Guiding Principles for Data Architecture to Support the Pathways Community HUB
Model
Authors: Zeigler Bernard P. , Redding Sarah , Leath Brenda A. , Carter Ernest L. , Russell Cynthia 
Published: January 2016

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 coordination services and population health.