Telemedicine is the best approach to provide health services to the people of communities having least access to healthcare services which fits best for countries like Nepal. Even in the generation where modern health technologies are making sophisticated treatments possible, our country has been facing lack of basic healthcare services available in most of the remote villages. We have collaborated with Telecare Nepal to provide telemedicine service in Nepal which has been initiated from a small community in Dadeldhura. Telecare Nepal provides basic telemedicine service from the service center established in Dadeldhura where all the important and baic vital signs of a visiting patients are measured by a Nurse who works in the center. Some of the health vital data are generated by the IoT medical devices developed by Electronic Lab Nepal. The data and every information of the patient gets added into the server which will be accessed by the Doctor in Kathmandu who visits the center to provide qualitative telemedicine service. Telecare Nepal has been practicing Telemedicine Service as per the guidelines set by the Nepal Medical Council and has also informed the Ministry of Health and Population about the practice being carried out in Dadeldhura. Electronic Lab Nepal makes sure all the technical devices and software are in proper shape for the communication between doctor and patient whenever required. The word telemedicine simply describes the process of providing medical services from distance as the word tele refers to remote and medicine refers to healthcare service. From the very early 1900’s the practice of transferring health data began in the form of the first known experience of telemedicine. The first practice of telemedicine was found in Europe and was done by a Dutch Physician with the transmission of electrocardiogram over a long distance. Different information sources gathered information suggests that the telemedicine practice officially was initiated in cardiology as professional clinical application. The information was delivered by radio consultation via different centers in european countries including Norway, France and Italy. In the context of Nepal, telemedicine has been limited to a simplified version of telephone conversation where a patient informs the problem to the service center. Nepal is a country where the reach of healthcare services has not been strong and in the rural areas of the country the situation is even worse not only because doctors do not want to go and provide the healthcare services but also because of the absence of small pharmacies. People living in the remote areas of the country are forced to visit the district hospital, not present in every location, for simple checkup and even face the lack of proper medical equipment which results in absence of basic healthcare services. Those who can afford to cities like Kathmandu travel to get proper healthcare services spending ten times as much as the services would have been available locally. However, the majority of people in remote locations of Nepal cannot afford to travel to Kathmandu even in the worst case scenario and leave the hope of living a better life in the age of modernisation where technology can connect the world physically and virtually. With some research and identification of the need of providing proper healthcare services in rural regions of Nepal, a team was formed in August 2020, named as Telecare Nepal focused and determined to open up telemedicine service centers in different remote locations of the country. The team decided to initiate the service from Dadeldhura as the district itself is remote in terms of infrastructural development and people living in that community have limited access to only one district hospital. The team also informed the Ministry of Health and Population about the initiation of telemedicine in Dadeldhura and the ministry recommended to work in collaboration with Dadeldhura hospital to provide better services to the community. Every plan and strategy that Telecare Nepal intends to provide has been informed to the ministry and the plans were appreciated by the ministry. Before presenting the plans to the ministry, the team went through the guidelines of Telemedicine set by the Nepal Medical Council and every plan that Telecare Nepal carries at present falls under the guidelines and the team has been following that very strictly. At present, Telecare Nepal has a service center in Dadeldhura where the team is accompanied by a Nurse, a Pharmacist and an Assistant. It also has an office in Kathmandu where the doctor visits twice a week for normal telemedicine consultation and also depending upon the need of the service center. For the moment, every communication that is carried out between patient and doctor is done via a well secured telemedicine application, some developed in Nepal and some abroad. The medical devices that are currently available in the Dadeldhura service center helps in generating vital signs of a patient in visit which gets stored in the cloud during the time of appointment addition which makes the entire consultation process a step faster because the doctor will not have to wait until the vitals are generated. The process is carried out at least an hour before the visit of the doctor in the Kathmandu office which will be made available to the doctor through the software that the team has developed. Every vital sign generated in the Dadeldhura service center appears in the software immediately which makes it easier to present to the doctor and also becomes very helpful in history keeping. Telecare Nepal at Dadeldhura service center is capable of generating following vital signs as of today: Blood Glucose Level Pulse Rate Blood Oxygen Level Body Temperature Body Weight Blood Pressure IoT based ECG Right after the above mentioned vital signs are generated and stored in the cloud, the team listens to the complaints and those are also stored in the cloud right after that which makes the tracking of patients possible in a very reliable manner. The doctor can view in real time the number of patients who have taken appointments in the service center and then inform the Kathmandu office about the possible time of the visit to the office. The Kathmandu office then communicates with the Dadeldhura service center informing about the time and date of the doctor’s visit which will then be notified to the patients accordingly. During the visit of the doctor in Kathmandu office, the communication between patient and doctor takes place in presence of the Nurse and the Pharmacist at Dadeldhura service center. The video conferencing for the telemedicine consultation takes place with a very highly secured software platform developed under the HIPAA compliance set for securing health data. HIPAA is Health Insurance Portability and Accountability Act that is defined to protect the health data, emergency health records, etc. Telecare Nepal currently uses the software Clocktree developed under HIPAA compliance to carry out the video conferencing between doctor and patients. Doctor interacts with every patient for about ten minutes and prescribes the treatment which at the same time gets added to software with the nurse and pharmacist taking care of what the doctor is addressing. The doctor then makes an official signature in the prescription that has been made during the consultation which immediately gets sent to the Dadeldhura service center and the pharmacist looks after it to deliver the medicine. The doctor at the time of consulting can also refer a patient to the Dadeldhura hospital if needed as Telecare Nepal was given access to work in collaboration with the district hospital. So far Telecare Nepal has provided consultation services to more than sixty patients who have visited the Dadeldhura service center since the 1st of October, 2020. The team has also started receiving the feedback from the patients who took medicine as prescribed by the doctor during the telemedicine consultation and they have reported that service provided was able to heal their problem. They also stated that “addition of a clinical laboratory” would benefit the entire community in near future, which also comes under the future enhancement of the entire team of Telecare Nepal. The addition of following medical devices are under the key priorities of Dadeldhura service center: 1. X-Ray Machine 2. Biochemistry Machine 3. Urine Analyser 4. Chemistry Machine The service center would be able to serve even at a high ratio to the community of Dadeldhura once it gets added up with the above machine which would uplift the healthcare service in the entire community. The practice of telemedicine service has to be more intense during this kind of pandemic and it is also one of the reasons behind the startup of such service in Dadeldhura of Nepal. Apart from pandemic, Nepal is a country that can benefit from this feature of technology which allows to provide high grade healthcare services without having a patient to visit physically to doctors as traveling to different locations is also not very feasible due to various factors. Furthermore, the team has also set a plan to educate the community of Dadeldhura to make it tech-friendly so that in near future the people will not have to visit the service center for basic healthcare services which they do because they do not have knowledge about smartphones or a computer nor any other digital devices. With the campaigns related to encouraging tech-friendly community, telemedicine can even groom from every household in the community making the entire district of Dadeldhura an example towards making things possible with technology for the betterment of their basic health. Also, for this to happen the government of Nepal needs to encourage the reach of the internet in every part of Dadeldhura or any other rural regions of Nepal as at present Telecare Nepal has been utilizing wireless internet very luckily at high amount which cannot be realized for everyone in that particular community.