Telemedicine, which stuffed medical gaps through the COVID-19 pandemic and final yr’s medical-political battle by way of pilot operations, is lastly coming into the institutional framework. Relationship again to 1988 when pilot initiatives started below the time period “distant session,” the legalization of distant medical care—permitting sufferers to obtain therapy with out immediately visiting hospitals—has been achieved after 37 years. Till now, Korea was the one main member nation of the Group for Financial Cooperation and Growth (OECD) the place telemedicine was not legally established.
The Ministry of Well being and Welfare introduced on Dec. 2 {that a} Medical Service Act modification offering authorized grounds for telemedicine handed the Nationwide Meeting plenary session. This modification will take impact one yr after promulgation, following deliberation and backbone by the State Council.
The ministry evaluated that the modification holds significance because it was authorized by way of bipartisan settlement after gathering opinions from medical and pharmaceutical communities, affected person and client teams, and consultants. The ministry defined that it established a versatile authorized framework contemplating the 4 main ideas agreed upon with the medical group—centered on face-to-face therapy and follow-up sufferers, clinic-level medical establishments, and prohibition of devoted establishments—in addition to technological development.
The modification specifies that telemedicine is a complementary means to face-to-face therapy, and telemedicine have to be performed for sufferers who’ve information of receiving face-to-face therapy for a similar signs inside a sure interval. In circumstances the place this isn’t relevant, telemedicine is restricted to medical establishments within the affected person’s residential space solely. Whereas operations are centered on clinic-level medical establishments, exceptions are made for sufferers who require hospital-level or increased medical establishments, similar to uncommon illness sufferers, Kind 1 diabetes sufferers, correctional facility inmates, and sufferers requiring post-surgical follow-up. Regional restrictions don’t apply to uncommon illness sufferers and Kind 1 diabetes sufferers.
The proportion of telemedicine circumstances amongst complete therapies is restricted to a most of 30%. That is to forestall devoted telemedicine practices that don’t see precise sufferers in any respect. Moreover, the kinds and portions of medicines that first-visit sufferers could be prescribed by way of telemedicine, in addition to the scope of permitted drug supply, are restricted to weak space residents similar to these in islands and distant areas, and people with mobility difficulties. This measure goals to take care of the ideas of face-to-face therapy and meting out below the Pharmaceutical Affairs Act and Medical Service Act whereas stopping drug misuse and abuse to make sure most security.
The Korean Medical Affiliation, which has opposed telemedicine laws for over a decade, gave a constructive analysis of this modification, stating that “the ideas demanded by the medical group have been considerably mirrored.”
Pilot initiatives to take away rules blocking telemedicine have been pursued since 1988. Seoul Nationwide College Hospital operated distant session between medical doctors with assist from Korea Telecom (now KT) to help with X-ray interpretation at Yeoncheon-gun Well being Heart in Gyeonggi Province. The preliminary telemedicine mannequin enabling distant communication between medical doctors and sufferers in underserved areas was established in 1994. Subsequently, with every new authorities, pilot initiatives for institutionalization have been pursued below altering terminologies similar to “U-Well being” and “E-Well being,” and associated legal guidelines have been launched within the Nationwide Meeting ranging from the 18th Meeting in 2010, however not a single invoice handed for 15 years as a result of physician opposition.
The dialogue on telemedicine institutionalization gained momentum through the COVID-19 pandemic. After working as a pilot mission for about 5 years and 9 months, consensus was reached that authorized grounds ought to be established for secure telemedicine provision. Within the present twenty second Nationwide Meeting, eight Medical Service Act modification payments for telemedicine institutionalization have been launched, and the Well being and Welfare Committee merged and deliberated on a complete of 9 payments, together with one Medical Service Act modification for introducing an digital prescription supply system, earlier than reaching another resolution and passing it on Nov. 20. Subsequently, the Laws and Judiciary Committee modified some content material, system, and wording earlier than passing it on Nov. 26.
The ministry plans to reorganize pilot mission content material for gradual implementation earlier than the regulation takes impact. Particular issues to be regulated in subordinate legal guidelines, similar to affected person standards, scope of regional restrictions, and sorts of prescription-restricted drugs, shall be ready in session with medical and pharmaceutical communities and affected person and client teams. Along with telemedicine between medical personnel and sufferers, discussions will embody pilot initiatives for strengthening major care in medically underserved areas by way of non-face-to-face collaboration amongst medical personnel, and institutional enchancment measures for strengthening regional, important, and public healthcare.
Well being and Welfare Minister Jeong Eun-kyung acknowledged, “I feel it holds nice significance that the Medical Service Act modification for telemedicine institutionalization handed the Nationwide Meeting plenary session 15 years after Nationwide Meeting discussions started,” including, “As options have been ready with medical high quality and affected person security as prime priorities, we are going to attempt to make sure that residents can use telemedicine safely and conveniently even after the regulation takes impact.”
Nonetheless, some critics argue that “the regulation has regressed,” citing increased regulatory ranges in comparison with pilot mission intervals. The federal government imposed no restrictions on telemedicine targets through the COVID-19 outbreak. Subsequently, as COVID-19 unfold subsided, rules have been strengthened to permit solely neighborhood hospitals to conduct telemedicine for follow-up sufferers in precept, then absolutely permitted once more final March when medical gaps turned a priority as a result of mass departure of residents protesting medical college enrollment will increase.
In the meantime, the “Physician Now Prevention Act” (Pharmaceutical Affairs Act modification), which was anticipated to move the Nationwide Meeting plenary session alongside the telemedicine invoice on Dec. 2, didn’t be positioned on the agenda. This invoice, launched concentrating on platform firm Physician Now which established pharmaceutical wholesaler Bijin Pharmaceutical as a subsidiary and operated associated companies in March final yr, basically prohibits telemedicine platform corporations from working pharmaceutical wholesale companies. Physician Now has immediately provided drugs to affiliated pharmacies whereas offering real-time medicine stock data to scale back “pharmacy hopping” by sufferers searching for prescribed drugs from telemedicine consultations amid drug supply prohibitions. Nonetheless, considerations arose that platform involvement in pharmaceutical distribution may result in preferential therapy of particular pharmacies or novel rebates encouraging prescription and gross sales of explicit pharmaceutical merchandise, resulting in the introduction of a Pharmaceutical Affairs Act modification that basically blocks platform wholesale enterprise operations. When this invoice was handed by the Nationwide Meeting’s Well being and Welfare Committee, startup business together with Physician Now criticized it because the “second Tada prohibition regulation.”
