Clinic-Level and Returning Patient Principles...
Prohibition of Promoting Misuse
Medication Delivery Limited to Medically Underserved Areas and Rare Disease Patients
Regulations Established for Intermediary Platforms
Telemedicine, which filled gaps in healthcare during the COVID-19 pandemic and periods of conflict between the medical community and the government, has been institutionalized after 5 years and 9 months of pilot operation. It has taken 15 years since an amendment to the Medical Service Act was first submitted in the 18th National Assembly in 2010 to allow telemedicine.
On December 2, the Ministry of Health and Welfare announced that the National Assembly plenary session had passed an amendment to the Medical Service Act providing a legal basis for telemedicine. This amendment will be enforced one year after promulgation, following deliberation and approval by the Cabinet.
The Ministry of Health and Welfare evaluated the amendment as meaningful, noting that it was passed through bipartisan agreement after collecting opinions from the medical community, patient and consumer groups, and experts, with top priority given to improving the quality and safety of healthcare and accessibility for vulnerable groups. In particular, the ministry expects that establishing a legal foundation for telemedicine, which has operated as a pilot project for a long time, will serve as a basis for the future development of primary care.
The amendment establishes a flexible legal framework that considers both the four main principles agreed upon with the medical community-namely, the principle of face-to-face care, a focus on clinic-level medical institutions, prioritization of returning patients, and a ban on dedicated telemedicine-only institutions-and technological advancements.
Accordingly, telemedicine is explicitly defined as a supplementary measure to face-to-face care. It is only permitted for patients who have a record of receiving in-person treatment for the same symptoms at the relevant medical institution within a certain period. Otherwise, restrictions will be placed on the region and prescriptions. While telemedicine will primarily be operated at clinic-level institutions, exceptions will be made for patients who require hospital-level care, such as those with rare diseases, type 1 diabetes, inmates in correctional facilities, and patients needing post-surgical follow-up. Regional restrictions will not apply to patients with rare diseases or type 1 diabetes.
In particular, the amendment prohibits dedicated institutions that primarily provide telemedicine and imposes regional restrictions, establishing legal mechanisms to ensure telemedicine is linked with in-person care. The Korean Medical Association and other organizations will prepare and recommend standard guidelines for medical professionals, and a self-regulation mechanism will allow for requests for administrative guidance if violations are suspected.
For patient safety, telemedicine cannot be used to prescribe narcotics or similar drugs. If the physician does not have sufficient information about the patient, additional restrictions will be placed on the types of medications and the number of days prescribed. The amendment also introduces institutional safeguards for patient safety, such as specifying conditions that require video consultations, and delegates the determination of detailed scope to ministerial regulations, allowing for flexible application in consultation with experts.
The amendment also specifies the legal responsibilities of medical professionals, including the requirement to explain the limitations and characteristics of telemedicine and obtain the patient's consent. Patients are prohibited from impersonating others to receive telemedicine or deceiving medical professionals to obtain prescriptions. The scope of permitted medication delivery is limited to residents of islands and remote areas, long-term care recipients, registered persons with disabilities, confirmed infectious disease patients, and patients with rare diseases, so that vulnerable populations can conveniently receive prescribed medications after telemedicine.
The amendment also establishes regulatory grounds for telemedicine intermediary platforms. Platforms with a certain number of subscribers must be certified by the Minister of Health and Welfare and are prohibited from encouraging the misuse of medical services or pharmaceuticals, as well as recommending or inducing patients to use specific medical institutions. A legal basis has also been established for the construction and operation of a public telemedicine support system, which will serve as a public intermediary platform for telemedicine, allowing patient treatment histories and qualification information to be managed safely and utilized by primary care institutions.
The Ministry of Health and Welfare plans to gradually implement the revised pilot project until the law comes into effect. Specific details to be stipulated in subordinate regulations, such as patient eligibility criteria, the scope of regional restrictions, and the types of medications subject to prescription restrictions, will be developed in consultation with the medical and pharmaceutical communities, patient and consumer groups, and others. In addition to telemedicine between medical professionals and patients, the ministry will also discuss pilot projects to strengthen primary care in medically underserved areas, such as teleconsultations between medical professionals, as well as institutional improvement measures to enhance regional, essential, and public healthcare.
Minister of Health and Welfare Chung Eun-kyung stated, "I believe it is highly significant that the amendment to the Medical Service Act to institutionalize telemedicine has passed the National Assembly plenary session 15 years after discussions began." She added, "As alternatives have been prepared with the utmost consideration for the quality of healthcare and patient safety, we will continue to make efforts to ensure that the public can use telemedicine safely and conveniently after the law is implemented."
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