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@icap-ethiopia/esm-ethiohri-app

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{ "name": "HEI Enrollment", "version": "1.0", "published": true, "retired": false, "encounter": "HEI Enrollment", "pages": [ { "label": "HEI Enrollment", "sections": [ { "label": "Infant Information", "isExpanded": "true", "questions": [ { "label": "Enrollment Date *", "type": "obs", "questionOptions": { "rendering": "date", "concept": "1ebc345c-6f09-43e1-a616-d7e52fff4c7d" }, "validators": [ { "type": "date", "allowFutureDates": "false" }, { "type": "js_expression", "failsWhenExpression": "myValue < new Date(patient.birthDate)", "message": "Enrollment date should not be earlier than Birth date" } ], "required": "true", "id": "enrollment_date" }, { "label": "HEI Code", "type": "obs", "required": false, "id": "heiCode", "questionOptions": { "rendering": "text", "concept": "2b30a270-be1f-4cce-9949-7d7eaba349be", "conceptMappings": [], "answers": [] }, "validators": [] }, { "label": "Place of Birth", "type": "obs", "required": false, "id": "birthPlace", "questionOptions": { "rendering": "text", "concept": "163531AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", "conceptMappings": [ { "relationship": "SAME-AS", "type": "CIEL", "value": "163531" } ], "answers": [] }, "validators": [] }, { "label": "Birth Weight (in grams)", "type": "obs", "required": false, "questionOptions": { "rendering": "text", "concept": "4ab93a3c-4373-4b9b-9268-5ff0641cc242" }, "validators": [ { "type": "js_expression", "failsWhenExpression": "!/^(0|[1-9]\\d*)(\\.\\d+)?$/.test(myValue)", "message": "Weight should be a numeric value" } ], "id": "birthWeight" }, { "label": "ARV prophylaxis started", "type": "obs", "required": false, "id": "arvStarted", "questionOptions": { "rendering": "radio", "concept": "b7f50074-b9f2-4b0d-9f20-d18b646d822e", "conceptMappings": [], "answers": [ { "concept": "b5b94269-9ee1-4733-8a24-96213cf3c291", "label": "NVP + AZT for 6 weeks and NVP only for additionally 6 weeks" }, { "concept": "d32ee1d2-2518-478d-bceb-7e80fc8cb3b1", "label": "None" } ] }, "validators": [] }, { "label": "Infant referred", "type": "obs", "required": false, "id": "infantReferred", "questionOptions": { "rendering": "radio", "concept": "a0b16ce2-80a8-4b26-9168-74a6f64adb09", "conceptMappings": [], "answers": [ { "concept": "1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", "label": "Yes" }, { "concept": "1066AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", "label": "No" } ] }, "validators": [] }, { "label": "Referring facility name", "type": "obs", "required": false, "id": "referringFacilityName", "hide": { "hideWhenExpression": "infantReferred != '1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA'" }, "questionOptions": { "rendering": "text", "concept": "161550AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", "conceptMappings": [ { "relationship": "NARROWER-THAN", "type": "SNOMED-CT", "value": "397670001" }, { "relationship": "SAME-AS", "type": "CIEL", "value": "161550" } ], "answers": [] }, "validators": [ { "type": "js_expression", "failsWhenExpression": "myValue.length > 20", "message": "Please use a maximum of 20 characters" } ] }, { "label": "Place of delivery", "type": "obs", "required": false, "id": "placeOfDelivery", "questionOptions": { "rendering": "radio", "concept": "1572AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", "conceptMappings": [ { "relationship": "SAME-AS", "type": "PIH-Malawi", "value": "2997" }, { "relationship": "SAME-AS", "type": "CIEL", "value": "1572" }, { "relationship": "NARROWER-THAN", "type": "AMPATH", "value": "2368" }, { "relationship": "NARROWER-THAN", "type": "AMPATH", "value": "6441" }, { "relationship": "NARROWER-THAN", "type": "SNOMED-CT", "value": "169812000" }, { "relationship": "SAME-AS", "type": "SNOMED-CT", "value": "366344009" }, { "relationship": "SAME-AS", "type": "PIH", "value": "2997" } ], "answers": [ { "concept": "1588AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", "label": "Health Facility" }, { "concept": "1536AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", "label": "Home" }, { "concept": "5622AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", "label": "Other" } ] }, "validators": [] }, { "label": "Specify other place of delivery", "type": "obs", "required": false, "id": "otherPlaceOfDelivery", "hide": { "hideWhenExpression": "placeOfDelivery != '5622AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA'" }, "questionOptions": { "rendering": "text", "concept": "2f3c7d4f-198f-40ce-94d2-a968c8c4bea4", "conceptMappings": [], "answers": [] }, "validators": [ { "type": "js_expression", "failsWhenExpression": "myValue.length > 50", "message": "Please use a maximum of 50 characters" } ] }, { "label": "Mode of delivery", "type": "obs", "required": false, "id": "modeOfDelivery", "questionOptions": { "rendering": "radio", "concept": "5630AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", "conceptMappings": [ { "relationship": "SAME-AS", "type": "PIH-Malawi", "value": "5630" }, { "relationship": "NARROWER-THAN", "type": "SNOMED-CT", "value": "236973005" }, { "relationship": "SAME-AS", "type": "AMPATH", "value": "5630" }, { "relationship": "SAME-AS", "type": "SNOMED-MVP", "value": "56301000105003" }, { "relationship": "SAME-AS", "type": "CIEL", "value": "5630" } ], "answers": [ { "concept": "1171AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", "label": "Cesarean section" }, { "concept": "1170AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", "label": "Spontaneous vaginal delivery" }, { "concept": "5622AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", "label": "Other" } ] }, "validators": [] }, { "label": "Specify other mode of delivery", "type": "obs", "required": false, "id": "otherModeOfDelivery", "hide": { "hideWhenExpression": "modeOfDelivery != '5622AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA'" }, "questionOptions": { "rendering": "text", "concept": "ed73985e-cbab-4912-8275-0c037d5674a3", "conceptMappings": [], "answers": [] }, "validators": [ { "type": "js_expression", "failsWhenExpression": "myValue.length > 50", "message": "Please use a maximum of 50 characters" } ] } ] }, { "label": "Mother's Information", "isExpanded": "true", "questions": [ { "label": "Mother's Status", "type": "obs", "required": true, "id": "mothersStatus", "questionOptions": { "rendering": "radio", "concept": "25b917ca-549d-4e9a-b03e-bc03e5ace41a", "conceptMappings": [], "answers": [ { "concept": "160432AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", "label": "Dead" }, { "concept": "6691e136-0289-4d2f-80bf-50ec816e121a", "label": "Alive" } ] }, "validators": [] }, { "label": "If Alive,", "type": "obs", "required": false, "id": "ifAlive", "hide": { "hideWhenExpression": "mothersStatus != '6691e136-0289-4d2f-80bf-50ec816e121a'" }, "questionOptions": { "rendering": "radio", "concept": "8d165f3a-89ae-4a0a-b557-cc2c8ce8f110", "conceptMappings": [], "answers": [ { "concept": "95daa4f8-b45d-4dee-b5d0-5f9446d22c19", "label": "Enrolled in HIV/ART care" }, { "concept": "380c0885-7018-40c1-baa6-e3bba4a52560", "label": "Not enrolled in HIV/ART care" } ] }, "validators": [] }, { "label": "If Enrolled,", "type": "obs", "required": false, "id": "ifEnrolled", "hide": { "hideWhenExpression": "ifAlive != '95daa4f8-b45d-4dee-b5d0-5f9446d22c19' || mothersStatus != '6691e136-0289-4d2f-80bf-50ec816e121a'" }, "questionOptions": { "rendering": "radio", "concept": "79538372-3b8f-45b3-bf13-d1c4790b637a", "conceptMappings": [], "answers": [ { "concept": "d2b461e5-dd7f-4d16-968e-354ac68cbd38", "label": "Within the facility" }, { "concept": "674a30fb-18d5-4bb1-a6eb-9a3a2ec02ba7", "label": "Out of the facility" } ] }, "validators": [] }, { "label": "Mother's MRN", "type": "obs", "required": true, "id": "mothersMrn", "questionOptions": { "rendering": "text", "concept": "162054AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", "conceptMappings": [ { "relationship": "SAME-AS", "type": "CIEL", "value": "162054" } ], "answers": [] }, "hide": { "hideWhenExpression": "mothersStatus != '6691e136-0289-4d2f-80bf-50ec816e121a'" }, "validators": [] }, { "label": "First Name", "type": "obs", "required": false, "id": "firstName", "questionOptions": { "rendering": "text", "concept": "1593AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", "conceptMappings": [ { "relationship": "SAME-AS", "type": "PIH", "value": "2725" }, { "relationship": "SAME-AS", "type": "CIEL", "value": "166102" }, { "relationship": "SAME-AS", "type": "SNOMED-CT", "value": "408677003" } ], "answers": [] }, "hide": { "hideWhenExpression": "mothersStatus != '6691e136-0289-4d2f-80bf-50ec816e121a'" }, "validators": [ { "type": "js_expression", "failsWhenExpression": "myValue.length > 20", "message": "Please use a maximum of 20 characters" } ] }, { "label": "Father's Name", "type": "obs", "required": false, "id": "fathersName", "questionOptions": { "rendering": "text", "concept": "f20f09fa-de8a-44ec-9761-47a11d220e1d", "conceptMappings": [ { "relationship": "SAME-AS", "type": "CIEL", "value": "1594" } ], "answers": [] }, "hide": { "hideWhenExpression": "mothersStatus != '6691e136-0289-4d2f-80bf-50ec816e121a'" }, "validators": [ { "type": "js_expression", "failsWhenExpression": "myValue.length > 20", "message": "Please use a maximum of 20 characters" } ] }, { "label": "Grand Father's Name", "type": "obs", "required": false, "id": "grandfathersName", "questionOptions": { "rendering": "text", "concept": "1b545ea1-0aed-4632-af99-ea2ceb61b13c" }, "hide": { "hideWhenExpression": "mothersStatus != '6691e136-0289-4d2f-80bf-50ec816e121a'" }, "validators": [ { "type": "js_expression", "failsWhenExpression": "myValue.length > 20", "message": "Please use a maximum of 20 characters" } ] }, { "label": "Mother's PMTCT Interventions", "type": "obs", "required": false, "id": "mothersPmtct", "questionOptions": { "rendering": "radio", "concept": "6b60a8c6-da45-4f10-9135-e5e5d4b2a1b9", "conceptMappings": [], "answers": [ { "concept": "1a259ed4-15b5-4e23-8382-972f89be84c8", "label": "ART" }, { "concept": "1107AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", "label": "None" } ] }, "hide": { "hideWhenExpression": "mothersStatus != '6691e136-0289-4d2f-80bf-50ec816e121a'" }, "validators": [] }, { "label": "If on ART, regimen", "type": "obs", "required": false, "id": "regimen", "hide": { "hideWhenExpression": "mothersPmtct != '1a259ed4-15b5-4e23-8382-972f89be84c8'" }, "questionOptions": { "rendering": "select", "concept": "6d7d0327-e1f8-4246-bfe5-be1e82d94b14", "conceptMappings": [], "answers": [ { "concept": "2798d3bc-2e0a-459c-b249-9516b380a69e", "label": "1a30 - D4T(30)+3TC+NVP", "hide": { "hideWhenExpression": "true" } }, { "concept": "3495d89f-4d46-44d8-b1c9-d101bc9f15d4", "label": "1a40 - D4T(40)+3TC+NVP", "hide": { "hideWhenExpression": "true" } }, { "concept": "ae0dc59c-eb3d-421b-913b-ee5a06ec6182", "label": "1b30 - D4T(30)+3TC+EFV", "hide": { "hideWhenExpression": "true" } }, { "concept": "c5995b5c-19bb-42f6-895b-0b4627bc9dd1", "label": "1b40 - D4T(40)+3TC+EFV", "hide": { "hideWhenExpression": "true" } }, { "concept": "a9da3e97-3916-4834-854c-6bcbc5142aca", "label": "1c - AZT+3TC+NVP", "hide": { "hideWhenExpression": "true" } }, { "concept": "b5951dd9-6bb2-4b63-af20-0707500108ea", "label": "1d - AZT+3TC+EFV" }, { "concept": "1f735bdd-4ccd-40ce-8746-28f031f38675", "label": "1e - TDF+3TC+EFV" }, { "concept": "8b727274-4a3c-4a81-ae50-9f759a87358d", "label": "1f - TDF+3TC+NVP", "hide": { "hideWhenExpression": "true" } }, { "concept": "a664a63f-57f5-4cfc-80c0-4a8456725c2a", "label": "1g - ABC+3TC+EFV" }, { "concept": "71ecf102-8d3d-4a2a-b799-30773ad5d447", "label": "1h - ABC+3TC+NVP", "hide": { "hideWhenExpression": "true" } }, { "concept": "eb171a2d-1b67-4adc-ae09-49b6d272810d", "label": "1i - Other Adult 1st line regimen" }, { "concept": "2a811ceb-3c34-47ff-943a-425b41651784", "label": "1j - TDF+3TC+DTG" }, { "concept": "c56be3a9-d678-4693-9566-84430239a2f5", "label": "1k - AZT+3TC+DTG" }, { "concept": "a87d9674-11af-4440-afd0-d097d84d0393", "label": "2a - ABC+DDL+LPV", "hide": { "hideWhenExpression": "true" } }, { "concept": "82e23d8c-4c9d-4b18-a960-9f8890b86f2f", "label": "2b - ABC+DDL+NFV", "hide": { "hideWhenExpression": "true" } }, { "concept": "cf29c24b-b796-4536-aaa5-8303f45bb5f8", "label": "2c - TDF+DDL+LPV", "hide": { "hideWhenExpression": "true" } }, { "concept": "2e84a82a-8b93-40fc-a556-2028d39f5710", "label": "2d - TDF+DDL+NFV", "hide": { "hideWhenExpression": "true" } }, { "concept": "a1056dfb-c16d-4e5c-a56b-e33228d634f8", "label": "2e - AZT+3TC+LPVr" }, { "concept": "891bf06e-298a-40ee-8970-2311d18fed48", "label": "2f - AZT+3TC+ATVr" }, { "concept": "e2d1786e-4849-473e-b32a-2c82bd35e947", "label": "2g - TDF+3TC+LPVr" }, { "concept": "a9ef6721-d2fb-4f47-bfe3-9f7902e107c7", "label": "2h - TDF+3TC+ATVr" }, { "concept": "73c10f0d-0a24-411f-9c97-49ab9e7eb2ce", "label": "2i - ABC+3TC+LPVr" }, { "concept": "2a17d96a-3457-4b93-b007-b540a7543618", "label": "2j -TDF+3TC+DTG" }, { "concept": "707d6943-9ec0-4c6b-8c72-f64143663043", "label": "2k - AZT+3TC+DTG" }, { "concept": "25758e89-bfb1-4b9f-ba6d-240d953c99e8", "label": "2L - Other Adult 2nd line regimen" }, { "concept": "ab265c19-afab-4497-84a9-c8b44a202ca5", "label": "3a - DRV/r+DTG+AZT+3TC" }, { "concept": "7f9aed33-cc7e-4043-adc8-b947dd9638eb", "label": "3b - DRV/r+DTG+TDF+3TC" }, { "concept": "664137bb-d538-4afc-bbd1-7538cf158882", "label": "3c - DRV/r+ABC+3TC+DTG" }, { "concept": "dea28eb8-1f9b-455f-afcc-dc566898cb86", "label": "3d - Other Adult 3rd line regimen" }, { "concept": "74f685e8-7ea1-40e1-adf1-651cdf30b272", "label": "3e - DRV/r+TDF+3TC+EFV" }, { "concept": "e8cdf6eb-2b36-4cde-bb4b-f0fd1d6d748b", "label": "3f - DRV/r+AZT+3TC+EFV" }, { "concept": "c33efc4a-734f-4e89-92a4-71b259a5e547", "label": "4a - D4T+3TC+NVP", "hide": { "hideWhenExpression": "true" } }, { "concept": "7bbee32a-31a8-4199-a8a2-2d15c748d80a", "label": "4b - D4T+3TC+EFV", "hide": { "hideWhenExpression": "true" } }, { "concept": "756b4487-f358-4817-b248-9c05080bad67", "label": "4c - AZT+3TC+NVP", "hide": { "hideWhenExpression": "true" } }, { "concept": "ad169a6d-cf1a-4363-a2da-be85998612bd", "label": "4d - AZT+3TC+EFV" }, { "concept": "d3eedcf3-9571-42a2-b8b0-189e93f72f47", "label": "4e - TDF+3TC+EFV" }, { "concept": "0343175a-e931-4f6c-a0c2-99e55637bda9", "label": "4f - AZT+3TC+LPVr" }, { "concept": "e4353cd1-5a0e-4870-8af4-f012ca0145fe", "label": "4g - ABC+3TC+LPVr" }, { "concept": "582c6b67-2f0a-4cc0-b7c0-632b4b387a17", "label": "4h - Other Child 1st line regimen" }, { "concept": "0dbe6b49-7356-4cf0-b489-890e18c38465", "label": "4i - TDF+3TC+DTG" }, { "concept": "eae01634-65ec-4174-a95c-622456663727", "label": "4j - ABC+3TC+DTG" }, { "concept": "dabcfa6d-56e5-4e5d-a2f2-faf4e18b9211", "label": "4K - AZT+3TC+DTG" }, { "concept": "c94ca2da-8066-42f7-b4c9-582dae83e552", "label": "4L - ABC+3TC+EFV" }, { "concept": "fcafc964-f018-41c8-9dc9-343a2f4a94b5", "label": "5a - ABC+DDL+LPY", "hide": { "hideWhenExpression": "true" } }, { "concept": "7c30ed1a-a770-4b74-8704-82077427128d", "label": "5b - ABC+DDL+NFV", "hide": { "hideWhenExpression": "true" } }, { "concept": "18c78c5f-082c-4acc-a121-62fa334f34d3", "label": "5c - TDF+DDL+LPV", "hide": { "hideWhenExpression": "true" } }, { "concept": "5c9424e6-4f18-44e1-a074-e561643a7d91", "label": "5d - TDF+DDL+NFV", "hide": { "hideWhenExpression": "true" } }, { "concept": "fbb4db0f-4cf4-4ca3-bde0-e20eb065e7da", "label": "5e - ABC+3TC+LPVr" }, { "concept": "9ef4d67d-0e05-422a-aac5-80eaf71daadc", "label": "5f - AZT+3TC+LPVr" }, { "concept": "ee5b1c56-1131-40a6-a880-5dd33a72a861", "label": "5g - TDF+3TC+EFV" }, { "concept": "e341cf6c-4923-4eb1-8c47-e76eef19e8cf", "label": "5h - ABC+3TC+EFV" }, { "concept": "1294646b-2c36-4169-a0aa-a0c7692003fc", "label": "5i - TDF+3TC+LPVr" }, { "concept": "0cc9e467-c1ce-4eff-879d-8936a81b6ea3", "label": "5j - Other Child 2nd line regimen" }, { "concept": "2e58ef33-d019-4bd9-97b8-553e39e12646", "label": "5k - RAL+AZT+3TC", "hide": { "hideWhenExpression": "true" } }, { "concept": "8feb33db-71db-4fd0-a0e7-c02f81fcc76f", "label": "5l - RAL+ABC+3TC", "hide": { "hideWhenExpression": "true" } }, { "concept": "3ed5d8a0-c957-4439-8f86-6c2538e69d3a", "label": "5m - ABC+3TC+DTG" }, { "concept": "10c0f78a-cd78-40cd-9824-8d24dc95bb90", "label": "5n - AZT+3TC+DTG" }, { "concept": "d34b5c26-c70d-4720-9784-cf8a0673d6b0", "label": "5o - TDF+3TC+DTG" }, { "concept": "5415f1b1-a680-4870-89c5-3324d42da408", "label": "6a - DRVr+RAL+AZT+3TC", "hide": { "hideWhenExpression": "true" } }, { "concept": "3e7d018b-9669-4f48-9298-d7c633f86b0f", "label": "6b - DRVr+RAL+TDF+3TC", "hide": { "hideWhenExpression": "true" } }, { "concept": "5c8d27eb-4642-4c6f-b131-1182df8d1276", "label": "6c - DRVr+DTG+AZT+3TC" }, { "concept": "ee226f28-5e37-4c40-a8e0-47dfade32712", "label": "6d - DRVr+DTG+TDF+3TC" }, { "concept": "57eef726-e977-4efd-996b-a94860341320", "label": "6e - Other Child 3rd line regimen" }, { "concept": "e3eb6ae1-fd70-47b2-b1a6-702fae87b061", "label": "6f - DRV/r+DTG+ABC+3TC" }, { "concept": "a270c994-8182-4204-9a1e-c7aa78a43b23", "label": "6g - DRV/r+ABC+3TC+EFV" }, { "concept": "f0724e33-ca6e-415e-b385-91d53e125cfb", "label": "6h - DRV/r+AZT+3TC+EFV" } ] }, "hide": { "hideWhenExpression": "mothersStatus != '6691e136-0289-4d2f-80bf-50ec816e121a' || mothersPmtct != 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}, "validators": [ { "type": "date", "allowFutureDates": "false" } ] }, { "label": "Unique ART number", "type": "obs", "questionOptions": { "rendering": "text", "calculate": { "calculateExpression": "getIdentifier(patient, 'UAN')" }, "concept": "162054AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", "hide": { "hideWhenExpression": "mothersPmtct !== '1a259ed4-15b5-4e23-8382-972f89be84c8'" } }, "hide": { "hideWhenExpression": "mothersStatus != '6691e136-0289-4d2f-80bf-50ec816e121a'" }, "id": "artNumber" } ] }, { "label": "Father's Information", "isExpanded": "true", "questions": [ { "label": "Father's Status", "type": "obs", "required": false, "id": "fathersStatus", "questionOptions": { "rendering": "radio", "concept": "2d5b2754-423e-47d3-9bf5-81ee0c2108f5", "conceptMappings": [], "answers": [ { "concept": "160432AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", "label": "Dead" }, { "concept": "6691e136-0289-4d2f-80bf-50ec816e121a", "label": "Alive" } ] }, "validators": [] }, { "label": "If Alive HIV status,", "type": 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