Pathways Community HUB: A Model for Coordination of Community Health Care

Zeigler, Bernard P.; Redding, Sarah; Leath, Brenda A.; Carter, Ernest L.

doi:10.1089/pop.2014.0041

Cited by 23 publications

(26 citation statements)

References 4 publications

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“…This did not require any new resources and brought significant benefits to ED. 15 A further 35% were discharged from the VFC. These patients would incur a cost if they accessed the telephone helpline and this was modelled.…”

Section: Data Collection—simulation Modelsmentioning

confidence: 98%

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Cost comparison of orthopaedic fracture pathways using discrete event simulation in a Glasgow hospital

et al. 2017

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ObjectiveHealthcare faces the continual challenge of improving outcome while aiming to reduce cost. The aim of this study was to determine the micro cost differences of the Glasgow non-operative trauma virtual pathway in comparison to a traditional pathway.DesignDiscrete event simulation was used to model and analyse cost and resource utilisation with an activity-based costing approach. Data for a full comparison before the process change was unavailable so we used a modelling approach, comparing a virtual fracture clinic (VFC) with a simulated traditional fracture clinic (TFC).SettingThe orthopaedic unit VFC pathway pioneered at Glasgow Royal Infirmary has attracted significant attention and interest and is the focus of this cost study.Outcome measuresOur study focused exclusively on patients with non-operative trauma attending emergency department or the minor injuries unit and the subsequent step in the patient pathway. Retrospective studies of patient outcomes as a result of the protocol introductions for specific injuries are presented in association with activity costs from the models.ResultsPatients are satisfied with the new pathway, the information provided and the outcome of their injuries (Evidence Level IV). There was a 65% reduction in the number of first outpatient face-to-face (f2f) attendances in orthopaedics. In the VFC pathway, the resources required per day were significantly lower for all staff groups (p≤0.001). The overall cost per patient of the VFC pathway was £22.84 (95% CI 21.74 to 23.92) per patient compared with £36.81 (95% CI 35.65 to 37.97) for the TFC pathway.ConclusionsOur results give a clearer picture of the cost comparison of the virtual pathway over a wholly traditional f2f clinic system. The use of simulation-based stochastic costings in healthcare economic analysis has been limited to date, but this study provides evidence for adoption of this method as a basis for its application in other healthcare settings.

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Section: Data Collection—simulation Modelsmentioning

confidence: 98%

“…14 More recently, computerised algorithmic forms have been called ‘care coordination pathways’ which support a variety of functions. 15 These would include benchmark treatment steps with an associated cost and are considered in a different way to clinical pathways.…”

Section: Introductionmentioning

confidence: 99%

Cost comparison of orthopaedic fracture pathways using discrete event simulation in a Glasgow hospital

et al. 2017

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“…In this context, coordinated strategies are necessary to ensure that priority risks are addressed, avoid service duplication, and enable comprehensive measures of impact. 9…”

Section: Research Potential and Applicationmentioning

confidence: 99%

Risk Reduction Research Initiative: A National Community–Academic Framework to Improve Health and Social Outcomes

Redding

Hoornbeek

Zeigler³

et al. 2019

Population Health Management

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“…To date, the Pathways Community HUB Model has been implemented in some 16 communities, 2 and standards for certifying Community HUB programs have been developed. 18 However, requirements for data architecture to support the Model have not been developed.…”

Section: Pathways Community Hub Model and Formalizationmentioning

confidence: 99%

“…The HUB Model was recognized by the Agency for Healthcare Research and Quality (AHRQ) Innovations Exchange, and a collaborative learning network of 16 communities was implemented. 1 As detailed in Zeigler et al, 2 the HUB Model creates the infrastructure within a community to organize care coordination services. Pathways are used as a common outcome measurement tool across all care coordination agencies that connect with the HUB.…”

Section: Introductionmentioning

confidence: 99%

Guiding Principles for Data Architecture to Support the Pathways Community HUB Model

Zeigler¹,

Redding²,

Leath

et al. 2016

eGEMs

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Introduction:The Pathways Community HUB Model provides a unique strategy to effectively supplement health care services with social services needed to overcome barriers for those most at risk of poor health outcomes. Pathways are standardized measurement tools used to define and track health and social issues from identification through to a measurable completion point. The HUB use Pathways to coordinate agencies and service providers in the community to eliminate the inefficiencies and duplication that exist among them.Pathways Community HUB Model and Formalization:Experience with the Model has brought out the need for better information technology solutions to support implementation of the Pathways themselves through decision-support tools for care coordinators and other users to track activities and outcomes, and to facilitate reporting. Here we provide a basis for discussing recommendations for such a data infrastructure by developing a conceptual model that formalizes the Pathway concept underlying current implementations.Requirements for Data Architecture to Support the Pathways Community HUB Model:The main contribution is a set of core recommendations as a framework for developing and implementing a data architecture to support implementation of the Pathways Community HUB Model. The objective is to present a tool for communities interested in adopting the Model to learn from and to adapt in their own development and implementation efforts.Problems with Quality of Data Extracted from the CHAP Database:Experience with the Community Health Access Project (CHAP) data base system (the core implementation of the Model) has identified several issues and remedies that have been developed to address these issues. Based on analysis of issues and remedies, we present several key features for a data architecture meeting the just mentioned recommendations.Implementation of Features:Presentation of features is followed by a practical guide to their implementation allowing an organization to consider either tailoring off-the-shelf generic systems to meet the requirements or offerings that are specialized for community-based care coordination.Discussion:Looking to future extensions, we discuss the utility and prospects for an ontology to include care coordination in the Unified Medical Language System (UMLS) of the National Library of Medicine and other existing medical and nursing taxonomies.Conclusions and Recommendations:Pathways structures are an important principle, not only for organizing the care coordination activities, but also for structuring the data stored in electronic form in the conduct of such care. We showed how the proposed architecture encourages design of effective decision support systems for coordinated care and suggested how interested organizations can set about acquiring such systems. Although the presentation focuses on the Pathways Community HUB Model, the principles for data architecture are stated in generic form and are applicable to any health information system for improving care coordinati...

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Pathways Community HUB: A Model for Coordination of Community Health Care

Cited by 23 publications

References 4 publications

Cost comparison of orthopaedic fracture pathways using discrete event simulation in a Glasgow hospital

Cost comparison of orthopaedic fracture pathways using discrete event simulation in a Glasgow hospital

Risk Reduction Research Initiative: A National Community–Academic Framework to Improve Health and Social Outcomes

Guiding Principles for Data Architecture to Support the Pathways Community HUB Model

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