Shared features of successful tele-ICU models–A narrative review of successful implementation with a focus on LMIC models

The COVID-19 pandemic exposed multiple pre-existing frailties in healthcare systems including the shortage of critical care services and equipment in Low- and Middle-Income Countries (LMICs). The training of a critical care doctor is expensive and time intensive. Novel, low-cost solutions that optimize existing resources and enable the limited number of specialists to deliver care to more people are needed. Telemedicine can sustainably bridge the gaps in critical care services in LMICs. There are limited data on the use of telemedicine for critical care in LMICs. In this paper, we review the few well documented tele-ICU models, with a focus on a novel model in India, and highlight several key attributes including timely implementation, practical on the ground training, financial feasibility, adaptability to the local context, scalability, and quality data collection.