Three Key Issues Accelerating Legislation of 'Non-Face-to-Face Medical Care'... ① Follow-up Visits Focus ② Medicine Delivery ③ Platform Certification

As the government strongly pushes for the formal institutionalization of non-face-to-face medical consultations, some contentious issues are expected to act as obstacles. While there is consensus on the introduction of non-face-to-face medical consultations itself, there are disagreements regarding detailed operational plans such as the target users, platform management, and prescription drug delivery. Since the government initially set the deadline for the legalization of non-face-to-face medical consultations as June this year, prompt discussions with the medical and industrial sectors are required.

Non-face-to-face medical consultation reference photo. [Photo by Dr. Now]

‘Follow-up Visit-Centered’ Principle, the Biggest Issue for Medical and Industrial Sectors

Previously, the government and the medical community agreed through medical-government consultations on three principles: ▲ face-to-face consultations as the main rule, using non-face-to-face consultations as a supplementary method ▲ operation centered on follow-up patients ▲ implementation mainly at clinic-level medical institutions, with dedicated non-face-to-face medical institutions prohibited. Among these, the most controversial part is the operation centered on follow-up patients. The medical community holds the position that non-face-to-face consultations are only a supplementary method and should be conducted mainly for follow-up patients to ensure patient safety. In fact, over the past three years, excluding COVID-19 home treatment, out of a total of 7.36 million non-face-to-face consultations, 6 million (81.5%) were conducted for follow-up patients.

However, there are also strong arguments that legally restricting initial consultations could diminish the advantages of non-face-to-face consultations, such as resolving medical blind spots, and infringe on the rights of medical users. Baek Nam-jong, director of Bundang Seoul National University Hospital, pointed out at a National Assembly forum that “If only follow-up visits are allowed, situations may arise where patients cannot experience non-face-to-face consultations if their usual hospital does not provide them.” The fact that most non-face-to-face consultations over the past three years were conducted for mild patients without significant safety issues is also cited as a reason to allow initial consultations.

Currently, it is likely that some initial consultations will be permitted in remote islands, mountainous areas, or small provincial cities where clinics and hospitals are relatively scarce. However, if such limited initial consultations are allowed, it is expected to be a burden for non-face-to-face consultation platforms, most of which are startups. The platform industry has expressed concerns, calling it a decision that ignores the safety and convenience of non-face-to-face consultations. The Remote Medical Industry Council, consisting of 13 companies operating non-face-to-face medical consultation platforms, plans to issue a statement on the 15th condemning the principle of institutionalization centered on follow-up and chronic patients and will convey their opinions to the National Assembly.

The scene from the "Discussion Forum for the Preparation of Domestic Non-Face-to-Face Medical Legislation" held at the National Assembly on January 10.
[Photo by Remote Medical Industry Council]

Pharmaceutical Association Opposes ‘Drug Delivery’... Who Certifies the Platforms?

The issue of drug delivery, one of the core conveniences of non-face-to-face consultations, also needs to be resolved. In principle, non-face-to-face consultations fall under the Medical Service Act, while drug delivery is related to the Pharmaceutical Affairs Act, making them separate matters. However, in reality, many non-face-to-face consultation platforms provide drug delivery services. The Korea Pharmaceutical Association strongly opposes drug delivery services resulting from non-face-to-face consultations, citing indiscriminate delivery of dispensed drugs and patient solicitation practices. The difficulty of providing proper medication guidance is also pointed out as a problem with drug delivery. Reflecting these concerns, the ‘Temporary Non-Face-to-Face Medical Consultation Brokerage Platform Guidelines’ established by the Ministry of Health and Welfare in August last year include provisions that allow platforms to let patients choose pharmacies and prohibit brokerage, solicitation, and mediation. However, since the Pharmaceutical Association demands a complete ban on drug delivery, conflicts are likely to continue even after the legalization of non-face-to-face consultations.

Discussions on the introduction of certification or qualification management systems for non-face-to-face consultation platforms must also be actively pursued. Since these platforms handle sensitive personal information of patients, both the medical and industrial sectors agree that only platforms with certain qualifications should be used. At a previous National Assembly forum, Jang Ji-ho, co-chairman of the Remote Medical Industry Council, stated, “I believe that a system where the government certifies or authorizes platforms can create a proper ecosystem,” adding, “The medical field, which is directly related to public health, requires its own standards.”

However, opinions differ between the industrial sector, which favors government-led certification, and the medical sector, which prefers certification led by private expert organizations such as the Korean Medical Association. Both sides have pros and cons. If a government agency becomes the certifying body, objectivity would be relatively high, but understanding of the medical field would inevitably be limited. Conversely, if a medical association leads the certification, the opinions of the medical field would be reflected, enhancing the usability and expertise of platforms, but the entry barriers for platforms would increase, which is viewed negatively from an industrial perspective.