Consensus Reached on Legalizing 'Non-Face-to-Face Medical Care'... Detailed Plans Expected to Face Challenges

Government's National Tasks Planned for Implementation by June
Confirmed Resolution of Concerns over Misdiagnosis and Side Effects
Disagreements over Scope of Treatment Subjects and Diseases

[Asia Economy Reporter Lee Gwan-joo] As the Yoon Seok-yeol administration plans to legislate telemedicine by June, serious discussions have begun in the new year. A broad consensus appears to have been formed among the medical community, industry, and the public on legalizing telemedicine, which is currently temporarily permitted. However, disagreements remain over detailed policy design, such as the extent to which telemedicine should be allowed and the level of platform regulation, suggesting that the negotiation process ahead may face difficulties.

At the 'Discussion Forum for the Preparation of Domestic Telemedicine Legislation' held at the National Assembly on the 10th, a comprehensive discussion is underway with Baek Nam-jong, Director of Bundang Seoul National University Hospital (far right), serving as the chairperson.
[Photo by Remote Medical Industry Council]

35 Million Telemedicine Cases... 9 out of 10 People "Willing to Use Telemedicine"

Since temporary telemedicine was permitted in February 2020, when the COVID-19 pandemic (global outbreak) intensified, over 35 million telemedicine cases have been conducted, creating an atmosphere for institutionalizing telemedicine. At a forum held at the National Assembly on the 10th titled 'Discussion on Preparing Domestic Telemedicine Legislation,' Kim Dae-jung, a research fellow at the Korea Institute for Health and Social Affairs, presented the results of a 'Telemedicine Usage and Satisfaction Survey,' where over 90% of respondents expressed willingness to use telemedicine in the future.

The widespread awareness of telemedicine began with the COVID-19 pandemic. Especially during the first half of last year, when the Omicron variant was rampant and confirmed cases surged sharply, telemedicine cases also increased. As many people experienced telemedicine, the range of diseases treated diversified. In the same survey, among those who had used telemedicine platforms, the symptoms for which telemedicine was used were COVID-19 confirmed symptoms (38.2%), cold and flu symptoms (23.4%), skin diseases (9.2%), abdominal pain, indigestion, heartburn (7.9%), and so on.

Regarding these results, Kim interpreted that the advancement of digital technology strengthens consumer empowerment and promotes participation. He explained, "Korea's healthcare delivery system has been dominated by a provider- and treatment-centered paradigm, but with the development of digital healthcare, it is entering a period of transition. As consumer choice becomes more important, a new doctor-patient relationship and new medical ethics different from before are needed."

Concerns Over Misdiagnosis and Concentration in Medical Institutions Resolved

Entering its fourth year, actual data related to telemedicine is accumulating. Analysis suggests that many of the side effects anticipated at the initial stage of allowance have been resolved. The medical community raised concerns that telemedicine, which involves diagnosis without direct patient contact, could increase the possibility of misdiagnosis and cause patient concentration in large hospitals rather than local clinics or primary care institutions. However, among 3,523,451 telemedicine cases conducted from February 2020 to January last year, 2,780,485 cases (78.9%) were at clinic-level institutions. Cases at tertiary general hospitals accounted for only 247,074 (7.0%). Primary care institutions led telemedicine.

Temporary Non-Face-to-Face Medical Treatment Billing Status. [Data provided by Assemblywoman Shin Hyun-young's office]

During this period, the top five diseases were hypertension, diabetes, dyslipidemia, acute bronchitis, and gastroesophageal reflux disease. There was no significant difference in medication prescription volumes between face-to-face and telemedicine consultations. Baek Nam-jong, director of Bundang Seoul National University Hospital and academic chairman of the Korean Society of Telemedicine, analyzed, "The number of telemedicine cases slightly exceeds 1% of the prescription volume reviewed by the Health Insurance Review and Assessment Service, so it is not enough to shake the entire medical system and is likely around 10% at most. Current data suggests that the public uses telemedicine safely and wisely."

Despite 35 million telemedicine cases, no significant misdiagnosis issues have emerged. This is attributed to the excellence of domestic medical staff, advanced IT technology, and the focus on mild cases. Director Baek predicted, "I do not believe telemedicine increases the risk of medical accidents. Telemedicine will not be used for diagnosing cancer or performing surgeries."

"Medical Community Leads, Government Manages, Industry Supports"… Detailed Policies Open to Debate

The stance of the medical community, including the Korean Medical Association (KMA), which had opposed telemedicine in principle, has changed. Instead of opposing telemedicine legislation, they have shifted to a position advocating for medical community leadership to secure public health rights. The telemedicine platform industry agrees with this. Jang Ji-ho, co-chairman of the Remote Medical Industry Council and director of Dr. Now, said, "Since medical treatment is an act between doctor and patient, telemedicine must ultimately be led by the medical community. I hope policies are introduced where the medical community leads, the government manages, and the industry supports."

Jang Ji-ho, Co-Chairman of the Remote Medical Industry Council. [Photo by Remote Medical Industry Council]

However, differences remain regarding detailed policy settings during the legislative process. The KMA Medical Policy Research Institute's report on 'Essential Conditions for Telemedicine' proposes telemedicine be limited to follow-up visits only, with no initial consultations allowed. The target patients are restricted to those in island regions, deep-sea fishing vessels, military, prisons, and severely disabled patients. Participating medical institutions should be primary care institutions within the patient's region, and applicable diseases limited to some chronic illnesses such as hypertension and diabetes. The report also includes platform regulation measures, such as the government developing a public telemedicine platform managed by the KMA or the KMA certifying private platforms. The KMA's proposal leans toward 'positive' regulation, which only specifies what is allowed.

However, this positive regulation approach limits medical consumers' choices and faces opposition regarding telemedicine's effectiveness. Director Baek pointed out, "If only follow-up visits are allowed, patients cannot even experience telemedicine if their regular hospital does not offer it. For post-surgery patient management, tertiary general hospitals should also participate in telemedicine." He added, "There is a need for 'negative' regulation that only prohibits what is not allowed. The public will use telemedicine wisely first, and doctors can provide face-to-face care if telemedicine is insufficient."

Beyond the question of whether to allow telemedicine, the need for detailed policy design is also raised. Co-chairman Jang suggested, "There are telemedicine platforms focused on initial consultations and mild cases, but remote monitoring for cancer patients who have undergone surgery also exists. Alongside policies focused on mild cases and primary care initial consultations, policies for follow-up patients who have already visited university hospitals for treatment and surgery need to be carefully distinguished and designed."

This content was produced with the assistance of AI translation services.