@icap-ethiopia/esm-ethiohri-app

{ "name": "ICT Screening", "version": "1.0", "published": true, "retired": false, "encounter": "ICT Screening", "pages": [ { "label": "ICT SCREENING (OLD)", "sections": [ { "label": "ICT REGISTRATION SCREENING", "isExpanded": "true", "questions": [ { "label": "Is the client eligible for partner and family based ICT?", "type": "obs", "required": false, "id": "eligibleForIct", "questionOptions": { "rendering": "radio", "concept": "15063af6-4d52-4f58-94a3-c151048d9c57", "conceptMappings": [], "answers": [ { "concept": "1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", "label": "Yes" }, { "concept": "1066AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", "label": "No" } ] } }, { "label": "Maternal HIV status", "type": "obs", "required": false, "id": "maternalHivStatus", "questionOptions": { "rendering": "select", "concept": "3535f4d1-bf1e-47d5-822d-60c1da143cad", "conceptMappings": [], "answers": [ { "concept": "703AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", "label": "Known Positive" }, { "concept": "5e4fc757-0b14-49ae-b3b7-419666f41e15", "label": "Negative" }, { "concept": "1067AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", "label": "Unknown status & alive" }, { "concept": "160432AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", "label": "Dead" } ] } }, { "label": "Marital status", "type": "obs", "required": false, "id": "maritalStatus", "questionOptions": { "rendering": "select", "concept": "2feaa615-f6af-41db-91c1-301def421146", "answers": [ { "concept": "5555AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", "label": "Married" }, { "concept": "1057AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", "label": "Single" }, { "concept": "1056AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", "label": "Separated" }, { "concept": "1058AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", "label": "Divorced" }, { "concept": "1059AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", "label": "Widow/Widower" }, { "concept": "1060AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", "label": "Living together" } ] }, "validators": [] }, { "label": "Number of contacts elicited?", "type": "obs", "required": false, "id": "contactsElicited", "questionOptions": { "rendering": "text", "concept": "cb018c94-17f1-4065-98c0-af892e5f7a36", "conceptMappings": [], "answers": [] } }, { "label": "Did the index case agree to be interviewed?", "type": "obs", "required": false, "id": "agreeInterviewed", "questionOptions": { "rendering": "radio", "concept": "4dd6e628-fcc9-4629-92b8-192751c3de9c", "conceptMappings": [], "answers": [ { "concept": "1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", "label": "Yes" }, { "concept": "1066AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", "label": "No" } ] } }, { "label": "Reason for not being interviewed", "type": "obs", "required": false, "id": "reasonNotBeingInterviewed", "hide": { "hideWhenExpression": "agreeInterviewed !== '1066AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA'" }, "questionOptions": { "rendering": "radio", "concept": "a4c912a5-bb4d-4250-ab4c-35a7d3020587", "conceptMappings": [], "answers": [ { "concept": "afe90395-0720-4515-929b-6796e45a11ae", "label": "Refused" }, { "concept": "160432AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", "label": "Dead" }, { "concept": "5622AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", "label": "Other" } ] } }, { "label": "Date index case interviewed", "type": "obs", "required": false, "id": "dateIcInterviewed", "hide": { "hideWhenExpression": "agreeInterviewed !== '1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA'" }, "questionOptions": { "rendering": "date", "concept": "5fff58c8-705d-4e4a-954e-41e7441c659d" } }, { "label": "Is the index case interviewed for partner service?", "type": "obs", "required": false, "id": "icInterviewedForService", "questionOptions": { "rendering": "radio", "concept": "75a0a101-a094-4c7d-a4c7-255fb0094440", "conceptMappings": [], "answers": [ { "concept": "1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", "label": "Yes" }, { "concept": "1066AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", "label": "No" } ] } }, { "label": "Date interview offered for index case", "type": "obs", "required": false, "id": "dateIcInterviewOffered", "hide": { "hideWhenExpression": "icInterviewedForService !== '1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA'" }, "questionOptions": { "rendering": "date", "concept": "93f85b06-9bd2-4789-a3d6-8fbfb3075429" } }, { "label": "Number of sexual partners in the past 12 month", "type": "obs", "required": false, "questionOptions": { "rendering": "number", "concept": "75dfe54f-30f1-404c-8523-eda893d51468", "max": 200, "min": 0, "showDate": "" }, "id": "12month" }, { "label": "Number of sexual partners in the past 24 month", "type": "obs", "required": false, "questionOptions": { "rendering": "number", "concept": "59ca144e-569b-4d8e-b83c-24c47af6b683", "max": 200, "min": 0, "showDate": "" }, "id": "24month" }, { "label": "Is index client willing to provide names of partners", "type": "obs", "required": false, "id": "willingToProvideNames", "questionOptions": { "rendering": "radio", "concept": "0e7e5389-0966-40f7-9e97-ae059b9f2ce7", "conceptMappings": [], "answers": [ { "concept": "1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", "label": "Yes" }, { "concept": "1066AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", "label": "No" } ] } }, { "label": "Reason for not willing to provide the names of partners", "type": "obs", "required": false, "id": "notWillingToProvideNames", "hide": { "hideWhenExpression": "willingToProvideNames !== '1066AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA'" }, "questionOptions": { "rendering": "text", "concept": "e637d9c3-49a1-4a00-8bbf-ace9f12a9b7e" } }, { "label": "Next visit date", "type": "obs", "questionOptions": { "rendering": "date", "concept": "c596f199-4d76-4eca-b3c4-ffa631c0aee9", "weeksList": "" }, "readonly": "false", "id": "nextVisitDate" } ] } ] } ], "availableIntents": [ { "intent": "*", "display": "default_intent" } ], "processor": "EncounterFormProcessor", "uuid": "ecefb340-0162-47b2-aec4-3db9b7bdc5e8", "referencedForms": [], "encounterType": "43a8ef4f-473e-4778-9c90-7b7f05014499", "allowUnspecifiedAll": true }