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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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