chf_annual_screening.xml

<htmlform
        formUuid="5e3363e6-594e-4b03-98c6-152616b955b1"
        formName="Cardiac and Vascular Disease Frequency Per Protocol Laboratory Tests"
        formEncounterType="dbab9217-29ec-477d-8d11-161cd4fd2b34"
        formVersion="3.0">

    <macros>
        <macro key="proteinuria" value="65717366-977f-11e1-8993-905e29aff6c1" />
        <macro key="negative" value="654994c2-977f-11e1-8993-905e29aff6c1" />
        <macro key="trace" value="6572cf72-977f-11e1-8993-905e29aff6c1" />
        <macro key="onePlus" value="65598fb2-977f-11e1-8993-905e29aff6c1" />
        <macro key="twoPlus" value="65597cde-977f-11e1-8993-905e29aff6c1" />
        <macro key="threePlus" value="65598706-977f-11e1-8993-905e29aff6c1" />
        <macro key="fourPlus" value="E1B2AF76-4B69-4BA4-9DDC-D801649BC212" />

        <macro key="egfr" value="6214728c-e515-4287-a869-bcde209f888b"/>
        <macro key="creatinine" value="657170a0-977f-11e1-8993-905e29aff6c1" />
        <macro key="potassium" value="6557b566-977f-11e1-8993-905e29aff6c1" />
        <macro key="rbs" value="654a98b8-977f-11e1-8993-905e29aff6c1" />
        <macro key="lipid" value="f77f0ba3-8668-4537-9f96-7aad3403cff8" />
        <macro key="normal" value="6557a15c-977f-11e1-8993-905e29aff6c1" />
        <macro key="highLipids" value="6623242A-F374-46C1-83D7-D17551E48A79" />
        <macro key="highTGs" value="F7A42154-66D8-41A9-97CD-C16DDE4C0F3B" />
        <macro key="nenoLocations" expression="fn.globalProperty('pihmalawi.systemLocationsTag')"/>
    </macros>

    <!-- Flowsheet table view -->
    <ifMode mode="VIEW" include="true">

        <table class="visit-table data-entry-table">
            <thead class="visit-table-header">
                <tr>
                    <th colspan="7">Screening (Frequency per protocol)</th>
                </tr>
                <tr>
                    <th>Date</th>
                    <th>Proteinuria</th>
                    <th>Cr</th>
                    <th>eGFR</th>
                    <th>K+</th>
                    <th>RBS</th>
                    <th>Lipid profile</th>
                </tr>
            </thead>
            <tbody class="visit-table-body">
                <tr class="visit-table-row">
                    <td class="nowrap visit-date">
                        <!-- Encounter Date -->
                        <encounterDate/>
                    </td>
                    <td>
                        <!-- Proteinuria -->
                        <obs conceptId="$proteinuria" style="radio" answerConceptIds="$negative,$trace,$onePlus,$twoPlus,$threePlus,$fourPlus" answerLabels="Negative,Trace,1+,2+,3+,4+"/>
                    </td>

                    <td>
                        <obsreference conceptId="$creatinine"/>
                    </td>
                    <td>
                        <obs conceptId="$egfr"/>
                    </td>
                    <td>
                        <obs conceptId="$potassium"/>
                    </td>
                    <td>
                        <obs conceptId="$rbs"/>
                    </td>
                    <td>
                        <obs conceptId="$lipid"/>
                    </td>
                </tr>
            </tbody>
        </table>

    </ifMode>

    <!-- Data entry view -->
    <ifMode mode="VIEW" include="false">

        <h4 style="font-style: italic;">
            <b>Screening (Frequency per protocol)</b>
            <span style="padding-left:50px;">Version 3</span>
            <span id="patientUuid" style="display:none"><lookup expression="patient.uuid"/></span>
            <span style="padding-left:50px;">
                <b style="padding-right:10px;">NCD Reg no:</b>
                <b>
                    <lookup complexExpression="#foreach( $id in $patientIdentifiers.get(&quot;Chronic Care Number&quot;) ) $!id #end"/>
                </b>
            </span>
        </h4>

        <span style="display:none">
            <encounterProvider default="16576"/>
        </span> <!-- Set provider to a default as not used -->

        <table class="visit-edit-table">
            <tr>
                <th>Date</th>
                <td>
                    <encounterDate id="visitDate" default="today"/>
                    <span id="visitDateError" class="error field-error" style="display:none;color: rgb(255, 0, 0);"></span>
                </td>
            </tr>
            <tr>
                <th>Location</th>
                <td>
                    <encounterLocation id="visitLocation" tags="$nenoLocations"/>
                </td>
            </tr>

            <tr>
                <th>Proteinuria</th>
                <td>
                    <obs conceptId="$proteinuria" style="radio" answerConceptIds="$negative,$trace,$onePlus,$twoPlus,$threePlus,$fourPlus" answerLabels="Negative,Trace,1+,2+,3+,4+"/>
                </td>
            </tr>
            <tr>
                <th>Cr</th>
                <td>
                    <obsreference conceptId="$creatinine" id="creatinineInput" showUnits="true"/>
                </td>
            </tr>
            <tr>
                <th>eGFR</th>
                <td>
                    <obs conceptId="$egfr" showUnits="true"/>
                </td>
            </tr>
            <tr>
                <th>K+</th>
                <td>
                    <obs conceptId="$potassium" id="potassiumInput" showUnits="true"/>
                </td>
            </tr>
            <tr>
                <th>RBS</th>
                <td>
                    <obs conceptId="$rbs" showUnits="true"/>
                </td>
            </tr>
            <tr>
                <th>Lipid profile</th>
                <td>
                    <obs conceptId="$lipid" answerConceptIds="$normal,$highLipids,$highTGs"/>
                </td>
            </tr> 

        </table>

        <submit/>

    </ifMode>

</htmlform>