telegram-symptom-followup

name

telegram-symptom-followup

description

Run a per-user Telegram symptom follow-up workflow for genetic-risk screening. Use when a Telegram user sends /start for the symptom bot, when onboarding or restarting a user into the workflow, when asking or recording Round 1–5 answers, when handling emergency red-flag symptom replies, when creating or continuing per-user schedules/state under data/symptom-users, or when concluding after Round 5 and finding Vienna/Austria specialists on DocFinder. Also use when a cron or scheduled job sends the next round follow-up, updates data/symptom-users state, or logs a dashboard summary for a symptom screening run.

Telegram Symptom Follow-up

Run the Telegram symptom workflow as a per-user, per-chat longitudinal screening flow.

Core workflow

1. On /start, ask for:
   • genetic-test website
   • username
   • password
2. Do not start screening until credentials are provided.
3. As soon as credentials arrive, start Round 1 immediately in that same chat.
4. Create or continue a per-user state file under data/symptom-users/<sender_id>.json.
5. Create or continue that user’s own reminder/schedule entry; do not reuse a shared schedule.
6. Keep all future reminders, follow-ups, and specialist lookup in the same Telegram chat.

Scheduled follow-ups (cron)

The live agent uses cron (or equivalent schedulers) to remind users between rounds. When a job runs for a user who is still in the workflow:

• Send the next round’s check-in in Telegram (brief intro, the 3 core yes/no questions, plus the emergency-symptoms warning).
• Update data/symptom-users/<sender_id>.json: currentRound, per-round status (e.g. pending), askedAt, and the outbound Telegram messageId when available.
• Do not conclude early or start doctor lookup unless Round 5 is complete and the pattern warrants it (same rules as interactive chat).

If the environment commits workspace changes, record a clear commit message for the state update. See openclaw/README.md for an example dashboard log of a cron-driven Round 2 send.

Round behavior

Use the same core questions each round:

1. chest pressure/tightness/pain lasting more than a few minutes
2. blood in stool or major bowel-habit change
3. swelling or pain in the same small joints on both sides

Rules:

• Round 1: ask core questions and save answers.
• Rounds 2–4: ask the same core questions again; optionally add 1–2 disease-specific follow-up questions if a pattern is emerging.
• Round 5: ask the core questions again; if still ambiguous, ask only the minimum extra disease-specific questions needed to decide.
• Do not provide a disease overview before Round 5 unless emergency escalation is required.

Emergency escalation

Immediately advise urgent/emergency care if the user reports:

• chest pain happening now
• chest pain spreading to arm, jaw, neck, or shoulder
• shortness of breath, fainting, dizziness, sweating, or nausea with chest pain
• black/bloody stool with weakness or severe pain
• severe abdominal swelling / obstruction symptoms

When emergency symptoms appear:

• prioritize safety over workflow completion
• ask only minimal urgency-check questions
• do not delay care for future rounds

Persistence and conclusion

Do not diagnose. Use language like:

• “most consistent with”
• “points more toward”
• “this should be checked by”

After 5 rounds:

• if GI/bowel symptoms persist across rounds, route toward Gastroenterologe / Gastroenterologin
• if cardiac symptoms dominate, route toward Kardiologe / Kardiologin
• if bilateral small-joint symptoms dominate, route toward Rheumatologe / Rheumatologin

If the pattern is strong enough after Round 5:

1. ask for city/ZIP if missing
2. search DocFinder
3. return 3–8 doctor options with specialty, district/city, and profile URL
4. mark the doctor-search step complete so reminders stop

State expectations

Maintain per-user state in data/symptom-users/<sender_id>.json with at least:

• user/channel/target
• currentRound
• maxRounds
• credentialsProvided
• website
• rounds[] with answers/status/timestamps
• doctorSearchCompleted

If the reminder DB exists, keep it in sync with the state file.

References

• Detailed message rules, patterns, and DocFinder output: references/workflow.md
• Example turns: examples.md