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.

DOT MIS Modes and Categories

Software applications for drug and alcohol testing data management must maintain exhaustive data audits of DOT (Department of Transportation) employee Modes and Categories when random selections are generated in order to address the requirements of DOT MIS reporting as per CFR-49 of the Federal Guidelines for random drug and alcohol testing.

DrugTestNetwork, the web-based software application, and RandomWare desktop software (http://RandomWare.com) both automatically generate a DOT MIS Report for every Mode/Category represented by all employees tested.  The number of employees represented in each category is defined by the average number of employees included in each random selection conducted for the pool.  To calculate those averages, each of the software applications review the audit trails for all the random selections conducted for the period requested for the report.

Below is the list of covered-employee categories for the DOT Modes of Transportation [FMCSA, FAA, PHMSA, FRA, USCG, and FTA] reported for random testing of drugs and alcohol (all other “reasons for testing” are covered in the DOT MIS Report as well):

  • FMCSA (one category):
    • Driver
  • FAA (eight categories):
    • Flight Crew-member
    • Flight Attendant
    • Flight Instructor
    • Aircraft Dispatcher
    • Aircraft Maintenance
    • Ground Security Coordinator
    • Aviation Screener
    • Air Traffic Controller
  • PHMSA (one category):
    • Operation/Maintenance/Emergency Response
  • FRA (five categories):
    • Engine Service
    • Train Service
    • Dispatcher/Operation
    • Signal Service
    • Other: Includes
      •  yardmasters
      • hostlers (non-engineer craft)
      • bridge tenders
      • switch tenders
      • other miscellaneous employees performing 49 CFR 228.5 (c) defined covered service.
  • USCG (one category):
    • Crew-member
  • FTA (five categories):
    • Revenue Vehicle Operation
    • RevenueVehicle and EquipmentMaintenance
    • Revenue Vehicle Control/Dispatch
    • CDL/Non-Revenue Vehicle
    • Armed Security Personnel

[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.

Importing Personnel Data for Random Selection for Drug and Alcohol Testing

DrugTestNetwork’s online application software for drug and alcohol testing data management and random selection has easy to use import features to manage the upkeep of employer personnel rosters.

One of the biggest challenges faced by TPAs is keeping employee rosters up-to-date for the random selection of personnel for drug and alcohol testing.  Importing data is an easy task with resources that read Excel spreadsheets saved as “tab delimited” text files.

Employers often have the capability to review their active personnel/employee lists in an Excel spreadsheet.  From there it’s easy to modify the spreadsheet to import the data into the Employer’s account.  The system has the capability to import far more than simply an employee’s first name, last name and employee ID whether it is a Social Security Number or other proprietary employment ID, however, this article will limit the discussion to a subset of the possible fields for import. Continue reading

Random Selection Audit for Drug & Alcohol Testing

When you generate a random selection for drug and alcohol testing, the online software application, DrugTestNetwork, a cloud based SaaS system, maintains a thorough and complete audit trail.

The original list of employees eligible for random drug and alcohol testing from which the randomization was conducted is saved as a permanent record.  If John Doe was in the list at the time the random selection was conducted, his name will appear in the audit trail record.  If John Doe is removed from the personnel roster for the company in which he was employed, his name is forever maintained in the audit record.

A safety sensitive employee who must comply with Federal DOT guidelines must have passed a pre-employment drug test prior to his or her employment and must be eligible for random drug and alcohol testing from that point forward.  Therefore, one of the most frequently asked questions regarding random selection for drug and alcohol testing is whether an employee was in the list at the time a particular randomization was generated regardless if the employee is currently in the client’s pool of personnel eligible for selection.

The random selection audit answers the questions:
Users can query a list of random selections for a client by date as shown below.  To review the list of personnel eligible for the selection, the user simply clicks the icon to review the entire list that participated in the random selection generated for a specific randomization request.

In the application the user clicks the personnel icon (seen on the right) to review the list of employees eligible for each random selection in the report.

 

The Random Selection Listing for a specific account for a specified period of time:random selection audit trail

 

DOT MIS Report

DrugTestNetwork produces the DOT MIS report with ease and has an analytical reporting tool to clarify any potential problems regarding the reporting accuracy of test results for a client.

Only Drug and Alcohol Tests for specific reasons for testing and specific overall qualitative results are counted for the DOT MIS report.  Only test results recorded with be below listed Reasons for Testing are counted:

  • Pre-Employment
  • Random Selection
  • Post Accident
  • Reasonable Suspicion
  • Reasonable Cause
  • Return to Duty
  • Follow-Up Testing

If a test result is recorded with ANY OTHER reason for testing, it is NOT counted in the reported tests for the DOT MIS Report.

Test Result Codes: Only the Overall Qualitative Test Results listed below are counted in the DOT MIS Report:

  • Negative
  • Positive
  • Cancelled
  • Shy-Bladder (No Medical Explanation)
  • Shy-Lung (Breath-Alcohol)
  • Declined to Participate (Other Refusals)

Test Results that use ANY OTHER overall qualitative test result are NOT Included in the reported test counts for the DOT MIS Report.

 

Quick Result Tools

DrugTestNetwork’s Data Management Software provides resources to generate random selections for drug and alcohol testing from individual client “pools” or across multiple personnel rosters from any number of separate client accounts managed as a “consortium.”When you generate a random selection the program automatically creates a drug and alcohol test result record for each person selected with the status of “Not-Collected.”  These “uncollected” tests are used to determine if a company is in compliance with their drug free workplace policy or their federally mandated requirements.If you are manually resolving test result records, you’ll find a “Quick Result” option that let’s you automatically set test results for the block of data generated as a result of the random selection.
List Random Selections
Click the icon to access the “Quick Results” manager.

DrugTestNetwork.com is an Internet based (SaaS: Sofware as a Service) software application for drug and alcohol testing; resources for TPAs, MROs, Labs, Employers or School Administrators to manage drug testing data for their drug free workplace, DOT compliance or drug free schools.

Collection Sites

DrugTestNetwork’s Data Management Software for Drug and Alcohol Testing allows you to create and manage your own list of Collection sites for drug and alcohol testing and keep track of their respective costs for all types of samples: urine, saliva, breath alcohol, etc.
Collection Sites in subscriber database
You can also assign collection sites to specific clients and include the site’s address in notification letters addressed individually to each person in a random selection for drug and alcohol testing.

Collection Module

DrugTestNetwork provides a specific data entry resource to easily enter collection information where donors can go for drug and alcohol testing.  The resource includes reporting features so you can email instant test results to the client when the sample has been collected and screened.
When you enter instant tests, you can immediately send an email with a full detailed report as a PDF attachment to the employer.