Patient Risk Factors

If a patient has any risk factors that affect the reading of a skin test result, they should be documented in the patient’s medical record. This topic explains the best procedure.

This is best accomplished by creating an Allergies/Conditions record (available from the Patient Folder > Medical History or from the Clinical Work Area (CWA) > Patient History Tab > Medical History), using TBFACTOR as the Allergy/Cond ID. You can indicate the nature of the factor (foreign-born recently arrived, close contact with active TB patient, known or suspected HIV, IV drug user, medically underserved population, etc.) in the attached memo. A portion of the Allergy/Cond ID memo is visible on the Medical History screen.

Note: If the risk factor is something that might be considered sensitive or confidential information, the memo should simply state “see chart,” or be left blank. Simply including a TBFACTOR record in a patient’s medical history makes the physician aware that a factor exists and s/he can then check the paper medical record to find out what the risk factor is.