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Feasibility Study for Electronic Fitness for Duty Medical Examination Reporting and Oversight.
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  • Abstract:
    This report examines the institutional and high-level technology aspects associated with potential mandated

    electronic reporting of every commercial driver license (CDL) driver fitness-for-duty medical examination

    performed by a medical examiner on the National Registry of Certified Medical Examiners (NRCME). To gauge

    views and concerns of effected stakeholders, the research team developed a “Base Scenario” outlining the elements

    of the potential system. A review via interviews was conducted, a similar concept administered by the Federal

    Aviation Administration was examined, ongoing electronic medical records initiatives in the Department of Health

    and Human Services were examined, and related third-party system approaches were studied. A historical review

    was conducted of related recommendations from Congress and other institutions, including the Commercial

    Driver’s License Advisory Committee. Implementation of the NRCME will improve the quality of medical

    examinations. However, it will not close the number of significant gaps that allow fraud. Based on the findings of

    these reviews and stakeholder input, three alternative approaches to a mandated electronic records system were

    examined, including a nationally-based system, a distributed State-based system, and a distributed medical

    examiner-based system. Architectural approaches were defined and analyzed relating to each approach. The

    researchers concluded that the most effective approach for Federal Motor Carrier Safety Administration

    consideration would be a nationally-managed system that would address the gaps. Appendix C outlines a proof of

    concept to test and evaluate the recommendations for implementing electronic transmission and housing of medical

    status and examination reports in an accessible database.

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