Telemedicine to Expand Access to Critical Care Around the World.

This multiauthored communication gives a state-of-the-art global perspective on the increasing adoption of tele-critical care. Exponentially increasing sophistication in the deployment of Computers, Information, and Communication Technology has ensured extending the reach of limited intensivists virtually and reaching the unreached. Natural disasters, COVID-19 pandemic, and wars have made tele-intensive care a reality. Concerns and regulatory issues are being sorted out, cross-border cost-effective tele-critical care is steadily increasing Components to set up a tele-intensive care unit, and overcoming barriers is discussed. Importance of developing best practice guidelines and retraining is emphasized.

Proceedings of the 16th International Conference of Telemedicine Society of India (TSI)

According to Telemedicine Guidelines 2020 – Govt of India, ‘it is doctor’s responsibilities to ensuring data privacy, ethics, and maintaining records of all the patients whose records are being collected during medical examination’. (3.7.1.2) The Registered Medical Practitioner would be required to fully abide by Indian Medical Council (Professional conduct, Etiquette, and Ethics) Regulations, 2002 and with the relevant provisions of the IT Act, Data protection and privacy laws or any applicable rules notified from time to time for protecting patient privacy and confidentiality and regarding the handling and transfer of such patient’s personal information. [...]it is essential that doctors and medical staff must be aware of simple security steps that can not only prevent a data breach but also prove ‘due diligence’ in case of such breaches. Following recommendations were given: (1) mandatory refresher course for all RMPs/nursing/record staff on an annual basis, (2) 10-min quiz and certification (may help in due-diligence claim too), (3) information security policy and audit of compliance for all clinical establishments, and (4) monthly awareness note on breach incidents of medical sector. 02.2 Telemedicine and its role in leveraging health care economy Moderator: Vimal Wakhlu -Past President, TSI Anoop Wadhawan Department of Commerce, Government of India Telemedicine has played a significant role in the Healthcare domain in 2020, when the world was battling the COVID-19 challenge.

Good Death in Neurological Practice.

BACKGROUND: Clinicians in neurological practice, particularly surgeons, encounter more deaths than most other specialists. OBJECTIVE: This communication reviews the literature on "good death" and extrapolates the observations and inferences to neurological practice. Changes in approaches to "good death" in the COVID-19 era (coronavirus disease 2019) are also discussed. MATERIALS AND METHODS: The author, over a 40-year period, has come across 2,500 deaths in a government, trust, and corporate hospital in Chennai, India. Retrospectively, the author questions if, in spite of his conservatism and obsession with quality of life, he should have taken proactive measures to also ensure a good quality of death. RESULTS AND CONCLUSION: In the background of the lessons learned in a metro, across various socioeconomic groups and with varied access to technology, the author concludes that ensuring "good death" should also fall within the domain of neurologic practice.

eNeuroIntensive Care in India: The Need of the Hour.

BACKGROUND: As ICU consultants in smaller hospitals may not be familiar with neurocritical care and with current travel restrictions due to the COVID-19 pandemic, one needs to relook at how neurocritical care can be provided. OBJECTIVE: This article reviews the authors' experience of providing remote neurointensive care, from a non-specialist ICU over a 16-month period. MATERIAL AND METHODS: 61 neuro consultations were provided for 56 patients admitted in remote ICU's, including five repeat consultations. Most teleconsultations were from three rural hospitals. The central command center has monitored remote patients with neurological conditions, in 23 ICUs. RESULTS AND CONCLUSIONS: Providing real-time virtual neuro intensive advice to ICU's in smaller cities even without dedicated neuro-intensive units is feasible in India. eNeuroIntensive care is particularly necessary in the current "New Normal" era.

Telemedicine and Neurological Practice in the COVID-19 Era.

BACKGROUND: The COVID-19 pandemic has within months turned the world upside down. With personal distancing and shortage of personal protective equipment, face-to-face health care encounters are increasingly becoming problematic. Neurological manifestations are also being observed in clinical presentations. OBJECTIVE: Worldwide most countries, the World Health Organization (WHO) and Centre for Disease Control (USA) have recommended use of Telemedicine during the current pandemic.With acute shortage of neurologists and neurosurgeons and their lopsided distribution, it becomes more difficult to provide neurological care to those who need it the most, particularly with travel restrictions. The author has since 2002 been advocating use of Telemedicine in Neurosciences. MATERIALS AND METHODS: This article reviews the increasing deployment of Telemedicine in neurological practice in the last few years, particularly the radical exponential use in the last few months due to COVID-19. CONCLUSIONS: With possible reduction in face-to-face consultations, remote evaluation may become mainstream. Webinars will play an increasing role. CME's and resident training will become more and more digital. The world will never be the same again. It is imperative that we accept and start deploying the "New Normal".