IEEE Technology and Society Magazine - Spring 2013 - 40
delay is expected to be small even
over a low data rate GprS channel. For instance, assume a case
load of 2400 community healthcare transactions per month and
that each transaction takes 50
kilobytes; the data transferred will
be of the order of 2400 # 50 kB =
120 MB or 0.12 GB for one central medical facility. This amount
of data transfer is unlikely to put
any strain on the capacity of the
cellular network, even when the
service scales to include other
medical facilities.
The data service transactions
are essentially machine-to-machine
based, even though managed by
community healthcare workers.
Most machine-to-machine communications are not expected to demand
much customer service support and
maintenance effort from the network
provider once the solution is set up
and tested.
Potential Business Model
The cost structure associated
with the rFID-backed community healthcare outreach scheme
generally has both a capital and
a recurring cost component. The
capital expenses of the system
include the cost of the rFID medical cards, the mobile rFID read/
write devices, equivalent rFID
read/write devices at the central
medical facility, the electronic
medical record system and server,
the cost for training personnel
and the cost of deploying the system. recurring operating cost
include the wages of the community healthcare workers, wide-area
communication costs, and the cost
of supporting and maintaining all
the system components.
The operating or business model
is of vital importance to ensure a
long-term self-sustaining system.
The system needs to generate sufficient revenues in order to cover,
at least, the cost, if not a reasonable profit. To facilitate this, the
healthcare worker will have to collect a fee from the patient for every
40
|
service transaction. The amount
could be similar to the fee that
the patient has to pay if s/he visits
the central medical facility in person. We may also adjust the fee to
include a "convenience premium
for home visit." The convenience
for the patient includes shorter
travel distance to seek medical
help, extended service hours of
medical services, access to urgent
out-of-hour services within his/
her neighborhood, reduced lossof-earnings due to taking time to
travel, avoiding the need for escort
by relatives, and reduced costs of
travel.
As an illustration, we propose
to split the revenue from the transaction fee between the healthcare
worker and the central medical
facility on a revenue-shared basis.
For instance, if the fee paid by
the patient is $A, the community
healthcare worker will take a cut of
$a. The remainder, $r = $A-a will
be the revenue that goes to the central medical facility, see Fig 3. The
medical facility may also provide
a basic retention wage to the community healthcare worker, but the
majority of the income will come
from the transaction fee with the
patient. A revenue sharing model
will encourage the community
healthcare workers to become
more proactive with reaching out
to the remote communities in her/
his neighborhood.
This will also reduce the loading of the central medical facility
by mundane and routine ailments
and enable the concentration of
resources on more serious cases -
the cases that cannot be serviced by
the community healthcare workers.
The part of the patient fee for the
central medical facility is needed
to support the operation of the electronic medical record system and
the mobile rFID system. If the
community healthcare worker is
not able to handle a case, it has to
be referred to the medical facility
for attention. This referral process
can help the medical facility to
become efficient in both handling
specialized cases and managing
inpatient admission.
An alternative operating model
is that the central medical facility
may increase the charge to people
attending the facility in-person as
an outpatient, as the facility is now
supposed to be handling more specialized medical cases. This also
has the effect of driving people with
less critical illnesses to rely on the
community healthcare. With this
operating model, the central facility may subsidize patients in remote
locations to encourage them to use
the local services provided by community healthcare workers. The
increase in charge for outpatients
attending the central facility directly
will have to offset the cross-subsidy
to the remote patients in order to
ensure self-sustainability.
Yet another alternative revenue
model is to fund the system through a
micro-health-insurance scheme [7].
The micro-health-insurance scheme
may be run by the central medical
$a
Community Healthcare
Worker Cut
$A-a
Hospital Cut
$A
Patient Payment
Fig. 3. Revenue sharing model between community healthcare worker and
central medical facility.
IEEE TECHNOLOGY AND SOCIETY MAGAZINE
|
SprING 2013
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