Over 95 percent of the Korean medical community opposed telemedicine in 2014, but the proportion recently went down to about 65 percent, a survey showed.

The Korean Medical Association’s (KMA) Healthcare Policy Research Institute conducted an online poll on 955 KMA-member physicians from March 14-16.

The results showed that 65.2 percent of the respondents, or 623 doctors, said they were against telehealth, while 34.8 percent said they supported it. A majority of the physicians were opposed to telemedicine, but those against it fell significantly.

In a survey in 2014, 95.2 percent of the doctors said they did not want to practice telehealth, and only 3.48 percent said they would do it.

In the latest survey, medical professors were most positive about introducing remote patient care. Out of 209 professors, 57.9 percent (121) said they favored telemedicine, and 42.1 percent (88) said they were against it.

In contrast, clinic-owner physicians, hospital-hired doctors, and physician trainees were overwhelmingly against telehealth compared to those with other medical job titles.

By institute, physicians at tertiary hospitals were more positive about contactless care, with 53.5 percent supporting it, versus 46.5 percent opposing it. Conversely, doctors working at clinics, small hospitals, and general hospitals were more negative about telemedicine.

Of the total, 61.5 percent said physicians would have to go on an all-out strike if the government authorizes telehealth, while 9.8 percent said they would not. About 29 percent said they were undecided.

When asked why they opposed telemedicine, about 29 percent of the respondents said they might give misdiagnoses due to the unverified safety and efficacy of a medical device, and 23.8 percent said it could be unclear who would be legally responsible.

Twenty-eight percent said clarifying legal responsibility should be the first to be addressed when allowing telemedicine. The need to design a sophisticated model that does not damage the medical delivery system was the second most common answer.

The survey asked whether the respondents would participate in telehealth if the KMA made sure to minimize the risks, 38.5 percent (238 physicians) said they would, and 35.3 percent (218) said they wouldn’t. Another 26 percent (161) said they were undecided.

If telemedicine becomes legal, 53.5 percent said the government should allow remote monitoring between a doctor and a patient and remote consultation.

As for the scope of the first and second consultation, 72.5 percent said telehealth should not be allowed for the first consultation, while 26.3 percent said it would be okay to allow it for the first consultation, too.

When asked about regions where telemedicine is allowed, 46.7 percent said it should be allowed without restrictions in regions and target patients. Approximately 30 percent said that remote care should be open to only patients with poor access to medical care, such as the disabled, and 20.5 percent said telehealth should be available only in areas with rare access to medical care, such as remote villages and prisons.

Asked which medical institutes should implement telemedicine, 57.4 percent said only clinics should do it and cooperate with small/general/tertiary hospitals. On the other hand, only 20.2 percent said hospitals should be allowed to provide remote care, and 22.3 percent said all institutes, including tertiary hospitals, should be able to do so.

As for the means of telehealth, 42.9 percent said it should be limited to a remote care system where voices and videos are communicated interactively.

On which diseases should be open to contactless care, 60 percent said only diseases designated by the medical community should be allowed for telemedicine.

While 50.1 percent said reimbursement for telemedicine should be higher than in-person care, 40.7 percent said it should be equal to face-to-face care. Conversely, only 8.1 percent said reimbursement for remote care should be lower than in-person care.

“We could recognize changes in our KMA members’ perception about telehealth,” the KMA said.

The survey found that it was necessary to clarify the restrictions on telemedicine if the KMA goes in favor of it.

Areas that needed to be clarified were diagnosis and prescription in telemedicine, no restrictions in regions, no first consultation through telemedicine, diseases designated by the medical community, clinicians only, and allowing the telemedicine-only system, the KMA added.