{
  "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",
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                "answers": [
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                    "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"
								}
                  },
                  {
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                    "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"
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                  {
                    "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"
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                  {
                    "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"
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