[The Future of Telemedicine ②] "Enhancing Patient Convenience with Greater Safety"... Discussions Begin on Subordinate Regulations

Ministry of Health and Welfare to Announce Enforcement Decree in the Second Half of the Year Ahead of Full Implementation in December
Stakeholders Including Medical Community, Platform Industry, and Patient Groups to Discuss Regulations and Support Measures by Issue

Editor's Note
An era has arrived where, instead of waiting in long lines at hospital waiting rooms, patients can consult with doctors on their smartphone screens. After being temporarily permitted during the COVID-19 pandemic and periods of conflict between the medical community and the government, and following a pilot program, telemedicine is set to be fully implemented at the end of this year. While telemedicine offers the convenience of filling gaps in healthcare for remote areas and vulnerable populations, it also comes with limitations due to the prohibition of medication delivery and concerns about the misuse of pharmaceuticals. There remain significant differences in perspective among the medical community, platform industry, and patient organizations. In the face of this major shift that could disrupt the paradigm of the healthcare industry, we examine the current state of Korea's medical field as it adapts to telemedicine, and analyze the challenges that must be addressed to achieve true innovation.

Telemedicine, which has so far been operated as a pilot program, will be officially implemented at the end of this year. The government has begun drafting enforcement decrees and regulations through practical discussions to ensure that the "Medical Service Act Amendment," which passed the National Assembly late last year, is smoothly established in the medical field.

On February 3, the Ministry of Health and Welfare announced that it has begun gathering expert advice and holding practical discussions to prepare subordinate regulations for the telemedicine system, and is collecting a wide range of opinions. With the legal basis established through bipartisan agreement last year, the focus now is on developing the detailed provisions that will be included in the actual regulations.

To this end, the Ministry plans to regularly convene stakeholders from public institutions such as the National Health Insurance Service and the Health Insurance Review and Assessment Service, as well as representatives from medical and pharmaceutical associations, patient groups, consumer organizations, and the platform industry. The agenda includes: building a telemedicine support system; introducing and establishing standards for a telemedicine platform reporting and certification system; and improving the telemedicine system. The feedback gathered will be reflected in the drafting of the regulations.

As a result, future discussions are expected to go beyond simply gathering opinions, becoming a substantial legislative process that will determine the specific regulations and support measures to be stipulated in the law.

The most contentious issue regarding improvements to the telemedicine system is the restriction on prescription medications. The amendment to the Medical Service Act restricts the prescription of narcotics and psychotropic drugs via telemedicine, and allows doctors to further limit the types of medications and the number of prescription days if they determine that patient information is insufficient. Consequently, there may be changes to the current restrictions on tele-prescribing emergency contraceptives and obesity treatments, which are limited due to concerns about misuse, as well as to the approval of non-reimbursed medications such as hair loss and acne treatments.

The issue of medication delivery, which is essential for the convenience of telemedicine, is also under debate. The pharmaceutical industry opposes medication delivery due to concerns about drug misuse and potential deterioration during delivery, while the platform industry insists that medication delivery is essential for user convenience. The government is expected to propose a compromise, gradually expanding delivery to certain groups such as those with mobility issues or infectious diseases.

At the same time, to improve access to healthcare, the government is considering allowing initial telemedicine consultations for residents of islands and remote areas, as well as during holidays and nighttime hours. However, the medical community maintains the "follow-up consultation principle," citing the risk of misdiagnosis. In particular, the specific scope of the "regional restriction"-which would limit telemedicine to clinics near the patient’s place of residence (such as at the city, county, or district level)-is expected to be determined in the main implementation.

To prevent the emergence of medical institutions dedicated solely to telemedicine, subordinate regulations will specify that no more than a certain proportion (about 30%) of total consultations can be conducted via telemedicine. Another major issue is how to set the reimbursement rates for telemedicine compared to in-person consultations.

After practical discussions on these contentious issues, the government plans to announce proposed amendments to the enforcement decree and regulations in September or October, and to officially launch the full-scale program on December 24.

A Ministry of Health and Welfare official stated, "To ensure that the public can use telemedicine safely and conveniently, we will address and improve the shortcomings identified in the pilot program based on feedback from the field, as presented by the consultative body, and continue preparing the system."