The year 2023 marked significant transformations in the medical and pharmaceutical sectors. Despite facing resistance from the medical community, President Yoon Suk Yeol's administration declared its intention to increase the number of medical school seats starting in 2025. Additionally, 2023 witnessed the opening of the digital therapeutics market. The initiation of telemedicine this year led to an ongoing conflict between the medical community, opposing such practices, and the Ministry of Welfare, advocating for them, expected to persist into 2024. In the pharmaceutical industry, numerous domestic companies ventured into the global market. Korea Biomedical Review has compiled the 10 most noteworthy healthcare developments in 2023. -- Ed.

The Ministry of Health and Welfare (MOHW) reported on telemedicine pilot project at the Health Insurance Policy Review Committee on May 30 and started the project in June.

The pilot project, which began in June, was implemented in principle at clinic-level medical institutions, with limited access to hospital-level medical institutions, and targeted patients were treated according to the judgment of doctors to ensure safety.

Patients eligible for telehealth at clinics are those who have received at least one face-to-face treatment for their condition at the medical center. Patients with chronic diseases can receive contactless treatment within one year of an in-person visit, and other patients can receive telemedicine care within 30 days of an in-person visit.

Pediatric patients under the age of 18 are also eligible for telemedicine after a face-to-face consultation, but only on holidays and at night, even if there is no record of a face-to-face consultation, medical consultation through telemedicine is possible, but prescriptions are not allowed.

Patients who may be eligible for contactless treatment at clinic-level medical institutions despite their initial visit include those living in rural and remote areas, those with limited mobility such as the elderly and disabled over the age of 65, and those with infectious diseases.

In hospital-level medical institutions, telemedicine is allowed for rare diseases and patients who need continuous management after surgery and treatment, and rare diseases can be treated contactless within one year after face-to-face medical treatment.

Patients who need follow-up care after surgery and treatments are eligible for telehealth within 30 days of their in-person visit.

The treatment method is based on the principle of video treatment, and for patients who have difficulty using video communication, voice calls are also available. Telemedicine is not available through text messages and messengers.

Prescriptions are sent by fax or email to the patient's preferred pharmacy, and it is prohibited to automatically assign a pharmacy by an intermediary app, since it is specified that all pharmacies based on the patient's location must be displayed to ensure the patient's choice of pharmacy.

The fee for the pilot project was determined to be the existing consultation fee plus a 3,720 won ($2.9) management fee for the non-face-to-face treatment pilot project.

In response, the medical community demanded the withdrawal of the project, saying, "The pilot project was launched at a speed demanded by the industry, rather than the safety emphasized by the medical community, to coincide with the Covid-19 endemic and the institutionalization of virtual care.

Civil society organizations have also raised their voices against the project, saying it could encourage the privatization of healthcare by platform companies seeking to make commercial profits through telehealth care.

According to the MOHW, in the two months (June and July) following the start of the pilot project in June, a total of 291,626 medical procedures and 267,733 users were conducted, which was 60 to 70 percent of the limited contactless medical procedures conducted in response to Covid-19.

The MOHW, which said it would supplement the guidelines based on post-pilot evaluations, prepared a supplement to the pilot and applied it on Dec. 15.

The supplementary measures include allowing patients who have had an in-person visit within the past six months to receive virtual care regardless of their condition at the discretion of their healthcare provider, and ensuring that refusal of virtual care based on medical judgment does not constitute a denial of care.

In addition, vulnerable areas for emergency medical care have been added to the exceptionally permitted areas for non-face-to-face medical treatment, and the criteria for exceptionally permitting telemedicine during holidays and nighttime hours have been expanded from the current children under 18 to all.

The MOHW said, "We aimed to improve public convenience and strengthen safety to secure appropriate treatment models and implementation evidence through pilot projects."

However, after the implementation of the supplementary measures, the backlash from the medical community grew stronger. The Korean Society of Obstetrics and Gynecology declared its rejection of telehealth, and the Korean Medical Practitioners Association called on its members to boycott the program.

As the medical community continued to refuse to participate in the pilot project, the MOHW stated that it would take strong action as a violation of the Fair Trade Act, and the Korean Medical Association called it a threat.

The Korean Pediatric Association also filed a criminal complaint against Cho Kyoo-hong, Minister of Health and Welfare, and Park Min-soo, Second Vice Minister of Health and Welfare, alleging that the MOHW engaged in intimidation, coercion, and business interference over participation in the telemedicine pilot project.

Amid stalled discussions in the National Assembly to institutionalize virtual medical care, the MOHW announced its intention to continue the pilot project for three years without amending the law.

As a result, the conflict between the government and the medical community over the telemedicine pilot project is expected to continue in 2024.