-side policy initiatives, including Community-Based Health Insurance (CBHI), Community Health Worker (CHW) program, and a Performance Based Financing mechanism.
Recently, the CBHI was integrated into the Rwanda Social Security Board (RSSB) with an aim to consolidate the many separate insurance pools into a single national pool, where it can be managed alongside the civil servants’ social health Insurance (RAMA) and other social protection pools like the national pension fund. In order to manage these funds and process a large number of claims more efficiently, there is a great need for automation (particularly with the claims processing system).
In a parallel initiative, the Ministry of Health (MoH) is pushing forward with an ambitious plan to implement an electronic medical records system (EMR) with an automated billing module in all public hospitals. However, in order for these two systems to exchange data there is a critical need for standardization of coding systems.
In a separate initiative, the Ministry of Health and its partners have completed comprehensive costing exercises for both the public and private sector health services that have been used to establish standardized tariffs. Through this process, a list of over 1000 separate medical procedures have been identified by Rwandan providers as the most commonly provided medical services and procedures, however, this list is not linked to any standard classification system.
Earlier efforts to select coding standards for Rwanda have resulted in the adaptation of a sub-set of ICD-10 for diagnostic coding and the anatomical therapeutic chemical (ATC) codes for drugs and medical supplies. However, efforts to select the most appropriate coding system for medical acts and procedures have not been as straightforward. A variety of options have been considered such as the ICD-10-PCS (Procedure Coding System), ICPC-2 (International Classification of Primary Care), the Office of Population Censuses and Surveys’ Classification of Interventions and Procedures version 4 (OPCS-4) and SNOWMED.
There is an urgent need for technical support from an international expert in medical nomenclature and coding systems to work with a local consultant and a core team of stakeholders to complete the following tasks:
The international consultant in coordination with the local consultant will:
The international consultant must demonstrate: