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Technology is developed to benefit society. One of the applications of technology in the healthcare sector is telehealth monitoring system. The system proposes a new way of communication between the doctor and the patient, even in a very remote location. In this paper, we elaborate the progress and challenges regarding the development of Tele-ECG in Indonesia, which includes data acquisition, feature extraction, data compression, classification algorithm, mobile and web development system and small device implementation on an FPGA board. The classification is conducted by using LVQ, GLVQ, FNLVQ, FNLVQ-PSO, FNGLVQ, and AM-GLVQ. The compression is conducted by using SPIHT algorithm. Tele-ECG can assist in monitoring heartbeat anomalies and reduce the risk of heart attack. It could also be a solution for infrastructure discrepancy in healthcare.