When an employee’s lab test returns a positive result, employers often find themselves navigating a confusing and sometimes inefficient process. At the heart of this is the role of the Medical Review Officer (MRO) and the procedures that follow a flagged test result. Here’s a clearer breakdown of what happens and how Canadian employers can make this process more timely, more cost-effective, and still entirely defensible.

Understanding the Current Process

1. Initial Reporting: The lab reports test results to the employer’s MRO through platforms like Omega’s ExtraNet. This starts the verification process.
2. Verification Efforts: The MRO, or their assistant (MRO-A), has up to 10 days to contact the donor to conduct a verification interview to determine if there’s a valid medical explanation for the result. While US DOT regulations outline a 10-day period, this is not a Canadian requirement, yet many Third-Party Administrators (TPAs) still follow it.
3. Employer Notification: After the verification interview, the result is confirmed and passed along to the employer’s Designated Employer Representative (DER), who then takes the necessary action in line with company policy.

Where the Process Breaks Down

• Time Delays: Lab results can take a long time to reach employers, even though 95% of drug tests are negative and could be processed the same day.
• Courier Issues: For some employers, particularly in rural or remote locations like Corner Brook, delays in shipping specimens to labs (e.g., routing through St. John’s instead of direct flights to Toronto) are adding days to the turnaround time.
• Outdated Practices: Many TPAs operate with procedures modelled on US DOT standards. While legally defensible, these are often not the most efficient or economical choices for Canadian employers.

Smarter Solutions for Employers

• Direct Lab Reporting: Employers can request that labs send negative test results directly to their DER, eliminating unnecessary steps and reducing turnaround time.
• Contracting an Independent MRO: This provides employers with more control and usually a faster response. It’s legal, defensible, and often more cost-effective.
• Policy-Driven Timeframes: Employers can build shorter timelines into their drug and alcohol policies. For instance, notifying the DER within 24 hours, even if the donor hasn’t responded, can still be legally sound if reflected in policy.

Real Cost Savings

A simplified, employer-directed model can significantly reduce costs. For example:

• Lab analysis: ~$50 per specimen
  
• Courier: ~$15 per shipment
  
• MRO: ~$85+/hour on an as-needed basis
  

This model avoids bundled service fees and long wait times. Many of my clients who’ve moved to this approach have found it to be not only more affordable but also easier to manage once contracts and workflows are in place.

Streamlining

By rethinking how drug test results are handled, particularly positive results, Canadian employers can take back control of a process that’s too often opaque, administratively overburdened, and outdated. Streamlining communication, updating policies, and partnering directly with labs and independent MROs can lead to quicker decisions, cost savings, and safer workplaces.

Want to explore a streamlined drug testing strategy for your organization? Let’s talk.