From 3ef6134603ca5fdb37ccdcb2ad36dcf3d951aeb6 Mon Sep 17 00:00:00 2001 From: jabahum Date: Wed, 21 May 2025 15:02:07 +0300 Subject: [PATCH] add back death notification form --- ...0-NotificationAndCertificationOfDeath.json | 691 ++++++++++++++++++ 1 file changed, 691 insertions(+) create mode 100644 omod/src/main/webapp/resources/jsonforms/HMIS-ACP-100-NotificationAndCertificationOfDeath.json diff --git a/omod/src/main/webapp/resources/jsonforms/HMIS-ACP-100-NotificationAndCertificationOfDeath.json b/omod/src/main/webapp/resources/jsonforms/HMIS-ACP-100-NotificationAndCertificationOfDeath.json new file mode 100644 index 000000000..4d5d4c953 --- /dev/null +++ b/omod/src/main/webapp/resources/jsonforms/HMIS-ACP-100-NotificationAndCertificationOfDeath.json @@ -0,0 +1,691 @@ +{ + "name": "HMIS 100: Notification and Certification of Cause of Death", + "version": "4.1.0", + "description": "Notification and Certification of Death", + "encounterType": "e75c856a-9e91-4ffb-bf43-1b0450b4ff8c", + "encounter": "DEATH AND CERTIFICATION", + "uuid": "00001ae1-1b37-41ca-adb2-17c04df008da", + "processor": "EncounterFormProcessor", + "published": true, + "retired": false, + "referencedForms": [], + "pages": [ + { + "label": "HMIS FORM 100: Notification and Certification of Cause of Death", + "sections": [ + { + "label": "Notification of Death", + "isExpanded": "true", + "questions": [ + { + "label": "Date of Notification", + "type": "encounterDatetime", + "required": "true", + "id": "dateOfNotification", + "datePickerType": "calendar", + "questionOptions": { + "rendering": "date" + }, + "validators": [] + }, + { + "label": "Place of Death", + "type": "obs", + "required": "true", + "id": "placeOfDeath", + "questionOptions": { + "rendering": "text", + "concept": "5b3f4b6e-a7e2-11ed-afa1-0242ac120002" + }, + "validators": [] + }, + { + "label": "Date of Death", + "type": "obs", + "id": "dateOfDeath", + "questionOptions": { + "rendering": "date", + "concept": "dce14bd7-30ab-102d-86b0-7a5022ba4115" + }, + "validators": [] + }, + { + "label": "Time of Death", + "type": "obs", + "id": "timeOfDeath", + "questionOptions": { + "rendering": "date", + "concept": "51931527-8764-4245-b4c5-0bf5e763a617" + }, + "validators": [] + }, + { + "label": "Manner of Death", + "type": "obs", + "required": "true", + "id": "mannerOfDeath", + "questionOptions": { + "rendering": "select", + "concept": "96c0e2ba-0aa4-461c-8a92-c1577c5e51ee", + "answers": [ + { + "concept": "db6dc4d4-432d-44e0-a4c1-0b414d3cc639", + "label": "Disease" + }, + { + "concept": "dc68e03a-30ab-102d-86b0-7a5022ba4115", + "label": "Assault" + }, + { + "concept": "46d2a442-6249-455e-a278-4df8cd8a6a8e", + "label": "Accident" + }, + { + "concept": "4dd97db0-4714-11ee-be56-0242ac120002", + "label": "Legal Intervention" + }, + { + "concept": "a88e9552-8746-4dce-8190-0b179f008186", + "label": "Pending Investigation" + }, + { + "concept": "de3a9f71-add2-4cee-80e0-5b2322528cdd", + "label": "Intentional Self Harm" + }, + { + "concept": "54ab3e77-97fa-4ae9-ac0d-60d92892fc60", + "label": "War" + }, + { + "concept": "dc659b57-30ab-102d-86b0-7a5022ba4115", + "label": "Poison / External Causes" + }, + { + "concept": "dcd6865a-30ab-102d-86b0-7a5022ba4115", + "label": "Could not be determined / Unknown" + } + ] + }, + "validators": [] + }, + { + "label": "Date of Injury", + "type": "obs", + "id": "dateOfInjury", + "questionOptions": { + "rendering": "date", + "concept": "501e5438-27fa-4d47-98f6-5726e0705819" + }, + "validators": [], + "hide": { + "hideWhenExpression": "isEmpty(mannerOfDeath) || mannerOfDeath !== 'dc659b57-30ab-102d-86b0-7a5022ba4115'" + } + }, + { + "label": "Place of Occurance", + "type": "obs", + "id": "placeOfOccurance", + "questionOptions": { + "rendering": "select", + "concept": "5fd01982-3d71-4b30-8c5e-b82109001c2b", + "answers": [ + { + "concept": "51407370-b2c0-11ed-afa1-0242ac120002", + "label": "At home" + }, + { + "concept": "b0c9380a-1a97-4bd1-9a6c-b047ae62ec24", + "label": "Residential Institution" + }, + { + "concept": "159928AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "School, other institution, public administrative area" + }, + { + "concept": "14cc61a5-9e66-452c-a811-7d6bb4ef937e", + "label": "Sports and Athletics area" + }, + { + "concept": "6951432b-8dfe-43cb-a519-afe0c73f8d90", + "label": "Street and Highway" + }, + { + "concept": "d0486d1d-307a-4437-aeb1-01d5fafac69a", + "label": "Trade and Service area" + }, + { + "concept": "b0b67581-8665-4b6a-ad31-f7c0c3fd940f", + "label": "Industrial and Construction Area" + }, + { + "concept": "cf44737f-62ac-48d9-975f-adc06ffe9bfe", + "label": "Farm" + }, + { + "concept": "dcd6865a-30ab-102d-86b0-7a5022ba4115", + "label": "UNKNOWN" + } + ] + }, + "validators": [], + "hide": { + "hideWhenExpression": "isEmpty(mannerOfDeath) || mannerOfDeath !== 'dc659b57-30ab-102d-86b0-7a5022ba4115'" + } + }, + { + "label": "Please describe how external cause occurred (If poisoning please specify poisoning agent)", + "type": "obs", + "id": "pleaseDescribeHowExternalCauseOccurred", + "questionOptions": { + "rendering": "text", + "concept": "159395AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA" + }, + "validators": [], + "hide": { + "hideWhenExpression": "isEmpty(mannerOfDeath) || mannerOfDeath !== 'dc659b57-30ab-102d-86b0-7a5022ba4115'" + } + }, + { + "label": "Surgery with 4 Weeks", + "type": "obs", + "id": "surgeryWith4Weeks", + "questionOptions": { + "rendering": "select", + "concept": "5ec66b1d-2bba-4399-947a-6f5e666dd92c", + "answers": [ + { + "concept": "dcd695dc-30ab-102d-86b0-7a5022ba4115", + "label": "YES" + }, + { + "concept": "dcd69c06-30ab-102d-86b0-7a5022ba4115", + "label": "NO" + }, + { + "concept": "dcd6865a-30ab-102d-86b0-7a5022ba4115", + "label": "UNKNOWN" + } + ] + }, + "validators": [] + }, + { + "label": "Date of Surgery", + "type": "obs", + "id": "dateOfSurgery", + "questionOptions": { + "rendering": "date", + "concept": "c192e637-ea27-4a28-9e2f-2f2d690738cc" + }, + "validators": [], + "hide": { + "hideWhenExpression": "isEmpty(surgeryWith4Weeks) || surgeryWith4Weeks !== 'dcd695dc-30ab-102d-86b0-7a5022ba4115'" + } + }, + { + "label": "Reason for Surgery", + "type": "obs", + "id": "reasonForSurgery", + "questionOptions": { + "rendering": "select", + "concept": "156dab9a-9864-4639-92be-d270daf8d2e8", + "answers": [ + { + "concept": "db6dc4d4-432d-44e0-a4c1-0b414d3cc639", + "label": "Disease" + }, + { + "concept": "55f0b3dd-1aa9-4fd9-92e3-b376e5b304b1", + "label": "Health Condition" + } + ] + }, + "validators": [], + "hide": { + "hideWhenExpression": "isEmpty(surgeryWith4Weeks) || surgeryWith4Weeks !== 'dcd695dc-30ab-102d-86b0-7a5022ba4115'" + } + }, + { + "label": "Multiple Pregnancy", + "type": "obs", + "id": "multiplePregnancy", + "questionOptions": { + "rendering": "select", + "concept": "5b40e62c-a7e2-11ed-afa1-0242ac120002", + "answers": [ + { + "concept": "dcd695dc-30ab-102d-86b0-7a5022ba4115", + "label": "YES" + }, + { + "concept": "dcd69c06-30ab-102d-86b0-7a5022ba4115", + "label": "NO" + }, + { + "concept": "dcd6865a-30ab-102d-86b0-7a5022ba4115", + "label": "UNKNOWN" + } + ] + }, + "validators": [], + "hide": { + "hideWhenExpression": "age < 1" + } + }, + { + "label": "Still Birth", + "type": "obs", + "id": "stillBirth", + "questionOptions": { + "rendering": "select", + "concept": "125872AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "answers": [ + { + "concept": "1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Yes" + }, + { + "concept": "1066AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "No" + }, + { + "concept": "1067AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Unknown" + } + ] + }, + "validators": [], + "hide": { + "hideWhenExpression": "age < 1" + } + }, + { + "label": "If death within 24h specify number of hours survived", + "type": "obs", + "id": "hoursSurvived", + "questionOptions": { + "rendering": "number", + "concept": "159616AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "disallowDecimals": true + }, + "validators": [], + "hide": { + "hideWhenExpression": "age < 1" + } + }, + { + "label": "Number of completed weeks of pregnancy", + "type": "obs", + "id": "numberOfWeeksPregnant", + "questionOptions": { + "rendering": "number", + "concept": "dca0a383-30ab-102d-86b0-7a5022ba4115", + "disallowDecimals": true + }, + "validators": [], + "hide": { + "hideWhenExpression": "age < 1" + } + }, + { + "label": "Birth Weight", + "type": "obs", + "id": "birthWeight", + "questionOptions": { + "rendering": "number", + "concept": "dcce847a-30ab-102d-86b0-7a5022ba4115" + }, + "validators": [], + "hide": { + "hideWhenExpression": "age < 1" + } + }, + { + "label": "Age of Mother", + "type": "obs", + "id": "ageOfMother", + "questionOptions": { + "rendering": "number", + "concept": "4049d989-b99e-440d-8f70-c222aa9fe45c", + "disallowDecimals": true + }, + "validators": [], + "hide": { + "hideWhenExpression": "age < 1" + } + }, + { + "label": "If death was perinatal, please state conditions of mother that affected the fetus and newborn", + "type": "obs", + "id": "ifDeathWasPerinatal", + "questionOptions": { + "rendering": "text", + "concept": "86f85a98-d5ef-468b-bbf2-57a7e4565f3c" + }, + "validators": [], + "hide": { + "hideWhenExpression": "age < 1" + } + }, + { + "label": "Was the deceased pregnant?", + "type": "obs", + "id": "pregnantAtDeath", + "questionOptions": { + "rendering": "select", + "concept": "dcda5179-30ab-102d-86b0-7a5022ba4115", + "answers": [ + { + "concept": "1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Yes" + }, + { + "concept": "1066AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "No" + } + ] + }, + "validators": [], + "hide": { + "hideWhenExpression": "sex !== 'F'" + } + }, + { + "label": "Point of Death", + "type": "obs", + "id": "pointOfDeath", + "questionOptions": { + "rendering": "select", + "concept": "f9958caa-5215-44ad-8dbc-b18894f89ace", + "answers": [ + { + "concept": "9f00f01f-24c5-4860-ba8a-ebc6334664ab", + "label": "Pregnant at time of death" + }, + { + "concept": "3090ee03-200a-41a6-a1b3-3ef78c537995", + "label": "Between 43 days up to 1 year before death" + }, + { + "concept": "ee71932f-0cc8-47a5-b734-2dcda940fb08", + "label": "Died within 42 days after delivery" + }, + { + "concept": "dcd6865a-30ab-102d-86b0-7a5022ba4115", + "label": "UNKNOWN" + } + ] + }, + "validators": [], + "hide": { + "hideWhenExpression": "sex !== 'F'" + } + }, + { + "label": "Mode of Delivery", + "type": "obs", + "id": "modeOfDelivery", + "questionOptions": { + "rendering": "select", + "concept": "dcc3ac63-30ab-102d-86b0-7a5022ba4115", + "answers": [ + { + "concept": "dc9aee12-30ab-102d-86b0-7a5022ba4115", + "label": "SVD" + }, + { + "concept": "510c9c4b-9f8c-4f90-aeb0-3d83cb899fa2", + "label": "Assisted" + }, + { + "concept": "dc9af278-30ab-102d-86b0-7a5022ba4115", + "label": "Caesarean" + } + ] + }, + "validators": [], + "hide": { + "hideWhenExpression": "sex !== 'F'" + } + }, + { + "label": "Place of Delivery", + "type": "obs", + "id": "placeOfDelivery", + "questionOptions": { + "rendering": "select", + "concept": "4995ff16-0086-4994-b622-f8d775a2a902", + "answers": [ + { + "concept": "1d05f776-a0d5-4932-99d6-ff657a638e35", + "label": "Facility Based" + }, + { + "concept": "1ca0db4a-c5c6-48ed-9e17-84905f4487eb", + "label": "Community" + } + ] + }, + "validators": [], + "hide": { + "hideWhenExpression": "sex !== 'F'" + } + }, + { + "label": "Did the pregnancy contribute to Death", + "type": "obs", + "id": "didThePregnancyContributeToDeath", + "questionOptions": { + "rendering": "select", + "concept": "3023a240-ac5a-48f5-8645-b16e5e7fb251", + "answers": [ + { + "concept": "dcd695dc-30ab-102d-86b0-7a5022ba4115", + "label": "YES" + }, + { + "concept": "dcd69c06-30ab-102d-86b0-7a5022ba4115", + "label": "NO" + } + ] + }, + "validators": [], + "hide": { + "hideWhenExpression": "sex !== 'F'" + } + }, + { + "label": "Referred from", + "type": "obs", + "id": "referredFrom", + "questionOptions": { + "rendering": "text", + "concept": "524e6ef2-16a2-49f3-bcf0-b0cd58538933" + }, + "validators": [] + }, + { + "label": "Parity", + "type": "obs", + "id": "parity", + "questionOptions": { + "rendering": "number", + "concept": "1053AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "disallowDecimals": true + }, + "validators": [], + "hide": { + "hideWhenExpression": "sex !== 'F'" + } + }, + { + "label": "Delivered By Skilled Attendant", + "type": "obs", + "id": "deliveredBySkilledAttendant", + "questionOptions": { + "rendering": "select", + "concept": "607cdd69-162a-43d4-894d-ffa85a62852e", + "answers": [ + { + "concept": "dcd695dc-30ab-102d-86b0-7a5022ba4115", + "label": "YES" + }, + { + "concept": "dcd69c06-30ab-102d-86b0-7a5022ba4115", + "label": "NO" + }, + { + "concept": "dcd6865a-30ab-102d-86b0-7a5022ba4115", + "label": "UNKNOWN" + } + ] + }, + "validators": [], + "hide": { + "hideWhenExpression": "sex !== 'F'" + } + } + ] + }, + { + "label": "Certification of Cause of Death", + "isExpanded": "true", + "questions": [ + { + "label": "Autopsy Requested", + "type": "obs", + "required": "true", + "id": "autopsyRequested", + "questionOptions": { + "rendering": "select", + "concept": "b8f3624a-0eb9-4697-9fa8-bd849e9dc62c", + "answers": [ + { + "concept": "dcd695dc-30ab-102d-86b0-7a5022ba4115", + "label": "YES" + }, + { + "concept": "dcd69c06-30ab-102d-86b0-7a5022ba4115", + "label": "NO" + }, + { + "concept": "dcd6865a-30ab-102d-86b0-7a5022ba4115", + "label": "UNKNOWN" + } + ] + }, + "validators": [] + }, + { + "label": "Results Used in Certification", + "type": "obs", + "id": "resultsUsedInCertification", + "questionOptions": { + "rendering": "select", + "concept": "8c9c2dae-4fc0-4281-bcb7-1942f935b062", + "answers": [ + { + "concept": "dcd695dc-30ab-102d-86b0-7a5022ba4115", + "label": "YES" + }, + { + "concept": "dcd69c06-30ab-102d-86b0-7a5022ba4115", + "label": "NO" + }, + { + "concept": "dcd6865a-30ab-102d-86b0-7a5022ba4115", + "label": "UNKNOWN" + } + ] + }, + "validators": [], + "hide": { + "hideWhenExpression": "isEmpty(autopsyRequested) || autopsyRequested != 'dcd695dc-30ab-102d-86b0-7a5022ba4115'" + } + }, + { + "label": "Cause of Death", + "type": "obsGroup", + "questionOptions": { + "concept": "163153AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "rendering": "repeating" + }, + "questions": [ + { + "label": "Cause of Death", + "type": "obs", + "id": "adherenceCodes", + "questionOptions": { + "rendering": "select", + "concept": "dce03b2f-30ab-102d-86b0-7a5022ba4115", + "answers": [ + { + "concept": "dcdf1b36-30ab-102d-86b0-7a5022ba4115", + "label": "FAIR ADHERENCE" + }, + { + "concept": "dcdf1708-30ab-102d-86b0-7a5022ba4115", + "label": "GOOD ADHERENCE" + }, + { + "concept": "dcdf1f4a-30ab-102d-86b0-7a5022ba4115", + "label": "POOR ADHERENCE" + } + ] + }, + "validators": [] + }, + { + "label": "Time of Death", + "type": "obs", + "id": "sessionDate", + "questionOptions": { + "rendering": "date", + "concept": "163154AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA" + }, + "validators": [ + { + "type": "date", + "allowFutureDates": "false" + } + ] + }, + { + "label": "Interval", + "type": "obs", + "id": "sessionDate", + "questionOptions": { + "rendering": "date", + "concept": "163154AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA" + }, + "validators": [ + { + "type": "date", + "allowFutureDates": "false" + } + ] + } + ], + "id": "__IKHospqEM" + } + ] + }, + { + "label": "Acknowledgement", + "isExpanded": "true", + "questions": [ + { + "label": "Medical Practioner", + "type": "encounterProvider", + "id": "medicalPractioner", + "questionOptions": { + "rendering": "ui-select-extended" + }, + "validators": [] + } + ] + } + ] + } + ] +} \ No newline at end of file