What is the difference between point-to-point and hub-and-spoke integration?

Point-to-point integration creates direct connections between pairs of systems — simple for small numbers but unmanageable at scale (n systems require n(n−1)/2 interfaces). Hub-and-spoke uses a central integration engine where each system connects once to the hub, which handles routing and transformation centrally. NHS organisations increasingly adopt hub-and-spoke to reduce complexity, while modern approaches add API gateways and event-driven architectures.