12 — Health Screening authoritative flow (PM video)

Authority: PM Fahim’s voiceover walkthrough of mForm V2 production, recorded 2026-05-19 (“Video 2.mp4”, ~18 min, 167 segments). This note is the canonical Health Screening spec going forward. When this contradicts the V2 form JSON (forms 1010 / 1011), the video wins for surveyor-facing UX and field order. When the video doesn’t state a specific threshold, the HS_Logics sheet (raw/pm-design/extracted/HS_Logics.md) wins for numeric values. The V2 JSON fills in option lists only.

Program context

Health Screening is one of the core programs Swasti runs. It sits immediately after Member Profiling in the lifecycle: once a member is profiled, a field worker opens the Health Screening form for that member.

The program has a structured follow-up lifecycle:

Initial Screening (5.1)
    └── if any marker abnormal → Follow-up 1 (5.2, visit 1)  [~15 days later]
            └── if still abnormal → Follow-up 2 (5.2, visit 2)
                    └── optional → Follow-up 3 (5.2, visit 3 or 4)
                            └── Re-screening (5.2, final visit)
                                    └── workflow closes
    └── if all markers normal → workflow closes immediately

“There are technically three follow-ups and the fourth one is the rescreen, so there are total four follow-ups.” — PM Fahim [00:50–00:57]

The V2 system had two separate forms: form 1010 (initial screening) and form 1011 (follow-up). V3 folds both into one Health Screening doctype (health_screening), distinguished by visit_number:

• visit_number = 1 → initial screening
• visit_number = 2, 3, 4 → follow-up visits (numbers go up if a follow-up couldn’t be completed in one visit)
• visit_number = 5 (or final) → re-screening

Entry point and auto-population

The surveyor navigates to the member’s detail page and taps the Health tab. If no screening exists, the tab shows an “Add Health Screening” button. Tapping it opens the 5.1 Health Screening form.

“Once a member is created and profiled we move to the health section here, when we click on the add health screening the health screening form automatically opens.” — Fahim [01:06–01:11]

Auto-population on open:

• Question 6 (Member Details) uses a dynamic option that pulls name + phone number for the identifier. The surveyor selects the member from this dropdown; selecting it triggers population of the remaining pre-filled fields.
• Geography (State → District → Block → Grampanchayat → Village) all cascade and auto-fill from the logged-in user’s context / the member record.
• Demographics (Gender, Date of Birth, Age, Age in months, Marital Status, Disabled, Pregnant) are pre-populated from the Member profile — the surveyor does not re-enter these.
• Date of Health Screening defaults to today.

“Few of the details are automatically imported which are not to be selected from the user.” — Fahim [01:23–01:29]

Form structure (Initial Screening — visit_number = 1)

The initial screening form renders as one vertical scroll. Sections are collapsible but most are expanded by default. Field sequence follows V2 viewSequence order.

Section 1 — Member details (pre-filled, read-only)

All fields in this section are auto-populated from the member profile. The surveyor cannot edit them here.

Section 2 — BMI Details

“Here we capture the weight, height, and BMI is automatically calculated.” — Fahim [02:19–02:25]

“Since this is an adolescent kid, the BMI status based on Z-score is calculated as described by the World Health Organization. The member is classified as obese — this automatically comes.” — Fahim [03:45–04:04]

Section 3 — HB (Haemoglobin) Value

“Now we move to the HB value — here we can give the HB value. The value is 14, which is in the normal range.” — Fahim [04:04–04:15]

Section 4 — BP Value 1 (First reading)

“If this is in abnormal range — for example, the status of the systolic pressure is severe high — which means [the surveyor should] pause the form for 30 minutes and save it as a draft, then reopen it and continue the form.” — Fahim [05:04–05:34]

If BP reading 1 shows an abnormal result, the surveyor is instructed to pause, wait 30 minutes, and re-take the reading before entering BP reading 2.

Section 5 — BP Value 2 (Second reading)

“The first time it was normal / high normal. Now if the member’s blood pressure has come as normal — it’s normal and high normal — and based on this, this is our second reading.” — Fahim [05:55–06:13]

Section 6 — Diabetes (Blood Sugar / RBS)

“After that we move to the diabetic status. It is coming as diabetic.” — Fahim [07:06–07:14]

Section 7 — Healthy Days Question

These two fields are non-mandatory. The video does not explicitly walk through them; they appear in the section list.

Section 8 — Illness and Referral

“After that we move to the diabetic status… there are the illnesses if there are any health [issues] we capture based on the values that we get in the field.” — Fahim [06:13–06:28]

Section 9 — Status

“This is the final status. Since the health is not normal of this member, we are moving into the first follow-up. Follow-up happens first after 15 days, so due date for the first follow-up has been set.” — Fahim [07:14–07:28]

Eligibility logic by band

The thresholds below come from the HS_Logics sheet — these are the authoritative numeric cutoffs. The app computes statuses automatically; surveyors see only the result label and interpretation text.

BMI thresholds

Adults (age ≥ 18) — BMI in kg/m²

Children/Adolescents (age 5–18) — BMI-for-Age Z-Score (WHO SD)

“BMI for children from 0–5 and 5–10 as well as 10 above and for adults varies a lot. We use a concept of Z-score and therefore calculating those values.” — Fahim [17:29–17:51]

Children (age 0–5) — Weight-for-Height Z-Score

Uses WHO WFH tables; SD scores sd_minus2_wfh and sd_plus2_wfh stored for reference.

Haemoglobin thresholds (g/dL)

Blood Pressure thresholds (mmHg) — applies to age ≥ 13, all genders

Final bp_status is the higher of systolic stage and diastolic stage across both readings.

Systolic stage logic

Diastolic stage logic

BP Status — combined label (used in bp_status field)

Note: members under age 13 get bp_status = "NA as the member's age is less than 13".

Blood Sugar (RBS, mg/dL) — all age groups

Final status and workflow

Current Status options (initial screening)

Closure rule at initial screening

“The cumulative final status — based on which we either move the member to the health screening follow-up stage or the workflow closes here if the member has a normal health status.” — Fahim [02:02–02:19]

If all of the following are true, the workflow closes immediately:

• HB status = Normal (No Anaemia)
• BP status = Normal or Low
• Diabetes status = Normal

If any marker is outside normal range, current_status = "Moving to 1st Follow-up" and followup_due_date = today + 15 days.

Follow-up flow (form 1011, folded into visit_number 2+)

The follow-up form is titled 5.2 Health Screening Follow-up in V2. In V3 it uses the same health_screening doctype with visit_number incrementing.

“Visit number 1, 2, 3… Since the first follow-up didn’t happen in one visit, it happened in two visits, so the visit number is now four.” — Fahim [08:36–14:48]

Follow-up form structure

“Since this is the visit number two, this ‘previous follow-up status’ will not come for visit number one, but it will start coming from visit number two because there’s a precursor.” — Fahim [10:23–10:33]

Follow-up 1 (visit 1) — key questions

• Did the member visit the referral centre (government hospital / PHC)?
• If yes: was the screening completed there?
  • If no → reason (e.g., “lab facility not available”)
  • If yes → record HB, BP, RBS values from the referral centre

Follow-up statuses

Follow-up 2 and 3 — what’s different

“In the second follow-up we don’t capture any value or reading — we don’t capture it at all.” — Fahim [13:04–13:12]

Follow-up 2 and 3 focus on:

• Is the member taking medication regularly?
• Side effects experienced (multi-select)
• Refer to doctor again?
• Diet plan provided?
• Health education session conducted?
• “Do you want to do a 3rd follow-up?” (Yes/No) — this gates whether FU3 opens

“Also here there’s an option that if you don’t want to do a third follow-up, click on No and the status is ‘member is under medication and second follow-up completed’ — and the member will directly move to rescreening.” — Fahim [13:20–13:46]

Due date for each follow-up = 15 days from the current visit date.

Re-screening (final visit)

Re-screening opens after third follow-up is completed. It re-captures HB, BP (SBP + DBP), and RBS values just like the initial screening, then sets a final status.

“In the re-screening we capture the values like we captured in follow-up 1. We don’t capture the readings in follow-up 2 and 3, but here we calculate again.” — Fahim [15:18–15:30]

After rescreen is submitted, no further follow-up is allowed — the workflow closes permanently.

“Since there’s no further follow-up happening, the workflow closes here once I submit this.” — Fahim [16:23–16:31]

Gap analysis vs current doctype

The doctype JSON at frappe-bench-swasti/apps/mform_swasti/mform_swasti/health/doctype/health_screening/health_screening.json is the implementation baseline. Gaps identified below are action items for the build team — the doctype should not be changed without a separate review.

Open items for PM (Fahim)

1. status_final_score field — what does this store? Is it a numeric composite of the four marker statuses, or something else? Is it displayed to the surveyor?
2. BMI age boundary at 18 — is a member aged exactly 18 classified as adult (kg/m²) or adolescent (Z-score)? The doctype has both fields; which one takes priority at 18?
3. “Do you want 3rd follow-up?” as a standalone field — should this be added as an explicit Yes/No field in the doctype, or is it implied by the surveyor’s fu_current_status selection?
4. Follow-up 2 and 3 sub-fields — confirm the complete list: medication adherence (Yes/No), side effects (which multi-select options?), diet plan (Yes/No), health education session (Yes/No). Are these all mandatory?
5. Re-screening raw values — should RS HB Value, RS SBP, RS DBP, and RS RBS be stored as numeric fields (for trend analysis over time) in addition to the computed status labels?
6. Referral failure reason options — what are the valid options for “reason referral couldn’t be completed”? The video showed one example (“lab facility not available”). Full list needed.
7. Expressed illness options — what ailments are in the multi-select list for express_illness? Is this a fixed set or a configurable master?
8. BP combined status rule — the video shows bp1_systolic_stage, bp1_diastolic_stage, bp2_systolic_stage, bp2_diastolic_stage as four separate staged readings that roll up to bp_status. Confirm: is the final bp_status the maximum stage across all four readings, or the max of the two readings (each reading being the max of its systolic vs diastolic)?
9. visibleWhen for in_prediabetic / in_diabetic HTML fields — V2 forms 1010 and 1011 disagree on the parent condition for these two interpretation banners (the known visibleWhen conflict logged in audit/out/visible_when_overrides.json). Which form’s rule should V3 use?
10. Pregnant BMI — the HS_Logics sheet doesn’t list a separate BMI table for pregnant women (only a separate Hb threshold). Confirm: should pregnant women use the adult female BMI thresholds, or is BMI not assessed for pregnant members?

Source files

• PM video: ~/Dhwani/video-walkthrough/ (Video 2.mp4, transcript.txt, INDEX_dense.md, frames_dense/)
• HS_Logics spec: raw/pm-design/extracted/HS_Logics.md (thresholds)
• Screenshot spec: pm-spec/2026-05-20/SPEC.md + pm-spec/2026-05-20/screenshots/hs_*.jpg
• Doctype JSON: frappe-bench-swasti/apps/mform_swasti/mform_swasti/health/doctype/health_screening/health_screening.json
• V2 audit patches: audit/out/health_screening.reqd.patch.json
• V2 form JSON: raw/mform-forms/1010.json (initial), raw/mform-forms/1011.json (follow-up)

This note is the authority for Health Screening. Subsequent PM videos for other forms become notes 13–15.