'Doctor-led, disease-specific telemedicine platforms needed in Korea'

Korean physicians recently pointed out that, to institutionalize the limited-time permitted telemedicine care, platforms should be designed to integrate with the existing healthcare system. They also suggested that platforms should prioritize disease-specific specialization over convenience.

In Korea, telemedicine is currently permitted on a limited-time basis. The government allowed its use starting Feb. 23 last year, citing the need to minimize disruptions in care after junior doctors collectively resigned in protest of the policy to expand medical school admissions. Since then, the National Assembly has been discussing ways to institutionalize telehealth, including a bill to amend the Medical Act to allow its use at all times.

Professor Kim Hun-sung of the School of Healthcare Informatics at the Catholic University of Korea, along with other researchers, recently published a paper in the Journal of Korean Medical Science (JKMS) titled Evolving Regulations in Telemedicine Pilot Project: Insights Into Law, Practice, and Patient Care through International Case Studies. The study analyzed international cases and recommended a policy direction for telemedicine within the Korean healthcare environment.

The study found that most countries -- including the U.S., the U.K., Canada, France, and Japan -- have expanded the use of telemedicine in response to the Covid-19 pandemic. Telehealth is primarily used for return visits, though some countries have also begun allowing its use for first-time consultations.

There is a wide range of virtual care platforms, particularly in the U.S., where only platforms compliant with the Health Insurance Portability and Accountability Act (HIPAA) are permitted. In the U.S., private companies such as Zoom, Cisco Systems, and Amwell have developed and operate telehealth platforms, with no government-led platform in place. In Canada, the U.K., and Australia, telehealth services are provided through phone calls, video conferencing, and digital messaging. In France, virtual care kiosks are also installed in public locations such as pharmacies. In Japan, healthcare institutions cover the costs of developing and operating telemedicine platforms, while patients pay only after receiving care.

The researchers concluded that the key to effectively utilizing a telehealth platform is its organic integration with the existing healthcare system. They emphasized that for telemedicine to function properly, “a medical practitioner-led medical system should be established first.” Additionally, they stressed the importance of clearly defining the scope of services, including applicable diseases, treatment methods such as remote monitoring, counseling, and repeat prescriptions, as well as online and video-based care.

The researchers stated that the appropriate platform should be selected based on the specific purpose of telemedicine. “The importance of a specialized platform designed to achieve specific objectives, rather than a general platform intended for broad use, should be emphasized,” the said.

However, they pointed out that commercial competition in Korea has intensified to such an extent that a new term has emerged: “platform war.” Telemedicine platforms being commercialized in Korea tend to be broad and general, focusing mainly on “convenience” rather than tailored specifically for patient management, they noted.

The researchers noted that the boundary between digital health and telemedicine is not clearly defined and emphasized that it is time for physicians to pay more attention to and gain experience with telemedicine and related platforms. They also called for the establishment of policy guidelines at the national level.

Above all, they emphasized that the system should be tailored specifically for Korea rather than simply replicating overseas models. Korea has a unique combination of high healthcare access, advanced ICT infrastructure, a government-led health insurance system, and relatively low healthcare costs, the researchers explained. The institutionalization of telemedicine should be designed to align with Korea’s distinctive institutional features and policy objectives, they added.

They also said it is necessary to develop a standardized, doctor-led platform and establish institutional regulations regarding the diseases covered by telemedicine, the scope of prescriptions, and how data is integrated. 

Additionally, legal responsibilities between doctors and platform companies must be clearly defined to prevent issues such as misdiagnosis, drug abuse, and data breaches, the research team said.