# Health Risk Assessment Plugin

A Canvas plugin for Medicare Annual Wellness Visit health risk assessments. Adds an ActionButton to the note header that launches an interactive questionnaire modal.

![Health Risk Assessment summary rendered in the note](assets/hra-summary.jpg)

## Problem it solves

Medicare Annual Wellness Visits require a documented health risk assessment, but capturing 18 questions with conditional follow-ups by hand is slow and easy to get wrong. The usual workaround is re-keying a paper HRA into the note or skipping structured capture entirely, which puts AWV billing and the resulting care plan at risk. This plugin puts the full assessment one click from the note header and writes a structured, color-coded summary back to the chart.

## Who it's for

Primary care providers and care teams conducting Medicare Annual Wellness Visits, plus the medical assistants and intake staff who complete the assessment with the patient.

## Installation

```
canvas install health_risk_assessment
```

The assessment works out of the box. Optionally set the `OUTPUT_MODE` secret (see Configuration) to control what gets written to the note.

## Features

- 18-question HRA with conditional follow-up logic
- Visual summary with risk indicators (yellow/red highlighting)
- Side-by-side display of Physical Activities and Daily Living Activities

## Button Visibility

The "Health Risk Assessment" button appears in the note header when:

1. **Note is editable** - Note state is one of: NEW, PSH (Pushed), ULK (Unlocked), RST (Restored), UND (Undeleted), CVD (Converted)
2. **No existing HRA** - Neither the custom command (`healthRiskAssessmentSummary`) nor a questionnaire command with "Health Risk Assessment" exists on the note

The button is hidden on locked/signed notes or when an HRA has already been completed.

## Note Content

The custom command displays a formatted HTML summary:

- **General Health Card** - Self-rated health compared to others (top banner)
- **Physical Activities** - 6 activities with difficulty levels (left column)
- **Daily Living Activities** - 5 ADL items with follow-up responses (right column)

Risk indicators:
- **Yellow** - Moderate concern (e.g., "Some Difficulty", "Fair" health)
- **Red** - High concern (e.g., "A Lot of Difficulty", "Unable", "Poor" health, needs help but doesn't receive it)

The print template uses the same layout with neutral styling (no color highlighting).

## Configuration

### OUTPUT_MODE Secret

Controls what gets added to the note when the assessment is submitted.

| Value | Description |
|-------|-------------|
| `custom` | Custom command with HTML summary (default) |
| `questionnaire` | Standard questionnaire command |
| `both` | Both custom command and questionnaire |

Set via Plugin Secrets in Canvas Admin.

## Testing (UAT)

1. Open a patient chart and create a new note
2. Click "Health Risk Assessment" button in the note header
3. Complete the questionnaire - verify conditional follow-ups appear:
   - "Yes" → "Do you receive help?"
   - "Don't Know" → "Due to your health?"
   - "No" → no follow-up
4. Submit the assessment
5. Verify the summary appears in the note with the layout described above
6. Re-open the note - verify the HRA button no longer appears