In India, where travelling long distances to avail of medical facilities can be prohibitively expensive and logistically difficult, patients can approach the ?spokes? to receive routine care and medication and travel to the ?hub? only during critical situations.

In India, the rate of cancer incidence is increasing at an annualised rate of 6.8 percent. According to the Federation of Indian Chambers of Commerce & Industry (FICCI), approximately 1.9-2 million cases are officially estimated in India in 2022. However, the actual incidence is estimated to be 1.5-3 times higher than the reported figures. India's oncology market is projected to grow by 11-12 percent, reaching Rs 26,300 crore by 2024. However, there is a significant demand-supply gap, with only 55-60 percent of the population being served by the existing 470-485 comprehensive cancer care centres.

Cancer not only affects one's well-being but also bears a significant impact on their financial situation, potentially jeopardizing the entire family's future. Nearly half of all families with cancer patients (45 percent) face overwhelming financial burdens due to treatment expenses, and a quarter of them (25 percent) are pushed below the poverty line. The cost of treatment in India is nearly double the average annual income, imposing a severe economic burden on individuals and families.

One promising method that can help address this gap is the hub-and-spoke model. This model involves setting up a network of primary and secondary healthcare facilities to provide services at all locations and refer patients requiring intensive treatment to the central hub facility. In a country like India, where healthcare infrastructure and resources are limited in rural communities, this model can help bridge the healthcare divide.

Enhancing cancer care: The patient-centric hub-and-spoke model

The hub and spoke model for cancer care is a patient-centric approach that provides comprehensive and accessible healthcare services. In this model, a specialized cancer center acts as the central ?hub? with advanced diagnostic and treatment facilities and a multidisciplinary team of specialists. This is supported by ?spoke? centers, where patients can avail of routine check-ups, follow-ups, treatments of repetitive nature and supportive care. In India, where travelling long distances to avail of medical facilities can be prohibitively expensive and logistically difficult, patients can approach the ?spokes? to receive routine care and medication and travel to the ?hub? only during critical situations. This patient-focused model provides convenient access to comprehensive cancer services, personalized treatment plans, and emotional support, improving the overall quality of care.

Centralizing the most capital-intensive services in one hub can reduce the cost of care

Rural areas pose multiple challenges for both healthcare professionals and patients, such as suboptimal care, availability of limited facilities, low awareness, and affordability issues. Approximately 70 percent of rural Indians use up a significant portion of their income for basic necessities such as food and shelter, leaving little for healthcare. Limited transportation and inadequate infrastructure in rural India hinder access to medical facilities, necessitating burdensome travel to urban areas for treatment. The lack of proper healthcare infrastructure further exacerbates their challenges, compelling them to seek medical assistance in urban centers. Unlike many other treatments, cancer treatment is not episodal and can go on for months. Cost of travel, accommodation, loss of income can easily exceed significantly than actual hospitalization expenses.

The hub-and-spoke model has emerged as a transformative solution, bringing specialized cancer care closer to remote regions. By establishing spokes in rural areas, this model ensures that specialized cancer care facilities and expertise are extended beyond urban centers and major cities, providing patients with comprehensive care closer to their homes and reducing travel and associated costs. As a result, healthcare services have become more affordable and easily accessible to individuals in rural communities, effectively bridging the healthcare gap and enhancing the overall healthcare environment.

Decentralization through the hub-and-spoke model and virtual care improves care availability

One of the key benefits of this model is its ability to enhance the diagnosis and treatment of cancer in rural areas. Spoke clinics equipped with advanced imaging technologies will enable early detection of cancerous growths. These clinics can then transmit the imaging data to the hub, where specialized oncologists can remotely analyze and provide timely diagnosis.

Once a diagnosis is made, the hub-and-spoke model allows for efficient treatment planning and coordination. Treatment protocols and recommendations can be discussed through teleconferencing, ensuring patients receive the most appropriate and personalized care. This collaborative approach reduces the need for patients to travel long distances for consultations, minimizing the physical and financial burdens associated with seeking timely cancer care.

Also, collaboration and knowledge exchange among healthcare professionals is enhanced through telemedicine and teleconsultation services, enabling remote diagnosis, treatment planning, and ongoing support. Furthermore, the model enables the development of specialized treatment protocols tailored to the specific needs and challenges of rural populations, optimizing cancer care outcomes and improving the patient experience. Through telemedicine, oncologists, radiologists, pathologists, and other specialists can collaborate on treatment plans, enhancing the quality of care provided to rural patients. This multidisciplinary approach fosters continuity of care which is vital for improving patient outcomes.

Future prospects of the hub-and-spoke model in rural cancer treatment

The implementation of the hub-and-spoke model holds promise for the future of cancer care in rural India. It is expected to bring significant advancements and improvements to the accessibility and quality of cancer treatment in underserved regions. By establishing spokes in rural areas, this model ensures that specialized cancer care facilities and expertise are extended beyond urban centres and major cities, providing comprehensive care closer to patients' homes and reducing travel costs. The model also facilitates the integration of innovative technologies and advanced treatment options in rural areas by effectively sharing resources and facilities from centralized hubs.

As this model continues to evolve and gain traction, healthcare policymakers and stakeholders must invest in infrastructure development, including the expansion of telecommunication networks and training programs for healthcare professionals in rural areas. By doing so, the hub-and-spoke model can attain its full potential, ensuring that quality healthcare services are made accessible to individuals living in remote and underserved areas. None of this is possible unless all stakeholders including providers, payors, regulators and accreditors change their mindsets and start accepting patient journeys that are not confined to a single location or only to physical spaces. Future belongs to players who provide long-term seamless patient journey through physical and digital omnichannel healthcare systems.