A hub and spoke model is a system or network architecture in which a central hub is connected to multiple peripheral spokes. The central hub acts as a central point of control, coordination, and distribution. The spokes are connected to the hub and rely on it for their connectivity and communication with each other. The spokes generally do not have direct connections or communication channels with each other.

In the context of, a hub and spoke model refers to a system where a central hub pathology lab is connected to multiple peripheral spoke labs or collection centers.

Today, this model is popularly used in healthcare systems like pathology labs to efficiently manage and process pathology samples. The model has one central hub pathology lab equipped with advanced infrastructure, technology, and expertise to handle complex pathology tests and diagnoses connected with peripheral spoke labs. These spoke labs are often referred to as collection centers and are typically located in different regions or healthcare facilities, closer to patients or healthcare providers.

Key characteristics of a hub and spoke model include:

Sample Collection: The collection centers are responsible for sample collections from patient locations. The sample collection procedures are followed by the SOPs. The collection person is equipped with the necessary equipment and training referred to as the runner boy.

Sample Transportation: The collected samples are stored in temperature-controlled containers to maintain sample integrity during transit and samples are transported from the peripheral spoke labs to the central hub pathology lab for processing and analysis.

Centralized Processing: The received samples are tested in the centralized processing lab. The lab is featured with capabilities of a wide range of tests. The necessary equipment, trained pathologists, and technicians to process and interpret the samples accurately.

Expert Moderation: Each spoke is monitored by experts providing consultations and support to the peripheral labs and healthcare providers. The centralized lab acts as a center of expertise, where experts review and interpret complex cases, provide guidance, and collaborate with the spoke labs to ensure accurate diagnoses and treatment recommendations.

Result Reporting: Each sample is associated with unique codes that help in identifying patient information at each step. And after the test and analysis of those samples, the results are communicated back to the referring healthcare providers or spoke labs.

The government of Madhya Pradesh in its mission to provide quality diagnostic services equitably to its population in urban and rural areas introduced the Hub & Spoke model. Under the model, 324 CHCs and equivalent centers were designated to function as ‘Hub Labs’ and have been fitted with a hi-tech, self-sufficient labs and close to 1600 PHCs were designated to function as ‘Spoke Center’s or sample collection points. The model enabled the government to make diagnostic services accessible to all citizens within an average distance of 10 kms from their homes. Thus, patient treatment and disease diagnoses have been made within reach of all sections of the society.

To operate the project NHM, MP floated a tender and after the due process awarded the mandate to a private company – Science House Medicals Pvt. Ltd., which functions as the service provider for integrated laboratory network.

The challenge we solved through the hub and spoke model:

We addressed several challenges associated with pathology labs. Here are some ways in which this model can be beneficial:

Specialized Services in Remote Areas

It is the biggest challenge for healthcare providers to diagnose people in remote areas. In fact, many medical failures occur due to a lack of immediate reports. The hub and spoke model allows peripheral labs and healthcare facilities to access specialized pathology services that may not be available locally. The central hub is featured with advanced testing capabilities, specialized equipment, and experienced pathologists. Therefore, patients in remote areas have access to accurate and comprehensive diagnostic services.

Better Utilization of Resources

The centralized hub is featured with high-end equipment, advanced technologies, and highly trained personnel, which might not be feasible for each spoke lab. By centralizing such resources and expertise at the hub pathology lab, the model allows for efficient resource utilization. This ensures optimal utilization of resources, cost-effectiveness, and standardized quality across the network.

Quality Control and Standardization:

It is very convenient to implement standardized processes and quality control measures throughout the hub and spoke model. This is controlled through the central hub. It defines every patient going through the best and standard testing process. Also, it ensures consistency and reliability in test results, leading to improved accuracy and patient care.

Collaboration and Consultation:

The central lab can provide expertise and guidance to the peripheral labs and healthcare providers. All the spokes and runner boys are continuously monitored and in touch with the centralized lab. The main benefit of the model is that complex cases can be reviewed by multiple experts, fostering knowledge sharing and ensuring accurate diagnoses. The collaborative approach improves the quality of pathology services and patient experience.

Efficient Workflow and Turnaround Time:

The ease of connectivity and less complexity is the key factor of the hub and spoke model. From collecting samples to delivering test results the turnaround time for pathology results becomes very low with more accuracy. The spokes are more focused on sample collection and transportation while specialized tests are performed in the central labs. Therefore, the diagnostic process accelerates ensuring timely results and prompt patient management.

Scalability and Flexibility:

The model is highly scalable as the network expands, and new spokes can be easily integrated. Thus, it is very to increase demographics and increased access to pathology services. Moreover, the central hub lab is adaptable to changing demands, allocation of resources effectively, and emerging healthcare needs.

Leveraging States:

The economically and socially weaker sections of the society, people living in remote rural areas, urban poor stand to benefit the most. Now they do not need to travel long distances or spend long hours or even days to get diagnostic services. High quality service is now available closer home and free of cost.

This results improved health outcomes for patients as early access to right diagnosis enables timely intervention. Additionally the burden of NCDs can be controlled. Further, population level screening through health profiles can also be done to meet government goals. It also enables real-time end-to-end access to information and data to stakeholders at all levels, which helps obtain rich insights in health indicators of the population at large, and also helps in critical data reporting.

Operational efficiency has been brought in as minimal manual intervention implies error free management and improved TAT with high level of automation. Logistics management is done centrally through software ensures optimum resource planning. Project monitoring is being done centrally, thus any outliers, incidents or issues are reported centrally and resolved expeditiously.