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Creative Approaches to Drug-Testing Remote Workers Will Persist

Oral-fluid testing key to remote sample collection

A woman is sitting on a couch and using a tablet.

​Remote work is a principal component of many employers' return-to-the-office plans, meaning that adjustments made during the pandemic such as video interviewing and virtual meetings will continue—as will using videoconferencing and online apps to drug test remote new hires.

The increasing adoption of oral-fluid testing allows employers to easily mail drug-testing kits to applicants and either directly observe them taking the tests via video or record them through an app.

"Telehealth has been around for a number of years but is relatively new to drug testing," said Brandon Williams, a senior account manager at OraSure Technologies, an oral-fluid drug-testing company based in Bethlehem, Pa. "Because of the availability of technology like Zoom and Skype, telehealth collections have become more popular. There was a major increase in adoption because of COVID-19."

In a survey conducted by the Current Consulting Group at the end of 2020, 14 percent of drug-testing providers indicated that clients were showing interest in telehealth collections.

"If that question had been asked at the beginning of 2020, prior to the pandemic, most people would not have even been familiar with it," said Bill Current, president and founding partner of the Current Consulting Group in Coral Springs, Fla.

Remote drug testing, or telehealth collections, usually involves the applicant or employee providing an oral-fluid sample from their home. "A telehealth collection is typically performed in an offsite location with the donor also acting as the collector by utilizing a video app to guide them through the collection process," Current said. "This makes it possible to perform a collection where it is most convenient, safe and secure for the donor. It fits well with the new-normal remote-working environment and may also relieve the anxiety some people feel when required to personally go to an occupational health care facility."

Telehealth collections are also easy to perform and cost-effective, he said. "Without leaving home, a job applicant or employee can follow simple step-by-step directions provided with the telehealth collection kit to provide an oral-fluid sample in minutes. The sample is sealed in a vial and, along with the appropriate paperwork, is sealed in a shipping envelope and sent to a specified laboratory. Results are available within 24 to 48 hours."

Oral-fluid testing, approved by the federal Department of Health and Human Services in October 2019, is the key to a successful telehealth collection program, Current said. "Oral fluid and telehealth collections go hand in hand because of the ease of performing an oral-fluid collection and the fact that each collection can be 100-percent observed, whether in-person or remotely."

Williams added that because oral fluid is "virtually impossible to adulterate," it serves well as the main sample type for remote collection. "Hair collection requires a trained professional, and it's obvious why urine is not the best type for video observation," he said.

Telehealth collections are ideal for pre-employment drug testing and work well for random testing of remote workers, Williams said.

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How It Works

Telehealth collection can be done either through a videoconferencing platform like Zoom or via an app. "Using Zoom or another video platform requires someone on the other end of the call to observe the sample collection live," said Kirk Cizerle, CEO of RecoveryTrek, a drug-testing services and technology company based in Norfolk, Va. "Another option is using an app, where the collection is recorded so no live collector is required. Collection recordings are viewed prior to lab testing. The benefit is that there is no need to schedule time with a collector, making it very easy and convenient to take the test."

The collection requires that the job candidate or employee open the app or start the videoconference, swab their mouth with the provided device, seal the specimen shut, place it in the provided package and mail the sample to the testing facility.

"Since collections are 100-percent observed, either live or via recording, it is virtually impossible to manipulate the process and cheat the test," Cizerle said. "It's very difficult to cheat using oral fluid because of the observable nature of the collection and because little or no adulteration products exist for this type of specimen." 

Experts recommended employers update their drug-testing policy on telehealth collections. "Review current policy and collective bargaining agreements prior to implementing remote collection," Cizerle said. "Communicate the new policy to the workforce, informing employees of the change, possibly with a virtual training session so they know what to expect. Be very specific about the when, where and how remote collections will be used."

Legal Considerations

Because telehealth collections are relatively new to workplace drug testing, it will be virtually impossible to find a state law that specifically mentions the practice, Current said. But he advised that organizations check all state and local drug-testing laws, especially in states with mandatory drug-testing laws.

Cizerle added that no state laws currently prohibit telehealth collections, but local statutes could limit how collections are performed or what specimens are used. He added that while these types of tests are not currently approved for employers that undergo federally regulated testing by the U.S. Department of Transportation, that approval is expected soon.


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