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@mherman22
Created November 4, 2025 09:23
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{
"name": "Structured SOAP note",
"description": "A form used to collect clinical information in a structured form",
"version": "1.1",
"published": true,
"uuid": "32f9bf88-f337-4995-9c37-6e639cc778f8",
"retired": false,
"encounter": "Consultation",
"pages": [
{
"label": "Visit Details",
"sections": [
{
"label": "Visit Particulars",
"isExpanded": true,
"questions": [
{
"value": [
"**This form is used to**:Document a structured clinical consultation"
],
"questionOptions": {
"rendering": "markdown"
},
"id": "heading"
},
{
"label": "Encounter & Datetime",
"type": "encounterDatetime",
"questionOptions": {
"rendering": "datetime"
},
"required": "true",
"default": "",
"id": "encDate",
"validators": [
{
"type": "date"
}
],
"questionInfo": "Date the encounter took place"
},
{
"type": "encounterProvider",
"label": "Encounter Provider:",
"id": "provider",
"required": "true",
"default": "",
"questionOptions": {
"rendering": "ui-select-extended"
}
},
{
"type": "encounterRole",
"label": "Role:",
"id": "role",
"required": "false",
"default": "",
"questionOptions": {
"rendering": "ui-select-extended"
}
},
{
"type": "encounterLocation",
"label": "Encounter Location",
"id": "location",
"required": "true",
"questionOptions": {
"rendering": "ui-select-extended"
}
},
{
"label": "Visit Type?",
"type": "obs",
"required": "false",
"id": "visitType",
"questionOptions": {
"rendering": "radio",
"concept": "164181AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"conceptMappings": [
{
"relationship": "SAME-AS",
"type": "CIEL",
"value": "164181"
}
],
"answers": [
{
"concept": "164180AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "New visit"
},
{
"concept": "160530AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Return Visit"
}
]
}
}
]
}
]
},
{
"label": "Subjective History",
"sections": [
{
"label": "Complaints and History of complaints",
"isExpanded": "true",
"questions": [
{
"label": "History of Presenting Complaints",
"type": "obsGroup",
"id": "chiefComplaint",
"questionOptions": {
"concept": "1390AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"rendering": "repeating"
},
"validators": [],
"hide": {},
"questions": [
{
"label": "Complaint",
"type": "obs",
"id": "Complaint",
"questionOptions": {
"concept": "5219AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"rendering": "select",
"answers": [
{
"concept": "151AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Abdominal pain"
},
{
"concept": "141631AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Abnormal Uterine Bleeding"
},
{
"concept": "121543AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Anxiety"
},
{
"concept": "148035AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Back pain"
},
{
"concept": "840AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Bloody Urine"
},
{
"concept": "117671AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Blood in stool"
},
{
"concept": "131021AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Breast Pain"
},
{
"concept": "120749AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Chest Pain"
},
{
"concept": "871AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Cold and Chills"
},
{
"concept": "120345AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Confusion"
},
{
"concept": "143264AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Cough"
},
{
"concept": "113054AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Convulsions"
},
{
"concept": "144576AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Coma"
},
{
"concept": "106AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Coryza"
},
{
"concept": "143129AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Crying Infant"
},
{
"concept": "119574AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Delirium"
},
{
"concept": "119537AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Depression"
},
{
"concept": "142412AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Diarrhea"
},
{
"concept": "122496AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Difficult in breathing"
},
{
"concept": "118789AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Difficulty in swallowing"
},
{
"concept": "142247AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Discharge from Penis"
},
{
"concept": "141830AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Dizziness"
},
{
"concept": "141585AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Ear Pain"
},
{
"concept": "141128AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Epigastric Pain"
},
{
"concept": "131040AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Eye Pain"
},
{
"concept": "140941AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Excessive Sweating"
},
{
"concept": "114399AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Facial Pain"
},
{
"concept": "162626AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Fatigue/weakness"
},
{
"concept": "140070AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Flank Pain"
},
{
"concept": "140238AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Fever"
},
{
"concept": "135462AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Genital Ulcer"
},
{
"concept": "139084AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Headache"
},
{
"concept": "117698AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Hearing Loss"
},
{
"concept": "116214AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Hypotension"
},
{
"concept": "879AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Itchiness/Pruritus"
},
{
"concept": "116558AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Joint Pain"
},
{
"concept": "114395AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Leg Pain"
},
{
"concept": "116334AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Lethargy"
},
{
"concept": "135595AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Loss of Appetite"
},
{
"concept": "135488AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Lymphadenopathy"
},
{
"concept": "121657AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Memory Loss"
},
{
"concept": "111721AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Mouth Ulceration"
},
{
"concept": "131015AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Mouth Pain"
},
{
"concept": "133028AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Muscle cramps"
},
{
"concept": "133632AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Muscle Pain"
},
{
"concept": "121AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Mylagia"
},
{
"concept": "5978AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Nausea"
},
{
"concept": "133469AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Neck Pain"
},
{
"concept": "133027AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Night sweats"
},
{
"concept": "132653AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Numbness"
},
{
"concept": "162628AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Unexplained bleeding"
},
{
"concept": "125225AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Pain when Swallowing"
},
{
"concept": "131034AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Pelvic Pain"
},
{
"concept": "5953AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Poor Vision"
},
{
"concept": "512AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Rash"
},
{
"concept": "127777AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Red Eye"
},
{
"concept": "6017AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Refusal to feed"
},
{
"concept": "113224AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Running/Blocked nose"
},
{
"concept": "131032AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Scrotal Pain"
},
{
"concept": "206AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Seizure"
},
{
"concept": "126535AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Shoulder Pain"
},
{
"concept": "112989AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Shock"
},
{
"concept": "158843AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Sore Throat"
},
{
"concept": "141597AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Sleep Disturbance"
},
{
"concept": "125198AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Swollen Legs"
},
{
"concept": "112200AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Tremors"
},
{
"concept": "160208AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Urinary Symptoms"
},
{
"concept": "157498AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Weakness of Limbs"
},
{
"concept": "832AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Weight Loss"
},
{
"concept": "123396AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Vaginal Discharge"
},
{
"concept": "122983AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Vomiting"
},
{
"concept": "111525AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Vertigo"
},
{
"concept": "5622AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Other"
}
]
}
},
{
"label": "Specify other complaints",
"type": "obs",
"id": "OtherComplaints",
"questionOptions": {
"concept": "160531AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"rendering": "textarea"
},
"validators": [],
"hide": {
"hideWhenExpression": "Complaint !== '5622AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA'"
}
},
{
"label": "Onset Date",
"type": "obs",
"id": "complaintsOnset",
"questionOptions": {
"concept": "159948AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"rendering": "date"
},
"validators": [
{
"type": "date",
"allowFutureDates": "false"
}
]
},
{
"label": "Duration (Days)",
"type": "obs",
"id": "complaintDuration",
"questionOptions": {
"concept": "1731AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"rendering": "number",
"min": "0",
"calculate": {
"calculateExpression": "calcTimeDifference(useFieldValue('complaintsOnset'), 'd')"
}
},
"validators": []
}
]
},
{
"label": "Chief complaint (text)",
"type": "obs",
"id": "chiefComplaintTxt",
"questionOptions": {
"concept": "160531AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"rendering": "textarea"
},
"validators": [],
"hide": {
"hideWhenExpression": ""
}
}
]
},
{
"label": "Past Medication History",
"isExpanded": "true",
"questions": [
{
"label": "Past medical & Surgical history narrative",
"type": "obs",
"id": "pmhx",
"questionOptions": {
"rendering": "textarea",
"concept": "160221AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"answers": []
},
"hide": {
"hideWhenExpression": ""
}
}
]
},
{
"label": "Allergies & Adverse Drug Reactions ",
"isExpanded": "true",
"questions": [
{
"label": "Allergies",
"required": false,
"id": "allergiesWorkspaceLauncher",
"questionOptions": {
"rendering": "workspace-launcher",
"buttonLabel": "+ Allergies",
"workspaceName": "patient-allergy-form-workspace"
}
},
{
"label": "Patient reports adverse drug reaction(s)? ",
"type": "obs",
"id": "adverseReactions",
"required": "false",
"questionOptions": {
"concept": "162871AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"rendering": "radio",
"answers": [
{
"concept": "1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Yes"
},
{
"concept": "1066AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "No"
},
{
"concept": "1067AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Unknown"
}
]
},
"hide": {
"hideWhenExpression": ""
},
"historicalExpression": "_.isEmpty(HD.getObject('prevEnc').getValue('162871AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA')) ? undefined : HD.getObject('prevEnc').getValue('162871AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA')"
},
{
"label": "Adverse drug reaction(s)",
"type": "obsGroup",
"questionOptions": {
"rendering": "repeating",
"concept": "162867AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA"
},
"id": "adrs",
"hide": {
"hideWhenExpression": "adverseReactions !== '1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA'"
},
"questions": [
{
"label": "Medicine Causing Reaction",
"type": "obs",
"id": "adrMed",
"questionOptions": {
"concept": "1193AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"rendering": "drug"
}
},
{
"label": "Reaction",
"type": "obs",
"id": "adrReaction",
"questionOptions": {
"concept": "160646AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"rendering": "select",
"answers": [
{
"concept": "148888AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Anaphylaxis"
},
{
"concept": "148787AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Angioedema"
},
{
"concept": "121629AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Anaemia"
},
{
"concept": "120148AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Arrhythmia"
},
{
"concept": "108AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Bronchospasm"
},
{
"concept": "143264AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Cough"
},
{
"concept": "142412AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Diarrhea"
},
{
"concept": "118773AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Dystonia"
},
{
"concept": "137162AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Flu-Like Syndrome"
},
{
"concept": "140039AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Flushing"
},
{
"concept": "140238AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Fever"
},
{
"concept": "159581AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "GI upset"
},
{
"concept": "5978AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Nausea"
},
{
"concept": "117399AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Hypertension"
},
{
"concept": "111061AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Hives"
},
{
"concept": "139084AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Headache"
},
{
"concept": "159098AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Hepatotoxicity"
},
{
"concept": "138111AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Hyperuricemia"
},
{
"concept": "879AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Itching"
},
{
"concept": "121677AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Mental status change"
},
{
"concept": "159347AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Musculoskeletal pain"
},
{
"concept": "114736AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Optic Neuritis"
},
{
"concept": "141600AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Shortness of breath"
},
{
"concept": "512AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Rash"
},
{
"concept": "113180AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Tendon Rupture"
},
{
"concept": "123074AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Visual Disturbances"
},
{
"concept": "122983AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Vomiting"
},
{
"concept": "1067AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Unknown"
},
{
"concept": "5622AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Other"
}
]
}
},
{
"label": "Severity",
"type": "obs",
"id": "adrSeverity",
"questionOptions": {
"concept": "162760AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"rendering": "select",
"answers": [
{
"concept": "1067AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Not graded"
},
{
"concept": "1498AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Mild"
},
{
"concept": "1499AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Moderate"
},
{
"concept": "1500AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Severe"
},
{
"concept": "162819AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Life threatening"
}
]
}
},
{
"label": "Date of Onset",
"type": "obs",
"id": "dateOnsetAdverse",
"questionOptions": {
"concept": "160753AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"rendering": "date"
},
"validators": [
{
"type": "date",
"allowFutureDates": "false"
}
]
},
{
"label": "Action taken",
"type": "obs",
"id": "actIonTaken",
"questionOptions": {
"concept": "1255AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"rendering": "select",
"answers": [
{
"concept": "1257AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Continue drug"
},
{
"concept": "981AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Dose adjusted"
},
{
"concept": "1260AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Discontinued"
},
{
"concept": "1259AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Substitution"
}
]
}
}
]
}
]
},
{
"label": "Family History",
"isExpanded": "true",
"questions": [
{
"label": "Family History Narrative",
"type": "obs",
"id": "familyHx",
"questionOptions": {
"concept": "160618AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"rendering": "textarea"
},
"hide": {
"hideWhenExpression": ""
}
}
]
},
{
"label": "Sexual History",
"isExpanded": "true",
"questions": [
{
"label": "HIV Status",
"type": "obs",
"required": false,
"id": "hivStatus",
"questionOptions": {
"rendering": "radio",
"concept": "159576AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"conceptMappings": [
{
"relationship": "SAME-AS",
"type": "PIH",
"value": "3753"
},
{
"relationship": "SAME-AS",
"type": "3BT",
"value": "10042719"
},
{
"relationship": "SAME-AS",
"type": "SNOMED CT",
"value": "278977008"
},
{
"relationship": "SAME-AS",
"type": "ICPC2",
"value": "B90"
}
],
"answers": [
{
"concept": "138571AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "(Known) HIV positive"
},
{
"concept": "664AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Negative"
},
{
"concept": "1067AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Unknown"
}
]
},
"validators": [],
"hide": {
"hideWhenExpression": "age < 3"
},
"historicalExpression": "_.isEmpty(HD.getObject('prevEnc').getValue('159576AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA')) ? undefined : HD.getObject('prevEnc').getValue('159576AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA')"
},
{
"label": "Months since HIV test was done",
"type": "obs",
"required": false,
"id": "hivTest",
"questionOptions": {
"rendering": "number",
"min": "0",
"max": "200",
"concept": "163191AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"conceptMappings": [
{
"relationship": "SAME-AS",
"type": "CIEL",
"value": "163191"
}
]
},
"validators": [],
"alert": {
"alertWhenExpression": "myValue > 12",
"message": "Client may be eligible for a HIV test if there are risk factors"
},
"hide": {
"hideWhenExpression": "isEmpty (hivStatus) || hivStatus !=='664AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA'"
}
},
{
"label": "Date of HIV Diagnosis",
"type": "obs",
"required": false,
"id": "hivDxDate",
"questionOptions": {
"rendering": "date",
"concept": "160554AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"conceptMappings": [
{
"relationship": "SAME-AS",
"type": "CIEL",
"value": "160554"
}
]
},
"validators": [
{
"type": "date",
"allowFutureDates": "false"
},
{
"type": "js_expression",
"failsWhenExpression": "myValue > useFieldValue('encDate')",
"message": "Cannot be after encounter date"
}
],
"hide": {
"hideWhenExpression": "isEmpty (hivStatus) || hivStatus !=='138571AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA'"
},
"historicalExpression": "_.isEmpty(HD.getObject('prevEnc').getValue('160554AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA')) ? undefined : HD.getObject('prevEnc').getValue('160554AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA')"
},
{
"label": "Sex with someone of unknown HIV status in the last 6 months?",
"type": "obs",
"required": false,
"id": "sexPartner",
"questionOptions": {
"rendering": "radio",
"concept": "166505AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"conceptMappings": [
{
"relationship": "SAME-AS",
"type": "CIEL",
"value": "166505"
},
{
"relationship": "SAME-AS",
"type": "KenyaEMR",
"value": "165027"
},
{
"relationship": "NARROWER-THAN",
"type": "SNOMED CT",
"value": "228466005"
}
],
"answers": [
{
"concept": "1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Yes"
},
{
"concept": "1066AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "No"
},
{
"concept": "160573AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Currently not sexually active"
}
]
},
"validators": [],
"hide": {
"hideWhenExpression": "age < 14"
}
},
{
"label": "Sex without a condom",
"type": "obs",
"required": false,
"id": "sexWithoutCondom",
"questionOptions": {
"rendering": "radio",
"concept": "166658AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"conceptMappings": [
{
"relationship": "NARROWER-THAN",
"type": "SNOMED CT",
"value": "2314005"
},
{
"relationship": "SAME-AS",
"type": "CIEL",
"value": "166658"
},
{
"relationship": "SAME-AS",
"type": "KenyaEMR",
"value": "165097"
}
],
"answers": [
{
"concept": "1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Yes"
},
{
"concept": "1066AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "No"
},
{
"concept": "1067AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Unknown"
}
]
},
"validators": [],
"hide": {
"hideWhenExpression": "isEmpty(sexPartner) || sexPartner !== '1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA' || age < 14"
}
},
{
"label": "Recent history of a Sexually Transmitted Infection",
"type": "obs",
"required": false,
"id": "recentSti",
"questionOptions": {
"rendering": "radio",
"concept": "0fb41bec-4847-4d8d-afba-1116991b4f71",
"conceptMappings": [],
"answers": [
{
"concept": "1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Yes"
},
{
"concept": "1066AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "No"
},
{
"concept": "1067AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Unknown"
}
]
},
"validators": [],
"hide": {
"hideWhenExpression": "isEmpty(sexPartner) || sexPartner !== '1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA' || age < 14"
}
}
]
},
{
"label": "Reproductive History",
"isExpanded": "true",
"questions": [
{
"label": "Last Menstrual Period",
"type": "obs",
"id": "lmp",
"questionOptions": {
"rendering": "date",
"concept": "1427AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"answers": []
},
"hide": {
"hideWhenExpression": "sex !== 'F' ||sex === 'F' && (age < 10 || age > 49)"
},
"validators": [
{
"type": "date",
"allowFutureDates": "false"
},
{
"type": "js_expression",
"failsWhenExpression": "myValue > useFieldValue('encDate')",
"message": "Cannot be after the encounter date"
}
]
},
{
"label": "Is client pregnant?",
"type": "obs",
"id": "pregnancy",
"questionOptions": {
"concept": "5272AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"rendering": "radio",
"answers": [
{
"concept": "1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Yes"
},
{
"concept": "1066AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "No"
},
{
"concept": "1067AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Unknown"
}
]
},
"hide": {
"hideWhenExpression": "sex !== 'F' || age < 14 || age > 49"
}
},
{
"label": "Expected Date of Delivery (EDD)",
"type": "obs",
"id": "edd",
"questionOptions": {
"concept": "5596AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"rendering": "date",
"calculate": {
"calculateExpression": "calcEDD('lmp')"
}
},
"hide": {
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