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.