UNPKG

@icap-ethiopia/esm-ethiohri-app

Version:
710 lines 17 kB
{ "name": "Family Information", "version": "1.0", "published": true, "retired": false, "encounter": "Family Information", "pages": [ { "label": "FAMILY MEMBERS HIV STATUS AT ENROLLMENT AND FOLLOW-UP VISIT", "sections": [ { "label": "FAMILY MEMBERS HIV STATUS", "isExpanded": "true", "questions": [ { "label": "Relationship type", "type": "obs", "required": true, "questionOptions": { "rendering": "radio", "concept": "1560AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", "answers": [ { "concept": "5617AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", "label": "Parent or spouse", "conceptMappings": [ { "type": "AMPATH", "value": "5617" }, { "type": "AMPATH", "value": "5617" }, { "type": "SNOMED-CT", "value": "127848009" }, { "type": "CIEL", "value": "5617" }, { "type": "SNOMED-CT", "value": "127848009" }, { "type": "CIEL", "value": "5617" } ] }, { "concept": "1528AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", "label": "Child or sibling", "conceptMappings": [ { "type": "AMPATH", "value": "1565" }, { "type": "SNOMED-CT", "value": "410601007" }, { "type": "AMPATH", "value": "1671" }, { "type": "PIH", "value": "6396" }, { "type": "CIEL", "value": "1528" } ] } ] }, "id": "familyMemberType" }, { "label": "Age in Years (at enrollment)", "type": "obs", "required": true, "questionOptions": { "rendering": "number", "concept": "1532AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", "max": 200, "min": 0, "showDate": "" }, "id": "familyMemberAge" }, { "label": "Sex", "type": "obs", "required": true, "id": "familyMemberGender", "questionOptions": { "rendering": "radio", "concept": "1533AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", "conceptMappings": [ { "relationship": "SAME-AS", "type": "LOINC", "value": "72143-4" }, { "relationship": "SAME-AS", "type": "CIEL", "value": "1533" } ], "answers": [ { "concept": "1534AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", "label": "Male" }, { "concept": "1535AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", "label": "Female" } ] } }, { "label": "Health status at enrollment", "type": "obs", "questionOptions": { "rendering": "radio", "concept": "4ab0e5e3-fff7-4819-bd2e-4f070eedcd3d", "answers": [ { "concept": "1855AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", "label": "Healthy", "conceptMappings": [] }, { "concept": "9c849633-3589-42c7-bcb1-b4af7ec392c5", "label": "Chronically Ill", "conceptMappings": [] }, { "concept": "160432AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", "label": "Dead", "conceptMappings": [] } ] }, "id": "familyMemberHealthStatus" }, { "label": "Counseled for HIV?", "type": "obs", "required": false, "id": "counselledForHIV", "questionOptions": { "rendering": "radio", "concept": "ff9eccda-485e-4044-ad92-414e97b279c0", "answers": [ { "concept": "1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", "label": "Yes" }, { "concept": "1066AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", "label": "No" } ] } }, { "label": "Date counselled for HIV", "type": "obs", "questionOptions": { "rendering": "date", "weeksList": "", "concept": "a4c7ffa9-ba89-4f7d-ae01-50c139527ce4" }, "hide": { "hideWhenExpression": "counselledForHIV !== '1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA'" }, "validators": [ { "type": "date", "allowFutureDates": "false" } ], "id": "counsellationDate" }, { "label": "Tested for HIV?", "type": "obs", "questionOptions": { "rendering": "radio", "concept": "164401AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", "answers": [ { "concept": "1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", "label": "Yes", "conceptMappings": [ { "type": "AMPATH", "value": "1065" }, { "type": "SNOMED CT", "value": "CT: 373066001" }, { "type": "PIH", "value": "1065" }, { "type": "CIEL", "value": "1065" }, { "type": "PIH", "value": "1065" }, { "type": "SNOMED-CT", "value": "373066001" }, { "type": "PIH-Malawi", "value": "1065" }, { "type": "AMPATH", "value": "1065" } ] }, { "concept": "1066AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", "label": "No", "conceptMappings": [ { "type": "PIH", "value": "1066" }, { "type": "PIH-Malawi", "value": "1066" }, { "type": "SNOMED-CT", "value": "373067005" }, { "type": "AMPATH", "value": "1066" }, { "type": "PIH-Malawi", "value": "1066" }, { "type": "AMPATH", "value": "1066" }, { "type": "SNOMED-CT", "value": "373067005" }, { "type": "PIH", "value": "1066" } ] } ] }, "id": "testedForHIV" }, { "label": "Date tested for HIV", "type": "obs", "questionOptions": { "rendering": "date", "concept": "164400AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", "weeksList": "", "conceptMappings": [ { "type": "CIEL", "value": "164400" } ] }, "validators": [ { "type": "date", "allowFutureDates": "false" } ], "hide": { "hideWhenExpression": "testedForHIV !== '1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA'" }, "id": "hivTestDate" }, { "label": "HIV test Result", "type": "obs", "required": false, "id": "hivTestResult", "hide": { "hideWhenExpression": "testedForHIV !== '1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA'" }, "questionOptions": { "rendering": "select", "concept": "2e770be1-7397-4684-bea6-6632c23b00d7", "conceptMappings": [], "answers": [ { "concept": "703AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", "label": "Positive" }, { "concept": "5e4fc757-0b14-49ae-b3b7-419666f41e15", "label": "Negative" }, { "concept": "165649AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", "label": "Inconclusive" } ] }, "validators": [] }, { "label": "Enrolled in care?", "type": "obs", "questionOptions": { "rendering": "radio", "concept": "3ca41707-40ef-424c-9e1a-923a407e68fc", "answers": [ { "concept": "1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", "label": "Yes", "conceptMappings": [ { "type": "SNOMED-CT", "value": "373066001" }, { "type": "PIH", "value": "1065" }, { "type": "PIH", "value": "1065" }, { "type": "AMPATH", "value": "1065" }, { "type": "CIEL", "value": "1065" }, { "type": "PIH-Malawi", "value": "1065" }, { "type": "CIEL", "value": "1065" }, { "type": "SNOMED-CT", "value": "373066001" }, { "type": "SNOMED CT", "value": "CT: 373066001" }, { "type": "PIH-Malawi", "value": "1065" }, { "type": "AMPATH", "value": "1065" } ] }, { "concept": "1066AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", "label": "No", "conceptMappings": [ { "type": "PIH", "value": "1066" }, { "type": "SNOMED-CT", "value": "373067005" }, { "type": "PIH", "value": "1066" }, { "type": "PIH-Malawi", "value": "1066" }, { "type": "CIEL", "value": "1066" }, { "type": "AMPATH", "value": "1066" }, { "type": "SNOMED-CT", "value": "373067005" }, { "type": "PIH-Malawi", "value": "1066" }, { "type": "AMPATH", "value": "1066" } ] } ] }, "hide": { "hideWhenExpression": "hivTestResult !== '703AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA'" }, "id": "enrolledInCare" }, { "label": "Date enrolled in care", "type": "obs", "questionOptions": { "rendering": "date", "concept": "1ebc345c-6f09-43e1-a616-d7e52fff4c7d" }, "hide": { "hideWhenExpression": "enrolledInCare !== '1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA'" }, "validators": [ { "type": "date", "allowFutureDates": "false" } ], "id": "dateEnrolledInCare" }, { "label": "Started ART?", "type": "obs", "questionOptions": { "rendering": "radio", "concept": "1149AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", "conceptMappings": [ { "type": "PIH-Malawi", "value": "7010" }, { "type": "CIEL", "value": "1149" }, { "type": "PIH", "value": "1432" }, { "type": "AMPATH", "value": "1149" }, { "type": "PIH", "value": "1622" }, { "type": "PIH", "value": "2589" }, { "type": "PIH", "value": "1577" } ], "answers": [ { "concept": "1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", "label": "Yes", "conceptMappings": [ { "type": "SNOMED-CT", "value": "373066001" }, { "type": "PIH", "value": "1065" }, { "type": "PIH", "value": "1065" }, { "type": "AMPATH", "value": "1065" }, { "type": "CIEL", "value": "1065" }, { "type": "CIEL", "value": "1065" }, { "type": "PIH-Malawi", "value": "1065" }, { "type": "CIEL", "value": "1065" }, { "type": "SNOMED-CT", "value": "373066001" }, { "type": "SNOMED CT", "value": "CT: 373066001" }, { "type": "PIH-Malawi", "value": "1065" }, { "type": "AMPATH", "value": "1065" } ] }, { "concept": "1066AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", "label": "No", "conceptMappings": [ { "type": "PIH", "value": "1066" }, { "type": "SNOMED-CT", "value": "373067005" }, { "type": "PIH", "value": "1066" }, { "type": "PIH-Malawi", "value": "1066" }, { "type": "CIEL", "value": "1066" }, { "type": "AMPATH", "value": "1066" }, { "type": "SNOMED-CT", "value": "373067005" }, { "type": "PIH-Malawi", "value": "1066" }, { "type": "AMPATH", "value": "1066" } ] } ] }, "hide": { "hideWhenExpression": "hivTestResult !== '703AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA'" }, "id": "artStarted" }, { "label": "Date started ART", "type": "obs", "questionOptions": { "rendering": "date", "concept": "ae329187-6232-4142-aa91-22c85bc8e5b5", "weeksList": "", "conceptMappings": [ { "type": "PIH", "value": "2516" }, { "type": "PIH-Malawi", "value": "2516" }, { "type": "SNOMED-MVP", "value": "1595991000105005" }, { "type": "CIEL", "value": "159599" } ] }, "hide": { "hideWhenExpression": "artStarted !== '1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA'" }, "validators": [ { "type": "date", "allowFutureDates": "false" } ], "id": "artStartDate" }, { "label": "Unique ART Number", "type": "obs", "questionOptions": { "rendering": "text", "concept": "162054AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA" }, "behaviours": [ { "intent": "edit", "questionOptions": { "rendering": "text", "concept": "162054AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA" } }, { "intent": "view", "questionOptions": { "rendering": "text", "concept": "162054AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA" } } ], "hide": { "hideWhenExpression": "artStarted !== '1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA'" }, "id": "uniqueArtNumber" }, { "label": "Remark", "type": "obs", "questionOptions": { "rendering": "textarea", "concept": "165095AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", "rows": "5", "conceptMappings": [ { "type": "LOINC", "value": "34109-9" }, { "type": "CIEL", "value": "165095" }, { "type": "CIEL", "value": "165095" } ] }, "validators": [ { "type": "js_expression", "failsWhenExpression": "myValue.length > 250", "message": "Please use a maximum of 250 characters" } ], "id": "remark" } ] } ] } ], "availableIntents": [ { "intent": "*", "display": "default_intent" } ], "processor": "EncounterFormProcessor", "uuid": "8ea1c633-2582-42ca-8859-6cba03e72ac3", "referencedForms": [], "encounterType": "d384d248-04f8-42d3-9c49-3c44ab50f1d8", "allowUnspecifiedAll": true }