Use of home telemedicine for critical illness rehabilitation: an Indian success story.

Unnikrishnan et al. Present a case report of a 26 year old male with Duchenne Muscular Dystrophy who benefited from the use of Telemedicine in the setting post-ICU rehabilitation. The Who defines Telemedicine as follows: “the delivery of healthcare services, where distance is a critical factor, by all healthcare professionals using information and communication technologies for the exchange of valid information for diagnosis, treatment and prevention of disease and injuries, research and evaluation, and for the continuing education of healthcare providers, all in the interests of advancing the health of individuals and their communities.”

India initiated the National Health Stack (NHS) project whereby one of the aims is to develop the telemedicine aspect of the heal care system. “The National Health Analytics Framework will initially focus on Health Insurance, it will provide for “horizontal expansibility” national health infrastructure such as telemedicine, teleradiology, and the enhancement of process controls.” Investing in such technology will enable more for a more adequate distribution of care to rural regions though the problem raised by Unnikrishnan et al. “internet penetration in various areas of India is suboptimal for high quality audio–video transmission.” is one that must be addressed. Barriers to the delivery of care include acquisition and installation of adequate equipment, once this will be managed transmission of care through outsourcing health professionals in settings where certain specialists are lacking underlines the true benefit, specifically in long term rehabilitations such as the one presented in this case report where a patient was managed for five weeks by a team of critical care specialists. Due to the scarcity of rehabilitation facilities in low middle income countries patients in such geographical areas could benefit from the reduced costs, distance, better long term follow up that tele medicine could provide. This article sheds light on a the ability to elegantly care for a complicated patient outside a medical setting with a multidisciplinary  team managing health variable at a distance. Such cases bring encouraging prospects to the way in which technology will penetrate and benefit the households of patients in low and middle income countries.


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 Unnikrishnan D, Raman D, Joshi D, et al. BMJ Case Rep 2019;12:e227779. doi:10.1136/bcr-2018- 227779