Telemedicine has emerged as a promising approach to manage chronic illnesses in urban slum populations, particularly addressing geographical and socioeconomic barriers. A mixed-methods approach combining quantitative surveys and qualitative interviews was employed to assess the effectiveness of telemedicine services over a one-year period. Patient engagement scores averaged at 85% within the first six months, with significant improvements observed in treatment adherence rates from baseline (60%) to post-intervention (72%). Telemedicine significantly enhanced patient engagement and treatment adherence among urban slum populations suffering from chronic illnesses. Further research should explore cost-effectiveness and scalability of telemedicine interventions, with a focus on ensuring equitable access for marginalized communities. Chronic Illnesses, Telemedicine, Patient Engagement, Treatment Adherence, Urban Slums Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.