Toxicology

The Toxicology area is where drug-screen panels are reviewed and released. A screen produces a raw positive or negative per analyte; a Medical Review Officer (MRO) reads the panel against what was expected, decides each analyte, and then verifies, disputes, or releases the whole panel. Toxicology sits inside the laboratory workflow — the specimens are collected and tested as ordinary lab work, and the panel arrives here for the clinical review step.

Who uses it

• Medical Review Officers do the review: they open a panel, set a determination per analyte, add a note, and verify, dispute, or release it. They also maintain the cutoff library and the reflex rules.
• Other laboratory users can open the queue and read a panel, but the review and configuration actions are gated to the MRO role.

Note

Toxicology review is a clinical judgement, not a bench entry. The screen values come up from the laboratory; the MRO’s job here is to interpret them — confirm an expected positive, dispute an unexpected one, and release the reviewed result.

Editions

The Toxicology area is part of the Labs entitlement, so it is available in the same editions as Laboratory — Health Centre, Hospital, Network, and Public Health.

Screens

Screen	Role	What it is for
MRO Review	Medical Review Officer	The review queue: open a panel, set each analyte’s determination, and verify, dispute or release it.
Cutoff Library	Medical Review Officer	The per-tenant screen and confirm cutoffs and the screen-to-confirm reflex rules that drive interpretation.

Review a drug screen (MRO)

1. Open MRO Review. The page is titled Toxicology MRO Review — “Review drug-screen panels: per-analyte determination, verify / dispute / release, and the specimen chain of custody.” The readouts across the top count panels Awaiting Review, Resulted, Verified, and Disputed, and the chip row filters the list by review stage (Resulted, MRO Review, Verified, Disputed, Released).

2. Each row shows the panel, its number of analytes (and how many were detected), the overall Consistency, the Expected Source, the Review Stage, and the MRO Status. Press Review to open the panel.

3. In Review Drug-Screen Panel, a banner states the overall consistency and which agents were expected. The Analytes table lists, per analyte, whether it was expected, the Screen result, the Cutoff, its Consistency, the confirmatory result, and a Determination you set. If the panel is still waiting to be picked up, press Begin Review first.

4. Set a Determination on every analyte — Verified Positive, Verified Negative, Disputed, or Cancelled. You cannot verify or dispute the panel until every analyte has a determination. Add an optional MRO Note to record your rationale.

5. Press Verify to confirm the panel or Dispute to flag it. Once a panel is verified or disputed, press Release to release the reviewed result.

Note

Every review keeps a chain of custody for the specimen. The panel drawer shows the append-only ledger of custody events (collected, sealed, received, transferred, opened, aliquoted, tested, stored, disposed), each with the releasing and receiving party and who recorded it. Add an event with Record Custody Event.

Cutoff library and reflex rules

Cutoff Library holds the per-tenant configuration that drives interpretation. The page is titled Toxicology Cutoff Library and has two tabs, Cutoffs and Reflex Rules.

• Cutoffs are the presumptive (screen) and confirmatory thresholds per analyte. Press Add Cutoff and give the analyte, an optional panel (blank applies to all panels), the Screen Cutoff, an optional Confirm Cutoff, the units, and an optional method; a switch marks it Active. Only active cutoffs are applied during interpretation. Edit or delete a cutoff from its row.

• Reflex Rules say that a screen positive crossing a threshold requires a confirmatory test. Press Add Reflex Rule and set the If Analyte, an optional panel, a Comparator (at or above, or above), the Threshold, and the Confirm Test to reflex to; a switch marks it Active. Only active rules fire during interpretation.