The CALINX Lab standard is based on the Health Level 7 (HL7) message standard for reporting test results. HL7 messages have a hierarchical structure that can represent more complex information than the flat-file records many labs use for retrospective reporting of results. HL7 is a national standard for the electronic transmission of clinical data and many laboratories are already able to generate HL7 messages.
The implementation of this standard is expected to confer the following benefits:
Having a single, statewide standard for batched, retrospective lab reporting will streamline the creation of these reports by clinical laboratories, enabling them to provide these data in a timely manner to more provider organizations and health plans. A single standard will also facilitate the integration and analysis of lab-result data by provider organizations and health plans that receive these data.
The standard explicitly specifies that laboratory tests used in the calculation of Pay-for-Performance and HEDIS measures must be coded using the standard LOINC coding system for lab tests. LOINC is used by NCQA and IHA to specify laboratory test related to clinical measures such as diabetes. Standardizing both the coding of these tests and the representation of their results will facilitate data analysis.
To support and facilitate adoption of the standard, data import software and a data standards toolkit are available free of charge. The software is designed to help organizations leverage the CALINX Lab data standard and allows data analysts to convert files containing hierarchical CALINX messages to flat files that can be loaded directly into relational databases and data warehouses. The toolkit serves as a user guide for provider organizations receiving lab data from contracted labs and other organizations, and includes a comprehensive set of instructions for lab data recipients to help them understand the basic structures of HL7 messages and LOINC codes, uses of lab results data, and how the lab software tool will convert messages.
“To drive major improvements, performance-based payments must exceed 10% of total provider income. Incentives of this magnitude can only be mobilized if they originate in payer savings.”
