Screening phase 1 #5720
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Screening phase 1 #5720
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## Because **Story card:** [sc-17007](https://app.shortcut.com/simpledotorg/story/17007/update-sync-api-for-suspected) **PRD:** [Screening in Simple](https://docs.google.com/document/d/1kWxOOAJEoH2yuj7eHJ9zn8ZHEdWbPrxH-RW8FYYBLnM/edit?tab=t.0) Currently, Simple only tracks confirmed diagnoses for patients, which limits the ability to record and follow suspected cases during community and facility-based screening. National NCD programs in India and Bangladesh require active identification of undiagnosed adults (≥30 years) and tracking their transition from suspected → diagnosed → under treatment. By adding diagnosis date fields and `diagnosed_confirmed_at`, we can accurately record when a patient is diagnosed with hypertension or diabetes, maintain longitudinal data, and ensure proper syncing across devices. ## This addresses - Ensures every patient has a medical history record and adds support for tracking diagnosis dates. - Adds `htn_diagnosed_at` and `dm_diagnosed_at` in `medical_histories` to store the date when a patient is confirmed with hypertension or diabetes. - Adds `diagnosed_confirmed_at` in `patients` to record the earliest diagnosis date among hypertension and diabetes. - Automatically updates `diagnosed_confirmed_at` when a new diagnosis date is set. - For existing records: - Populate `diagnosed_confirmed_at` from `recorded_at` in the `patients` table. - Prevents changing an already recorded diagnosis date: - Attempting to update `htn_diagnosed_at` returns: "Hypertension diagnosis date has already been recorded and cannot be changed." - Attempting to update `dm_diagnosed_at` returns: "Diabetes diagnosis date has already been recorded and cannot be changed." ## Test instructions 1. Create a patient without any diagnosis: - Confirm that `diagnosed_confirmed_at`, `htn_diagnosed_at`, and `dm_diagnosed_at` are null in the database 2. Update the patient with a confirmed hypertension diagnosis: - `htn_diagnosed_at` and `diagnosed_confirmed_at` should now be set to the diagnosis date - `dm_diagnosed_at` should remain null 3. Later update the same patient with a confirmed diabetes diagnosis: - `dm_diagnosed_at` should be set - `diagnosed_confirmed_at` should remain the earliest of the two diagnosis dates 4. Attempt to change an already set `htn_diagnosed_at` or `dm_diagnosed_at`: - Confirm that the respective validation error is returned
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…#5721) **Story card:** [sc-17153](https://app.shortcut.com/simpledotorg/story/17153/update-reporting-patient-states-to-not-include-screened-patients) ## Because We are adding screened patients to the system and don't want them to affect our reporting numbers. ## This addresses We are using "diagnosed_confirmed_at" column in the patients column to segregate between screened and regular patients. A null value in this would mean that patient is still under screening, hence exclude them. A timestamp value in this marks the time when the first diagnosis of patient was confirmed - resulting him being considered as a "regular" patient. This timestamp denotes the time from when we would actually start calculating it's actual "registration" to the program. ## Test instructions Test suite --------- Co-authored-by: Ayushi Agrawal <ayushiagrawal@RTSL-P172G93770.local>
#5727) …er_months **Story card:** [sc-17154](https://app.shortcut.com/simpledotorg/story/17154/update-latest-blood-pressures-per-patient-per-months-to-not-include-screened-patients) ## Because We want to exclude screening patients from latest_blood_pressures_per_patient_per_months ## This addresses Creating a new definition for latest_blood_pressures_per_patient_per_months which only includes patients where diagnosed_confirmed_at is not null. Also, adding a new rake task which will refresh the view that have been dropped and recreated as a result of dependencies. This rake task will accept a comma separated list if views that needs to be refreshed. If no argument is passed, it will do a refresh of the default list ## Test instructions Test suite --------- Co-authored-by: Ayushi Agrawal <ayushiagrawal@RTSL-P172G93770.local>
…#5728) **Story card:** [sc-17155](https://app.shortcut.com/simpledotorg/story/17155/update-blood-pressures-per-facility-per-days-to-not-include-screened-patients) ## Because We need to remove screened patients from our reporting views ## This addresses New definition of blood_pressures_per_facility_per_days which excludes patients where diagnosed_confirmed_at is null ## Test instructions Test Suite --------- Co-authored-by: Ayushi Agrawal <ayushiagrawal@RTSL-P172G93770.local>
) **Story card:** [sc-17157](https://app.shortcut.com/simpledotorg/story/17157/update-reporting-patient-blood-pressures-to-not-include-screened-patients) ## Because We need to remove screened patients from our reporting views ## This addresses New definition for reporting_patient_blood_pressures which excludes patients where diagnosed_confirmed_at is null ## Test instructions Suite test --------- Co-authored-by: Ayushi Agrawal <ayushiagrawal@RTSL-P172G93770.local>
**Story card:** [sc-17251](https://app.shortcut.com/simpledotorg/story/17251/backward-compatibility-risks-new-screening-existing-diagnosis-flow) **PRD:** https://docs.google.com/document/d/1kWxOOAJEoH2yuj7eHJ9zn8ZHEdWbPrxH-RW8FYYBLnM/edit?tab=t.0 ## Because We need to ensure backward compatibility for older screening records where `htn_diagnosed_at` and `dm_diagnosed_at` were not present. ## This addresses - Adds logic to handle cases where both diagnosis dates are `nil`. - If the patient is not suspected and has yes/no marked for HTN/DM, we set `diagnosed_confirmed_at` to `recorded_at` (only if it was previously nil). - Ensures older patient records still receive a valid `diagnosed_confirmed_at` value. ## Test instructions For the test cases, please refer to the **[PRD](https://docs.google.com/document/d/1kWxOOAJEoH2yuj7eHJ9zn8ZHEdWbPrxH-RW8FYYBLnM/edit?tab=t.0 )** section “Diagnosis date flow (HTN & DM)”.
**Story card:** [sc-17159](https://app.shortcut.com/simpledotorg/story/17159/update-reporting-patient-blood-sugars-to-not-include-screened-patients) ## Because We need to remove screened patients from our reporting views ## This addresses New definition for reporting_patient_blood_sugars which excludes patients where diagnosed_confirmed_at is null ## Test instructions Suite test Co-authored-by: Ayushi Agrawal <ayushiagrawal@RTSL-P172G93770.local>
#5733) **Story card:** [sc-17251](https://app.shortcut.com/simpledotorg/story/17251/backward-compatibility-risks-new-screening-existing-diagnosis-flow) When an older APK creates a patient and submits hypertension: yes or diabetes: yes without diagnosis dates, the backend now safely backfills missing dates using the patient’s recorded_at. Behavior If hypertension: yes, then ``` htn_diagnosed_at = patient.recorded_at diagnosed_confirmed_at = patient.recorded_at ``` If diabetes: yes, then ``` dm_diagnosed_at = patient.recorded_at diagnosed_confirmed_at = patient.recorded_at ```
**Story card:** [sc-17160](https://app.shortcut.com/simpledotorg/story/17160/update-reporting-overdue-calls-to-not-include-screened-patients) ## Because We need to remove screened patients from our reporting views ## This addresses New definition for reporting_overdue_calls which excludes patients where diagnosed_confirmed_at is null ## Test instructions Suite test --------- Co-authored-by: Ayushi Agrawal <ayushiagrawal@RTSL-P172G93770.local>
**Story card:** [sc-17161](https://app.shortcut.com/simpledotorg/story/17161/update-reporting-patient-visits-to-not-include-screened-patients) ## Because We need to remove screened patients from our reporting views ## This addresses New definition for reporting_patient_visits which excludes patients where diagnosed_confirmed_at is null ## Test instructions Suite test Co-authored-by: Ayushi Agrawal <ayushiagrawal@RTSL-P172G93770.local>
**Story card:** [sc-17162](https://app.shortcut.com/simpledotorg/story/17162/update-reporting-prescriptions-to-not-include-screened-patients) ## Because We need to remove screened patients from our reporting views ## This addresses New definition for reporting_prescriptions which excludes patients where diagnosed_confirmed_at is null ## Test instructions Suite test Co-authored-by: Ayushi Agrawal <ayushiagrawal@RTSL-P172G93770.local>
**Story card:** [sc-17163](https://app.shortcut.com/simpledotorg/story/17163/update-reporting-patient-follow-ups-to-not-include-screened-patients) ## Because We need to remove screened patients from our reporting views ## This addresses New definition for reporting_patient_follow_ups which excludes patients where diagnosed_confirmed_at is null ## Test instructions Suite test --------- Co-authored-by: Ayushi Agrawal <ayushiagrawal@RTSL-P172G93770.local>
#5740) **Story card:** [sc-17164](https://app.shortcut.com/simpledotorg/story/17164/update-reporting-facility-appointment-scheduled-days-to-not-include-screened-patients) ## Because We need to remove screened patients from our reporting views ## This addresses New definition for reporting_facility_appointment_scheduled_days which excludes patients where diagnosed_confirmed_at is null ## Test instructions Suite test Co-authored-by: Ayushi Agrawal <ayushiagrawal@RTSL-P172G93770.local>
**Story card:** [sc-17428](https://app.shortcut.com/simpledotorg/story/17428/edge-case-set-diagnosis-dates-for-both-yes-and-no) ### Because The app may send both htn_diagnosed_at and dm_diagnosed_at on create/update if hypertension: yes/no and diabetes: yes/no, and the backend must enforce consistent rules. ### **This addresses** **Suspected enforcement** — if any diagnosis field is suspected in an incoming record, the backend does not store the date for suspected diagnosis store date for the another diagnosos ex: hypertension: yes , htn_diagnosed_at: new_date (stored), diabetes: suspected, dm_diagnosed_at: nil. **Suspected → confirmed** — allowed; backend accepts client-provided dates when moving from suspected → yes/no, but only sets dates for fields that do not already have confirmed dates on the server. **Immutability** — once a confirmed *_diagnosed_at exists on the server, it is not overwritten by later updates; incoming dates only populate fields that are currently nil. **Backfill rules** — backfill from patient.recorded_at runs only when both diagnosed dates are nil and neither side is suspected. **diagnosed_confirmed_at** — set only when no suspected diagnosis is present; uses the earliest confirmed date and is never overwritten once set. ### Tests updated 1. Specs updated to reflect the above contract. 3. Use test suite cases **Run:** `bundle exec rspec spec/models/medical_history_spec.rb ` All tests should pass.
#5741) …nd_registrations **Story card:** [sc-17166](https://app.shortcut.com/simpledotorg/story/17166/update-reporting-facility-daily-follow-ups-and-registrations-to-not-include-screened-patients) ## Because We need to remove screened patients from our reporting views ## This addresses New definition for reporting_facility_daily_follow_ups_and_registrations which excludes patients where diagnosed_confirmed_at is null ## Test instructions Suite test --------- Co-authored-by: Ayushi Agrawal <ayushiagrawal@RTSL-P172G93770.local>
**Story card:** [sc-17156](https://app.shortcut.com/simpledotorg/story/17156/update-materialized-patient-summaries-to-not-include-screened-patients) ## Because We need to remove screened patients from our reporting views ## This addresses New definition for materialized_patient_summaries which excludes patients where diagnosed_confirmed_at is null ## Test instructions Suite test --------- Co-authored-by: Ayushi Agrawal <ayushiagrawal@RTSL-P172G93770.local>
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This is the PR to merge the feature branch for screening to master