Create a New Observation Form

Purpose and Benefits

Observation forms (also referred to as templates) are used to capture observations during an encounter in a pre-defined format. One can define observation forms to capture both general/non-disease-specific (e.g. Operation notes) information and condition/disease specific (e.g. Anaemia) information.

To the user, an observation form shows up as an input form in the "Consultation" user interface, while in the back end, the observation form is modeled as a concept set. The form elements can be customized by defining/modifying concepts within the concept set. They can also be customized by adding configuration in implementation-config such as Multiselect, Add more, etc.

Sample Screenshot of Observation Form

Steps

1. Import Existing Observation Forms to Bahmni  

Bahmni supports the ability to import Observation Forms via CSV Upload function in Admin Module. Please refer to the screenshot below:

• Create a CSV file of concepts that you would like to show on the New Observation form. Refer to sample concepts.CSV for the format
  • Each field you wish to see on the screen needs to be a concept.
    • "Shortname" of the concept is what is shown on the screen. 
    • If there is no "shortname" specified then "name" field is used for displaying the label
  • If you are looking at Drop downs or multi-selects then each value in the Drop Down or option buttons need to be a concept
    
    • To indicate that a Concept is a DropDown or Multi-select, use the DataType "Coded"
    • Also specify "name" of the possible answer concepts in the columns answer.1, answer.2 and so on
    • Refer to example of "Taking Medications" concept in the Sample concepts.csv below
• Each form needs and collection of fields needs to be a ConceptSet in OpenMRS.
  • Create a CSV file of all conceptSets in your Observation form that you need. Refer to sample concept_sets.CSV for the format
  • Child concepts within a concept set needs to be specified in columns child.1, child.2 and so on
    • For example, the sample concepts_sets.csv has 2 groups as concept sets "Chief Complaint Data" and "Consultation Images"
      
  • The form itself is created as a concept set, see "History and Examination"
  • check if it is uploaded successfully.
  • If there are any errors then download the err file and correct the errors
• Upload the concet_sets.csv file by selecting "Concept Set" option button (Refer screenshot above)
  • check if it is uploaded successfully.
  • If there are any errors then download the err file and correct the errors
• Now go to OpenMRS concept dictionary, Search for "All Observation Templates" and add this newly created Form concept set to this conv set. Refer screenshot below
• Once the form is ready, follow steps under 2. Configure New/Existing Observation Forms  to refine the visualisation further.

Sample CSVs: 

• concept_sets.csv
• concepts.csv

Few CSV examples for Observation Templates and generic concepts can be found at:

https://github.com/Bhamni/default-config/tree/master/openmrs/templates

https://github.com/anantraut/possible-config/tree/master/openmrs/templates

2. Configure New/Existing Observation Forms 

 To configure Disease Template Concept Sets, perform the following step in OpenMRS: 

1. Concepts usually have a default visualization on the forms UI, but there are some custom configurations that Bahmni allows. Since these cannot be directly added to the concept metadata on OpenMRS, we specify them in the app.json of the clinical module. See the code block below for details:

"visitTypeForRetrospectiveEntries": "GENERAL",
"conceptSetUI": {
		"Consent scan copy" : {
                        "allowAddMore" : true
                },
		"Baseline, List of drugs taken for more than a month": {
                	"multiSelect": true
                },
		"Baseline, Disease site": {
			"multiSelect": true
		        },
		"Baseline, Patients for whom the construction of a regimen with four likely effective second-line drugs is not possible": {
                	"multiSelect": true
                },
        "Baseline, Other patients who have high risk of unfavorable outcome but who do not fit the above categories": {
                	"multiSelect": true
                },
		"Baseline, Method of MDR-TB confirmation" : {
			"multiSelect" : true
		        }
        }

Please refer to https://github.com/Bhamni/endtb-config/blob/master/openmrs/apps/clinical/app.json in case of requirement of additional information.

The table below explains how various Concept Data types work with examples 

"Death Note, Primary Cause of Death": {
          "required": true,
          "answersConceptName": "Death Note, Cause, Answers",
          "autocomplete": true
}

  "Death Note, Cause, Answers" = Concept which has answers**

"Fully specified name of the concept": {
  "autocomplete" : true,
  "multiSelect" : true
}

Example :

"New Born status": {
  "autocomplete" : true,
  "multiSelect" : true
}

"Chief Complaint Data": {
   "answersConceptName": "Chief Complaint Answers",
   "autocomplete": true,
   "codedConceptName": "Chief Complaint",
   "nonCodedConceptName": "Non-Coded Chief Complaint",
   "durationRequired": false,
   "allowAddMore" : true
}

"multiSelect": true instead of "autocomplete": true

"Death Note, Primary Cause of Death": {
          "required": true,
          "dropdown": true
}

"Death Note, Primary Cause of Death": {
          "required": true,
          "buttonSelect": true
}

"Chief Complaint Notes": {
    "conciseText": true 
}

"Posture" : {
    "buttonSelect" : true
}

"No of children" : {
    "stepper": true
} 

"Death Note, Primary Cause of Death": {
          "required": true,
          "autocomplete": true
}

  "Death Note, Primary Cause of Death" = Concept which has answers

Capturing Video as observation in Bahmni

Steps:

1. Create a concept in OpenMRS Concept Dictionary with Class as 'Video', datatype as 'Complex' and handler as 'VideoUrlHandler'.
2. Include the concept in the observation template in which it should be part of.
3. In the observation template, for the video concept there will be a '+' button. On click of that button the files will be opened.
4. Select the video and save.

Notes:

1.  Only mp4, ogg and webm formats are supported for viewing of video. If other formats are uploaded, it will not be viewable in the browser, you can only download it.
2. The file size should be under 50mb (above that the browser might crash) while uploading.

Concept Data Conditions

Any concept in the parent concept set can be enabled / disabled conditionally based on the other concepts value. This makes the long forms usable and intuitive to use.

In the example below, "Chief Complaint Notes" is editable only if "Chief Complaint" concept is filled:

Conditionally enable/disable Concepts

The configuration to conditionally enabling/ disabling concepts based on value of other concepts (as shown in the image) is shown below (formConditions.js):

// Bahmni.ConceptSet.FormConditions.rules is a map with key as the <concept name> that matches with the currently changed element in the observation form
Bahmni.ConceptSet.FormConditions.rules = {
  '<concept name>': function(formName, formFieldValues) {
        // This function gets 2 parameters
        // 'formName' will be the concept name of the form in which a value has been changed. ("History and Examination" in the above gif)
        // 'formFieldValues' is a map with key as concept name and value as its current value
        //    All the editable fields like 'Chief Complaint', 'Chief Complaint Notes', 'History Notes' will be present with their values as seen on the screen
  
        return {enable: [], disable: []};
        // This method SHOULD return a map with two keys 'enable' and 'disable' with string array containing the concept names that needs to be enabled or disabled
  }

Bahmni.ConceptSet.FormConditions.rules = {      //This is a constant that Bahmni expects
  'Chief Complaint Data': function(formName, formFieldValues) {//'Chief Complaint Data' concept when edited, triggers this function
        var conditions = {enable: [], disable: []};
        var chiefComplaint = formFieldValues['Chief Complaint'];
        var nonCodedChiefComplaint = formFieldValues['Non-Coded Chief Complaint'];
        if(chiefComplaint || nonCodedChiefComplaint) {
            conditions.enable.push("Chief Complaint Notes")
        } else {
            conditions.disable.push("Chief Complaint Notes")
        }
        return conditions; //Return object SHOULD be a map with 'enable' and 'disable' arrays having the concept names
  }
}; 

Bahmni.ConceptSet.FormConditions.rules = { 
  'Tuberculosis, Type': function(formName, formFieldValues) {
    var conditions = {enable: [], disable: []};
    var selectedValues = formFieldValues['Tuberculosis, Type'];
    var found = _.contains(selectedValues, "Pulmonary") && _.contains(selectedValues, "Extrapulmonary")
    if(found) {
        //conditions
    } else {
        //conditions
    }
  }   
};

'<Concept Name>': function (formName, formFieldValues) {
        // This function gets 2 parameters
        // 'formName' will be the concept name of the form in which a value has been changed. ("History and Examination" in the above gif)
        // 'formFieldValues' is a map with key as concept name and value as its current value
        //  All the editable fields like 'Chief Complaint', 'Chief Complaint Notes', 'History Notes' will be present with their values as seen on the screen
  
        return {show: [], hide: []};
        // This method SHOULD return a map with two keys 'show' and 'hide' with string array containing the concept names that needs to be enabled or disabled
    }

Bahmni.ConceptSet.FormConditions.rules = {      //This is a constant that Bahmni expects
  'Chief Complaint Data': function(formName, formFieldValues) {//'Chief Complaint Data' concept when edited, triggers this function
        var conditions = {show: [], hide: []};
        var chiefComplaint = formFieldValues['Chief Complaint Data'];
        var nonCodedChiefComplaint = formFieldValues['Non-Coded Chief Complaint'];
        if(chiefComplaint || nonCodedChiefComplaint) {
            conditions.show.push("Chief Complaint Notes")
        } else {
            conditions.hide.push("Chief Complaint Notes")
        }
        return conditions; //Return object SHOULD be a map with 'show' and 'hide' arrays having the concept names
  }
}; 

"config" : {
"conceptSetUI": {
"Malaria, Treatment Start Date" : {
    "minYear": 1999,
    "maxYear": 2019,
    "allowFutureDates": true,
    "displayMonthAndYear": true
		}
	}
}

"config" : {
   "conceptSetUI": {
       "Adverse Events Template": {
          "allowAddMore": true
       }
   }
}

"config" : {
   "conceptSetUI": {
       "Adverse Events": {
          "isTabular": true
       }
   }
}