Rural E-Health Infrastructure Development - E-Healthcare Systems and Wireless Communications - page 205

9. IMPLEMENTATION FEASIBILITY 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,
as depicted in Figure 9. The medical facility may
also provide a basic retention wage to the com-
munity healthcare worker but the majority of the
income will come from the transaction fee with
the patient. A revenue sharing model will help to
encourage the community healthcare workers to
become more proactive with reaching out to the
remote communities in his/her neighborhood or
neighboring villages.
In addition, this will also reduce the loading
of the central medical facility by mundane and
routine ailments and enables the concentration of
resources to 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 also help the medical facility
to become efficient in handling specialized cases
and managing in-patient admission.
An alternative operating model is that the
central medical facility may increase the charge to
people attending the facility in-person as out-pa-
tient, as the facility is now supposed to be handling

The cost structure associated with the RFID-
backed community healthcare out-reach scheme
has both a capital and a recurring cost component.
The capital expenses of the system include the
cost of the RFID tags, 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 the
relevant personnel as well as the cost of deploying
the system. Recurring operating cost may include
the wages of the community healthcare workers,
wide-area communication cost, and the cost of
supporting and maintaining all the systems.
The operating or business model is of vital im-
portance to ensure the long-term self-sustainability
of the system. In other words, the system needs to
generate sufficient revenues in order to cover, at
least, the cost, if not for-profit. To facilitate this,
the healthcare worker will have to collect a fee
from the patient for every 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 can be attributed to
the reduced need of traveling over long distances,
extended service hours, or access to urgent out-
of-hour services within his/her neighborhood, etc.
It is proposed that the revenue from the transac-
tion fee to be split between the healthcare worker

Figure 9. Revenue sharing model between community healthcare worker and central medical facility