In developing countries, especially where a large proportion of the population still resides in rural areas, healthcare access and delivery are often poor, and can potentially benefit from innovative service models and supporting technologies. In these rural areas, the challenges of healthcare quality are many, ranging from poor infrastructure, low literacy, poverty, to inadequate monitoring of patients with chronic or serious diseases. The myriad of challenges requires innovative solutions that are affordable, robust and sustainable overtime. Furthermore, due to special characteristics of such rural areas and their inhabitants, any healthcare solution should embed a decision support mechanism to prevent basic medical errors and negligence. In this article, we first discuss a healthcare delivery model (home-based healthcare) in displaced rural areas of South Africa, and then we propose a patient monitoring system for supporting the model using Unstructured Supplementary Service Data (USSD) technology. The proposed system is decision support driven in that it supports medical staff (nurses, doctors) to decide on the course of intervention or further treatment based on the vital signs of the patients that are tele-monitored on a regular basis. This patient monitoring system facilitates patient information flow from home-based care workers to a local clinic or hospital, where the information is presented on a desktop computer used by clinic nurses and doctors for monitoring the patients' health and ultimately speeding up decision making. The proposed system is tested through a prototype, which is applied in practice and generates data for evaluation. (C) 2013 Elsevier B.V. All rights reserved.
