[Insight & Opinion] Let’s Start Telemedicine at a Level Where Consensus Is Possible

One of the notable areas during the major shift to a contactless society brought about by the COVID-19 pandemic over the past two years is the implementation of telemedicine or remote medical care. According to the Ministry of Health and Welfare, telemedicine introduced on February 24, 2020, recorded 4.73 million cases as of May 6. Including approximately 5.5 million telemedicine cases conducted during COVID-19 home treatment, the total exceeded 10 million cases. However, telemedicine due to COVID-19 was temporarily permitted through amendments to the "Infectious Disease Prevention and Control Act" allowing telephone consultations and prescriptions, and it does not imply full authorization of telemedicine.

Now that the COVID-19 pandemic is coming to an end, there is a situation where telemedicine should be discontinued, but discussions are underway on whether to institutionalize it at this time. The government has announced that institutionalizing telemedicine will be a national agenda, and medical associations are showing more support than before. The Ministry of Health and Welfare is also supporting the implementation of this national agenda through the formation of a telemedicine consultative body.

Under the current Medical Service Act, remote medical care is only allowed in a limited manner. According to Article 34, Paragraph 1 of the Medical Service Act, only "remote consultation," where a remote doctor provides knowledge or technical advice on the medical process of a distant medical professional, is permitted. However, "remote treatment," where a medical professional diagnoses a patient’s condition and issues prescriptions remotely instead of face-to-face treatment, and "remote monitoring," where a medical professional continuously monitors a patient’s disease status and provides counseling or education, are prohibited.

Supporters of telemedicine argue that it not only shifts the paradigm centered on doctors and patients in existing medical institutions to a patient-centered one but also can prevent the widening gap between metropolitan and rural areas, increase patient convenience, and suppress rising medical costs. Furthermore, they believe it can foster new industries related to digital healthcare and create new markets. Opponents argue that it could lead to a concentration of patients in large hospitals, potentially collapsing the medical delivery system, and raise concerns about safety, personal information leaks, misdiagnosis possibilities, and legal liability issues.

In principle, telemedicine makes most tests impossible, making safe diagnoses based on accurate information difficult. However, the experience of telemedicine during the COVID-19 situation has shown that side effects such as safety issues or concentration in large hospitals have not been significant.

There is a saying that you cannot be full with the first bite. While it is desirable to broadly allow telemedicine and support the digital healthcare industry as advanced countries like the United States and Japan do, it is reasonable to start with areas where safety and effectiveness have been confirmed at a level where consensus among stakeholders is possible. For example, as proposed by Representative Choi Hye-young, allowing telemedicine primarily for follow-up patients at clinic-level facilities, and targeting medically vulnerable areas, chronic patients, or patients with mobility difficulties could be considered.

Despite having top-level medical professionals and information and communication technology, we continue to face the unfortunate situation of not being able to utilize these for telemedicine. The ban on remote medical care, a representative Galapagos regulation unique to Korea, must be resolved in this government. It should be noted that the basic direction for this solution lies in increasing public benefit rather than adjusting interests and gains.

Seong-Yeop Lee, Professor, Graduate School of Technology Management, Korea University