DOT MIS Report: Correcting Mode/Category

The DrugTestNetwork (DTN) Drug & Alcohol Data Management system manages all the required information for random selection testing, pre-employment, post-accident, reasonable suspicion, return to duty, and follow-up testing, so your data conforms, without issue, to the DOT MIS Report. Occasionally, data corrections are needed so nuanced details can be managed without complication.  Some corrections include making sure the Reason for Testing is consistent with the DOT guidelines.  Another correction often required is the Mode (FMCSA, FAA, PHMSA, FRA, USCG, and FTA) and the covered-employee categories reported.

The DOT MIS Report breaks the data down by each Mode/Category represented by the employees who have submitted to drug and alcohol testing and participated in random selections. The MIS Report produces a separate page for each Mode/Category represented by the data. The no. of employees covered under each Mode/Category reported in the MIS is based on the average no. of employees who participated in random selections conducted within the period of the report.

Steps to Make the Required Corrections:

  • Set the Mode in the account profile for all accounts that participate in testing.
  • For the calendar period that will be covered by the MIS Report, review the random selection audit records that preserve a list of all the participants and make sure each participant’s Mode/Category, in the audit record, is properly set.
  • Using the DOT MIS Analytics report, check that every test result properly states the Mode/Category for the donor.

Set the Mode for the Account:
Every personnel record for each participant must include the DOT Category for the Mode specified for the account roster. If the employer has employees under different Modes, a separate account is required for each mode: the DOT Mode applies to everyone in the roster under the account.  To set the Mode for an account, search for the company and click the Account Profile Edit icon and set the Mode.

Set the Mode for each Consortium Member:
If you need to correct the Mode for Consortium member accounts, on the main page of the application, choose the Consortium in the drop-down, as shown below, and click the first icon , on the right, to list all member accounts:

When the accounts are listed, click the Profile Editor icon and make sure the Mode for each account is properly specified as needed.

Optionally, consortium member accounts can be listed from the Consortia Mgt page. Click the menu Consortia to open the page.  Under the Consortia menu, all consortia in the subscriber’s account are listed with management options.  To list the members for each consortium, click the option icon Show Accounts:

The listing will show each member account, its Mode, the number of active employees in the roster and a option icons to open the Account Profile Editor and the Personnel Management Utility.  The list will also show how many personnel records in the roster are missing a Mode/Category specification. 

Audit Records:
When a random selection is generated the list of participants is saved as a permanent record.  This record is used to count the number of participants in each random selection and calculate the average across the randoms selections that were conducted for the reporting period of the MIS Report.  The audit record includes each person, and their Mode/Category,  who participated in each random selection.  An MIS Report page is provided for each Mode/Category represented.  If Mode/Category modifications are required for the Account, the Mode/Category for each person in the audit record must be changed too in order for the MIS to correctly report the no. of employees covered.

Correct the Mode/Category in the Audit Record:
To change the Mode/Category for each participant recorded in the audit record, you’ll need to list the random selections that were generated for the account or the consortium.  For random selections generated for individual accounts, search for the account and click the list randoms icon . For a consortium, choose the consortium from the drop-down as noted above and click the list randoms icon there on the right.

Enter the dates for random selections that were generated for the period of the MIS report. For each random selection, click the people icon to list everyone who participated in the random selection.

When the list opens, choose the Mode/Category you want to apply to everyone in the list from the the drop-down selector:

To choose everyone in the list, put a check the check-box on the header line at the top of the list:

When everyone is selected, click the DOT icon to apply the Mode/Category, specified in the drop-down, to everyone selected.

Test Result Reports Refer to Mode/Category and may need corrections:
After every participant’s Mode/Category has been set, you will need to set the Mode/Category for all the test result records that will be considered for the MIS report.

For an individual account, click the report icon

For a consortium, choose the consortium from the drop-down as outlined above, and click the report icon on the right.

When the report module, opens, indicate the year of the report and choose the report:

After you set the year of the report, scroll down to select the MIS Report option:

When the Analytics Report opens, you will find a Mode/Category drop-down (see image below) it will list all the drug/alcohol reports for the account or the consortium, depending on how you navigated to the report.  Each drug/alcohol test result will show if it conforms to the MIS Report.  For test results that do not conform to the MIS Report, the reason for the non-conformity will be shown under the test result record:

This example, above, shows the Mode/Category is not consistent with the Mode for the account to which the test result belongs. In the dropdown selection with all the Mode/Category options, choose the Mode/Category for the test result record, and check the box for each drug/alcohol test listed in the report (the checkbox is on the far left) that requires a Mode/Category correction.

Check ALL Checkboxes in a single click: You will find a checkbox at the top of the list, when checked, it will automatically check the box for all the result records listed:

When all the check-boxes have been set as needed, click the Set Mode icon, under the Mode/Category drop-down, shown in the image above, to set the Mode/Category to every test result record selected with a check-box.

When completed, you can generate the MIS Report with the Mode/Category corrected.

Assign Clinics to Administrative Users

One data component of both the Collection and the Clinic Invoice modules is the identifier for the clinic where the services are performed. On any of the main application pages, click the Home icon to access these features. The clinics available for selection in these modules are the clinics assigned to the user who is logged in and recording the service.  If the service is not for self-pay by the customer, but gets invoiced later, it’s important to make sure the clinic has its Service Center attribute turned on.  A test result report can reference any clinic, however, if a sample collection is observed or collection-only, then those services are triggered to automatically invoice only if the clinic specified in the report record is a service center. If the clinic is not a service center, then only the drug/alcohol test is invoiced and the fee is usually determined by the panel and the alcohol test type, if alcohol tests are invoiced, for breath alcohol or oral fluid tests, for example.

To assign clinics to the user:
From any of the main application pages, click the Account menu.
On the Account page, click the feature: User Management.
On the User Management page, click the Assign icon , under the column titled Clinics, on the line that identifies the user.

When the Assignment module opens, click the green plus sign icon to search for and associate a clinic with the user.

Note: Clinics are managed under the Other-Data menu.

 

Random Selection Statistics Report

Many Random selection programs for drug and alcohol testing aim to annually test a percentage of their eligible employees. The U.S. Deportment of Transportation (DOT) specifies an annual target for each transportation mode: FMCSA, FAA, FRA, etc.

In DrugTestNetwork, the consortium profile and accounts that are their own pool, each specify annual targets, separately for drug and alcohol tests.

When a test is completed, and a collection date is entered, the test counts toward the annual targets.

When a random selection is generated, an empty drug/alcohol record is created for each person selected. The empty record is used to help notify employers when a test remains incomplete. If a collection date has not been entered or a result recorded, the test is considered incomplete. Some users find it helpful to set the overall qualitative result (OQR) as “Not-Tested” to indicate a test was not conducted. The drug and breath alcohol test are recorded in a single database record and the collection date is assumed to be for both the drug test and the alcohol test since both are usually conducted together.

Every OQR result code has an attribute in the OQR Table: DO NOT Contribute to Statistics. Setting this OQR attribute to Yes prevents the Random Selection tests from getting counted toward the annual targets when the test’s result code is set to an OQR with the attribute turned on.

After a collection date is entered, but only one of the tests was completed (drug or alcohol) the incomplete test should not be counted toward the annual target. Using the OQR Not-Tested, with the attribute turned ON, will prevent the test from counting toward the annual target.

eOrder: Find the Closet Clinic and Order Testing

DrugTestNetwork’s platform is integrated with Quest to place eOrders [online].  You can find the closest clinic to your location or the closet clinic to the employee: order a drug test, alcohol test and physical.  Over 10,000 Quest affiliated clinics are updated weekly.

Find the closest clinics and review the services they provide and print an Order Authorization you can give the employee; hard-copy and/or email. The clinic can use the printed or electronic document to conveniently bring up the order, confirm, perform the services and submit the collected sample.  LabCorp and CRL are the next labs planned for integration.

Click HERE to review the “Find Clinic Demo.

DOT MIS Report: Drug Classes and Substance Classifications

The DOT MIS Report is limited to 5 specific drugs and drug classes.  Click HERE to review the DOT pdf document that outlines the details to fill out the MIS Report. https://www.fmcsa.dot.gov/sites/fmcsa.dot.gov/files/docs/MIS_Data_Collection_Form_Instructions508CLN.pdf
  • Amphetamines
  • Opiates
  • Marijuana
  • Cocaine
  • PCP
DrugTestNetwork allows users to define drug test panels with any number of substances required for specific drug testing programs. Each substance is entered in two parts: a name/abbreviation and the full substance name/description. As such it is difficult to determine exactly which substances in a panel are related to Amphetamines or Opiates or might be Marijuana or Cocaine metabolites.  The DOT has added new substances to the list for reporting, however, the basic “5 Panel” has not changed over the last 10 years and continues to include the 5 drugs and drug classes outlined above.  Some panels might include items that are not reported such as Nicotine, for example. In order to accurately generate the DOT MIS Report, every substance that’s indicated with a Positive result needs to be correlated to one of the DOT MIS reporting classes: Amphetamines, Opiates, Marijuana, Cocaine or PCP.
For example, if a panel includes a positive for Carboxy-THC (a marijuana metabolite), the user will be asked to correlate the substance to its appropriate report classification: Marijuana.  Similarly, Ocycodone must be correlated to Opiates, etc.
As users have added new substances to their Federal DOT 5 Panel, this approach to classification has become necessary because, for example, abbreviations for the “Oxy” and “Hydro” drugs have varied from one user to another and EDI data (Electronic Data Interchange) from Labs and MROs also vary greatly. The new approach requires very little input from the user; a substance (Name, Description) only needs to be correlated once.
Before the MIS report is generated, the application automatically checks all test results for the period requested and every positive substance is added to the DOT MIS Substance correlation table and users must then specify to which reporting group the substance belongs.

Medtox EDI

Medtox EDI: Electronic Data Interchange – Results Delivered Electronically

We’ve made changes to how we report some items for Medox EDI.

Medtox provides EDI in their own proprietary format; quasi HL7 data.  The T segment in the Medox EDI data file reports substances and respective results.  Technically the T segment is Medtox’s “Observation Segment.” Some Medtox T segments report observed values for items such as Test Names, Price, Status, Units of Measure and others, which are not specific to a particular substance in the panel but represent overall qualitative values associated with the sample.
For Example:
T|1|95000||TEST NAME|ST|MIRTAZAPINE|||||||
T|2|95020||PRICE|ST|?.??|||||||
T|3|95040||RESULT|ST|NEGATIVE|||||||
T|4|95060||FLAG|ST|??|||||||
T|5|95080||NORMAL|ST|Normal Value|||||||
T|6|95100||UNIT OF MEASURE|ST|units|||||||
T|10|2529||DRUG TEST RESULT|ST|NEGATIVE|||||||
T|11|2526||DRUG TEST RESULT|ST|DILUTE|||||||

Some of these observed values do not fit into the standard reporting paradigm for substances; some T segments report qualitative results, such as Negative or Positive and some T segments report quantitative, or numeric values for levels of the drug that was detected.

DTNet now takes some T values and reports them in the Lab Notes.

The observations noted above will report in the Lab Notes section of the data record as:
TEST NAME: MIRTAZAPINE
PRICE: ?.??
RESULT: NEGATIVE
FLAG: ??
NORMAL: Normal Value
UNIT OF MEASURE: units
DRUG TEST RESULT: NEGATIVE
DRUG TEST RESULT: DILUTE

NOTE: Some T segment values are used to set flags in the DTNet result record; If Dilute is detected in these T segments, the boolean value for “Dilute” is set in the report record for the test.  Adulterated tests are monitored in a similar manner as well.  Medtox reports dilute, adulterated and substituted in multiple ways within a single report and DTNet monitors all the different ways to insure the status is not overlooked.

Previously, DTNet did not include lab comments in the Lab Notes section of the report record.  Lab Comments are provided through the “C” segment of their proprietary format.  The comments have always been preserved in the EDI Data component of the report record but not specifically in “Lab Notes” included on the standard report.

All C segments are now reported in Lab Notes and appear on the customer copy of the report along with the T segments outlined above.

Quest EDI

Quest EDI: Electronic Data Interchange – Results Delivered Electronically

We’ve made changes to how we report some items for Quest EDI.

Quest provides EDI as an HL7 report.  The OBX segment in the HL7 data file reports substances and their results.  Technically the OBX is referred to as the “Observation Segment.” Some Quest OBX segments report values for items such as Hair Source, Specimen information, Patient Phone Number, etc.

Some of these Observed values do not fit into the standard reporting paradigm for substances; some observed values report qualitative results Negative or Positive and OBX segments report quantitative, or numeric values for levels of the drug that was detected.

DTNet now takes some OBX values and reports them in the Lab Notes.

For example, consider the following 3 OBX segments:
OBX|1|TX|^^^81399^HAIR SOURCE||HEAD
OBX|2|TX|^^^70025^SPECIMEN SUBMITTED||HAIR RECD ON URINE CCF
OBX|3|TX|^^^70026^TEST(S) ORDERED||VERIFY ACCOUNT AND PANEL TO RUN

The observations noted above will report in the Lab Notes section of the data record as:
HAIR SOURCE: HEAD
SPECIMEN SUBMITTED: HAIR RECD ON URINE CCF
TEST(S) ORDERED: VERIFY ACCOUNT AND PANEL TO RUN

Employee/Patient Data Entry

The personnel data entry module has been reorganized; input has been economized so the screen is visually easy to navigate, the essential data elements are highlighted and the different data sections are easily identified.  DTNet’s employee/patient records provide a lot of information, however, not every subscriber needs to keep track of it all.  The data entry fields have been grouped together into logical sections and each section can be easily opened when the user needs to manage those components.

Javascript, HTML5 and JQuery technologies were leveraged to provide a richer data entry experience for the user.

DOT Drug Panel: 2018

The DOT (U.S. Department of Transportation) added four substances and removed one from the drug testing panel. It expanded the panel to include four “semi-synthetic” opioid drugs (hydrocodone, hydromorphone, oxycodone and oxymorphone) and removed methylenedioxyamphetamine (MDA).  The changes to the DOT rules take effect on January 1, 2018.

The Federal Drug Panel includes the following substances:

  • Marijuana
  • Cocaine
  • Phencyclidine (PCP)
  • Amphetamine
  • Methamphetamine
  • MDMA: commonly known as ecstasy (E)
  • MDA: Methylenedioxyamphetamine
  • Codeine/Morphine
  • 6-AM (Heroin)
  • Hydrocodone/Hydromorphone
  • Oxycodone/Oxymorphone

Your Federal Drug Panel should include each drug separately.  If you’re getting data directly from the lab and the result is negative for Hydrocodone/Hydromorphone, the lab may simply report both together as “Hydrocodone/Hydromorphone: Negative.”

If, however, one or both are specifically detected, the lab may report, for example:

  • Hydrocodone/Hydromorphone: Positive
  • Hydrocodone: Negative
  • Hydromorphone: Positive

Note: When subscribers get results via EDI (Electronic Data Interchange) and the results for Hydrocodone/Hydromorphone, or Codeine/Morphine, or Oxycodone/Oxymorphone are Negative, the lab may report it as a single item.  This will not cause any reporting issues relative to the DOT MIS report as the DOT MIS report modules manages it without a problem.

If you are manually managing results, the Federal Drug Panel should include each drug separately:

  • Marijuana
  • Cocaine
  • PCP (Phencyclidine)
  • Amphetamine (classified as Amphetamines)
  • MDMA (or Ecstasy & classified as Amphetamines)
  • MDA (classified as Amphetamines)
  • Codeine (classified as an Opiate)
  • Morphine (classified as an Opiate)
  • 6-AM (Heroin) (classified as an Opiate)
  • Hydrocodone (classified as an Opiate)
  • Hydromorphone (classified as an Opiate)
  • Oxycodone (classified as an Opiate)
  • Oxymorphone (classified as an Opiate)

The DOT report generator will count each positive according to the requirements when the individual items are classified as Amphetamines or Opiates.

[DTNet / Practice Fusion] Integration = EMR

DrugTestNetwork’s online software application, a web-based cloud solution for drug/substance testing result data management and reporting, now integrates with Practice Fusion  (visit http://www.practicefusion.com ).  This interface further deepens DTNet’s presense as an EMR (Electronic Medical Record) system for drug/substance test result reporting.

DTNet hosts a number of subscribers whose primary business is the provision of services as a reference labs for pain management clinics, rehabilitation clinics and other health care providers.  These clinics and other providers who subscribe to Practice Fusion can now get drug/substance test results reported directly into their Practice Fusion account.

How it works:
Practice Fusion [PF] provides a desktop application which acts as the interface to the subscribers database.  When the reference lab, as a DTNet subscriber,  completes a test result,  the application can export the result to an HL7 data file.  When the HL7 file is saved to the PF input folder, the PF application pushes it directly to the PF platform.  In the current configuration PF only accepts HL7 files that contain a single test result which necessitates the DTNet subscriber to save multiple exported files to their local area network.

[DTNet / LabTrak] Integration = EMR

DrugTestNetwork’s software, the online application for drug test data management, now integrates with JBR’s LabTrak LIS (Laboratory Information System) (visit http://www.labtrak.com ).  The integration deepens the functionality of DTNet as an effective EMR system (Electronic Medical Record) for substance test reporting.

About LabTrak:
LabTrak was developed by JRB Medical Associates, Inc.  It is a laboratory information system offered to medical professionals for the management of patient diagnostics information. The systems are designed for the average physician’s office, pain management clinics, specialty labs and in-house laboratories. It is compliant with CLIA, HIPAA, and all other regulations regarding patient records.

Their lab information system is proprietary software that works with up to four laboratory analyzers at a time and allows medical offices and specialty labs to track and manage diagnostic results with ease.

LabTrak’s HL7 Data Integrates seamlessly with DTNet:
LabTrak exports lab result data via HL7 which is easily uploaded and integrated into DTNet’s data system to facilitate test result reporting through the Client portal modules for your customers: Employers, Doctors, Pain Management Clinics, other Labs, etc.