Fitness-for-duty screening exists to produce a decision at sign-on: this person starts the shift, or they do not. A device that produces a number and no defensible record produces an argument instead.
The important distinction is stated first, because getting it wrong is expensive. A screening instrument is not an evidential one. Screening devices indicate; evidential instruments are subject to a separate approval regime and are used where a result may be relied on in a legal proceeding. Specifying one and expecting the other is the most common error in this category.
Beyond that, the difficulty is drift and circumvention. Electrochemical sensors age and require scheduled recalibration, so a fleet of devices needs a calibration state that is tracked centrally rather than assumed. And any device where the result affects whether someone works will be tested by the people it tests.