Tele-intensive care unit networks: A viable means for augmenting critical care capacity in India for the COVID pandemic and beyond

The COVID-19 pandemic has enormously stressed global healthcare systems compelling new approaches to care, especially by leveraging telehealth. In India, the timely release of the Telemedicine Practice Guidelines by the Government has enabled health providers to deliver essential medical evaluation, diagnosis, and triage remotely. Patients with COVID-19 present with a range of symptoms, and some need intensive care. The management of critically ill patients is resource-intensive and requires partnership between humans and machines. Monitoring vital physiology is key to effective critical care. In many countries, including India, the distribution of intensivists is skewed and tends to be predominantly based in urban tertiary care hospitals. Hospitals without on-site intensivists may benefit from tele-intensive care unit (ICU) services wherein electronic systems connect ICU patient data with intensivists at remote locations as part of a collaborative network. The tele-intensivists provide real-time data and audiovisual monitoring, diagnostic, and intervention services and work together with bedside teams bridging the critical care gap. This article is a practical guide for the logistics of telemedicine-based critical care in India for patients with COVID-19 and other conditions. In addition, this paper also suggests methods to expedite care. Information is provided for immediate use by physicians who have not practiced telemedicine in the ICU. As the number of patients affected increases around India rapid deployment of tele-ICU services will be essential to save lives. Caregiver stress can be minimized by remote care providers who can assist at any time.