Telecardiology is envisaged to bring remote and economically disadvantaged communities into the ambit of cardiac care, and thus as a key to making such care universal. However, a conventional telecardiology system, acquiring user electrocardiogram (ECG) data and transmitting that to a diagnostic facility, is not designed to operate under possible infrastructural and affordability constraints. Specifically, remote rural localities often lack access to grid power supply and have rickety communication links. To serve remote communities, it becomes imperative to develop a telecardiology system that can operate when available infrastructure is limited. Against this backdrop, we propose a two-tier telecardiology system that functions under practical resource constraints. Indeed, we envision a system that functions even under the severest conditions, potentially making such system universal. At the same time, a smaller subset of patients, generally post-operative, require continuous monitoring. This using conventional telecardiology would incur high bandwidth cost and require the physician to devote large amount of time and effort to process the entire record in order to make a diagnosis. In this context, to realize an affordable home-based continuous monitoring service suitable for the economically disadvantaged, we plan to detect anomalous beats and communicate a compressed version of only those beats, thereby reducing the operating cost as well as the physician's time and effort. To this end, we propose a dictionary-based technique that simultaneously achieves the desired classification and compression goals. Thus, by suitably enhancing the telecardiology system, we take a step towards not only extending basic cardiac care to everyone, but also serving the need of continuous monitoring of poor post-operative subjects. © 2019 IEEE.