This article will cover the process of giving a skintest in Summit. For more information on creating skintest panels or prescribing from a skintest, please refer to the Prescribing From a Skintest in Summit or Skintest Panels in Summit articles.
To create a new skintest, navigate to a patient's chart using the Patient Search by entering the patient's last name, first name, date of birth, and/or MRN. In the patient context, you can reach the skintest list for the patient by either clicking the Skintest quick button (if available) or using the user menu to navigate to Windows > Skintest List.
Here you can see all of the completed skintests for the patient. Click on the View button to see the details of a completed test or Print to print or download the results of a test. Clicking the green Create button will let you being a new skintest.
The next step of the skintest process is to choose which antigens to test for and what scoring protocol to use for the test. Scoring protocols are built to your clinical specifications to help determine what reaction counts as a positive score on the test. Because scoring protocols are highly customizable, it is likely your specific protocols will not match the one used in this article (which is very basic) but the overall process is the same. More information on creating skintest panels can be found in the Skintest Panels article.
In brief, skintest panels are a preselected list of antigens for a skintest. They allow a provider to quickly choose several antigens to test for with a single click rather than having to choose each antigen individually. The end result of choosing antigens individually versus using a skintest panel, however, is the same. After selecting a skintest panel you can still add or remove antigens individually. In the example above, Panel A has been selected, which turned every antigen for that skintest panel green. To add additional antigens to the panel, simply click on the antigen name to turn it green as well. To remove an antigen from the test, click on any green antigen to unselect it. Once all of the antigens have been selected, click Save to continue.
Note: If every antigen in a skintest panel is also found in an additional panel, clicking the panel will cause both boxes to be checked. In this example, every antigen in the "Test" panel is also found in "Panel A" so checking Panel A will also check Test.
You are now in the testing window. Begin by administering the pricks then clicking the Timer button. Choose a test length from the dropdown list then click Start. A popup window will appear allowing you to make a note for the test, either by choosing from the list of premade hot text buttons or writing in the freeform text box. Clicking OK in this window will begin the timer.
In addition to the timer found within the skintest itself, another timer will also appear on the main dashboard, as seen above. If you navigate away from the skintest while the test is running, clicking on this timer will return you to the skintest. When the timer reaches one minute, it will turn orange, and then red once the timer reaches zero. Once the timer hits zero, clicking the Stop button will open another note popup similar to the one from the beginning of the test.
Now that the test is complete, you can enter the observed reactions for each antigen. This example used a very simple scoring protocol with columns for values for wheal and flare size with a result of either a positive or negative score, but the overall process is the same for different and/or more complicated tests. Using either a keyboard or the on screen scorecard, enter the observed values for each antigen. If using the scorecard, entering a value will automatically move you to the next unfilled box on the test, but you are able to navigate freely throughout. The small icons at the bottom of the scorecard allow you to move the scorecard to the left, right, top, or bottom of the screen.
Throughout the skintest there are multiple icons allowing you to add notes to specific parts of the test. Clicking the pencil icon that the top of the test allows you to change the name of the skintest. To the left of the value boxes for each antigen is an icon that allows you to make reaction notes for that specific antigen. Finally, there is a pencil icon in the notes box that allows you to make notes about the skintest as a whole. Each of these note features have the option of choosing hot text boxes or entering freeform notes.
In addition to the notes box and a log of the actions taken during the skintest, the right hand side of the skintest window has a status dropdown and multiple buttons. The status dropdown allows you to set the current status of a skintest for quick reference both within the test itself as well as in the skintest queue. In the bottom corner of the window are Prescribe, Print, Delete, and Save buttons. The prescribe button is covered in greater detail in the prescribing from a skintest article. Print and delete are fairly self explanatory, opening either a window allowing you to set print and download options or a window asking for confirmation to delete the skintest.
While Summit can be configured to allow for autosaving after inactivity during a skintest, it is still strongly encouraged to use the save button any time you need to navigate away from the skintest or if you need to walk away from the computer. Finally, there is a Test is Complete checkbox towards the top of the window. Clicking this box will finalize the skintest, as well as allow you to use the skintest for creating prescriptions.
NOTE: once a skintest has been marked as complete, no changes can be made to any of the values recorded in the test, though you can continue to make and edit notes written for the test.
The skintest is now complete and can be viewed on the patient's skintest skintest history and skintest list. This concludes the process for giving a skintest in Summit! For additional questions, please refer to our other knowledge base article or contact Xtract support via Freshdesk ticket, email, or telephone.