Health Assessment

Abnormal Cases

Objective• Review Health Assessment Status transitions for

abnormal cases• Record HA (Health Assessment) Results for an

Abnormal medical case using the new US2014 form

• Record Hold Conditions• Validate the US2014 form of an Abnormal

medical case

• Initial Status• Core Services are Requested

RequestedHA-REQ

• At least one Core Service is scheduledScheduled

HA-SCH

• At least one Core Service is Completed• Not all Core Services are Completed

In ProcessHA-INP

• At least one non-core service (Hold Requirement) is Requested, Scheduled or No Show

HoldHA-HLD

• All core services either Completed or Not Done• All non-core services Completed or Not Done

CompletedHA-CPL

Health Assessment Status (Abnormal)

Prerequisites

• Case is Registered with a Medical Activity• Case is a USRAP (refugee) or US Immigrant

case• Individual is assigned or scheduled for Health

Assessment

Process Overview

• Find an Individual• Record Medical Results for each service in the

Health Assessment Form– Completion date is specified– One or more tests reveal significant findings– Add Hold Conditions– PE Result is Abnormal

• Validate the Health Assessment Form

Rules

• Rules are programme/workflow-specific• Abnormal is defined by the protocol• Abnormal is the result of the PE Medical

Service• Case Management Medical Tab fields are

updated when the HA Status is Completed– HA Exam Date– HA Completion Date– HA Expiry Date

ADD/VIEW HOLD CONDITIONSAdd Hold for US2014 Form

Add Hold/Deferral(s)

Add Hold/Deferral(s)

Add Hold/Deferral(s)

View Hold/Deferral(s)

View Hold/Deferral(s)

FIELD MAPPING TO NON-CORE MEDICAL SERVICES

Form-Service Mapping for US2014 Form

US2014 Form-Service Mapping (examples)SyphilisConfirmatory

Smear Culture DST

Completion Date

Date specimen obtained

Latest Date specimen reported

Date specimen obtained Vaccine given by Panel Site Date

Result Negative / Positive

3 Smear Results 3 Culture Results N/A

Final Result N/A Computed based on 3 Smear Results

Computed based on 3 Culture Results

Final Result

Test Name Confirmatory N/A N/A N/A

Titer Initial Titer N/A N/A N/A

US2014 Form-Service Mapping

The following non-core medical services can be populated by the US2014 Form:X-Ray / TB-related• IGRA• Smear• Culture• DST• Molecular Test

Lab• Syphilis Confirmatory• HIV Confirmatory• Syphilis RxVaccination• All available vaccines

in MiMOSA

VALIDATION RULES FOR AN ABNORMAL CASE

US2014 From

Treated is mandatory only if the result of the Syphilis Confirmatory is Positive

Laboratory Tab – Mandatory Fields

Other Therapy Detail is mandatory only if the Other Therapy is selected

Laboratory Tab – Mandatory Fields

At least one field from any of the following sub-sections is mandatory only if the X-ray findings is Abnormal– Can Suggest Tuberculosis (Need Smears and

Cultures)– No Sputum Specimens Required

X-Ray Tab – Mandatory Fields

If Signs or symptoms of tuberculosis is selected as Chest X-ray Indication, then Signs or symptoms of TB in the TB lab must also be selected

X-Ray Tab – Other Validations

If any field under the Can Suggest Tuberculosis (Need Smears and Cultures) is selected, the Chest X-ray suggests TB in the TB Lab tab must also be selected

X-Ray Tab – Other Validations

If at least one item under Class B Other is selected, then the Class B Other in the Classification tab must also be selected

X-Ray Tab – Other Validations

If Known HIV infection is selected as Chest X-ray Indication, then Known HIV infection in the TB Lab tab and the HIV in the Classification tab must also be selected

X-Ray Tab – Other Validations

If Class A is selected, no selection of Class B3 TB Contact Evaluation

TB Lab Tab – TB Classification Business Rules

If Class B1 TB Pulmonary is selected, no selection of Class B2 LTBI Evaluation

TB Lab Tab – TB Classification Business Rules

If Class B1 TB Extrapulmonary is selected, no selection of Class B2 LTBI Evaluation and Class B3 TB Contact Evaluation

TB Lab Tab – TB Classification Business Rules

If Class B2 LTBI Evaluation is selected, no selection of Class B1 TB (both Pulmonary and Extrapulmonary)

TB Lab Tab – TB Classification Business Rules

Mandatory if the TB Classification is Class B1 TB Pulmonary or Known HIV infection is selected

TB Lab Tab – Mandatory Fields

At least one item is mandatory under Yes, applicant has (mark all that apply) if TB Classification is B1 TB Pulmonary

TB Lab Tab – Mandatory fields

If any of the 3 Culture Result is Positive, then Tuberculosis Disease in the Classification tab must be selected

TB Lab Tab – Other Validations

If TB Classification = CLASS A, then Tuberculosis Disease in the Classification tab must also be selected

TB Lab Tab – Other Validations

If TB Classification = CLASS B1 TB PULMONARY, then B1 TB Pulmonary in the Classification tab must also be selected

TB Lab Tab – Other Validations

If TB Classification = CLASS B1 TB EXTRAPULMONARY, then B1 TB Extrapulmonary in the Classification tab must also be selected

TB Lab Tab – Other Validations

If TB Classification = CLASS B2 LTBI EVALUATION, then B2 LTBI Evaluation in the Classification tab must also be selected

TB Lab Tab – Other Validations

If TB Classification = CLASS B3 TB CONTACT EVALUATION, then B3 TB Contact Evaluation in the Classification tab must also be selected

TB Lab Tab – Other Validations

Reason for Blanket Waiver = H must be selected if HBsAg Result = Positive

Vaccination Tab – Other Validations

Any field in the Contraindication to Vaccination section can be checked only if there is at least one vaccine with Reason for Blanket Waiver = C

Vaccination Tab – Other Validations

Pregnant must be selected only if Pregnancy, current is Yes in the History tab

Vaccination Tab – Other Validations

At least one field is mandatory only if Class A is selected

Classification Tab – Mandatory Fields

At least one field is mandatory only if Class B is selected

Classification Tab – Mandatory Fields

Mandatory only if Class B Other is selected

Classification Tab – Mandatory Fields

Q & A

Exercises

1. Class A Non-TB2. Class Pending, Sent Out3. Class A TB4. Class B1 TB5. Class B2 TB6. Class B3 TB