**6. Role of telemedicine in Home PAL**

Telemedicine, which literally means 'healing at a distance', is the practice of consultation, care, diagnosis and interaction between the physician and the patients, who are located remotely via different technologies which involves video conferencing [15]. The world has evidenced the grievousness of covid crisis, where it's either risk taking to visit a hospital or it's difficult to arrange transportation every time due to the occasional curfews and lock downs. In such a scenario, the use of technology in the form of telemedicine is surely appealing to be used for palliation as well in the home set ups. It is evidence based that telemedicine has been used to be a success in different parts of the world, especially in the European countries [16]. Telemedicine while used for palliative care has proven to improve the symptoms, quality of life and care for the patient and also results in better satisfaction to the patient and the caregiver. It also saves the doctor's time. But the most important hurdle of using telemedicine round the globe is the technology related complications. To describe briefly, most of the patients eligible for palliative care are elderly, many of them are not techno friendly. There lacks proper connectivity of internet and electricity in most of the developing nations including India, which is a must for a successful telemedicine set up [17, 18]. Though in urban areas, things could be manageable, but the scenario is just the reverse in rural set up. Moreover, there always remains a difference between the in person care and the tele care provided by the councilor or the Home PAL team, when the patient is in his last days of life. Once these challenges are taken care of, there are prospective avenues to incorporate telemedicine in the regular Home PAL services.
