The non-face-to-face medical treatment, which had remained a pilot project for five years, has begun to be legislated following President Lee Jae-myung's pledge. Since its utility and stability have already been proven, the intention is to allow anyone to receive medical services without being restricted by time and place using digital technology. However, there are concerns that the bill promoted by the ruling party only allows non-face-to-face treatment at hospitals with in-person treatment history, which may be seen as a regression from the previous pilot project that allowed access without distinction between initial and follow-up visits.
According to the political circle on the 13th, Jeon Jin-sook, a member of the Health and Welfare Committee of the Democratic Party of Korea, recently proposed a bill to establish a legal basis for non-face-to-face medical care. Home delivery of medication, which faced significant backlash from the Korean Pharmaceutical Association, was excluded. The core of this bill is the limited allowance of non-face-to-face medical care focused on 'adult follow-up patients.' According to the bill, individuals can only receive non-face-to-face treatment if they have previously visited a medical institution at the level of a practitioner.
However, non-face-to-face treatment centered on follow-up cases is not as simple in practice. If patients cannot remember the hospital they visited earlier, if that hospital does not participate in non-face-to-face treatment, or if the hospital is not affiliated with the intermediary platform being used, treatment itself becomes impossible.
Above all, in order for the intermediary platform to verify whether a user is a follow-up patient, it needs to secure electronic medical records (EMR) containing treatment information for differentiation. However, there has been no precedent for the platform industry to share EMR with hospitals. In fact, currently, 99% of users on intermediary platforms are initial patients. To shift toward a focus on follow-ups requires both legal and technical reviews.
Lee Seul, chair of the telemedicine industry association (Director at Doctor Now), noted, "In the domestic EMR service, there are dozens of types, but currently, there is no interconnected public system" and added, "Ultimately, this will lead to inefficiencies where medical professionals have to individually review patients' EMR to verify whether they are initial or follow-up users of non-face-to-face treatment."
Non-face-to-face treatment was temporarily allowed for three years starting in February 2020 due to the COVID-19 pandemic, but transitioned to a pilot project form in June 2023 as the pandemic alert level was lowered. Recently, criteria were set to receive non-face-to-face treatment only at hospitals visited within the last six months; however, as dissatisfaction from users arose for the same reason, it was fully allowed again without distinction between initial and follow-up cases starting in February of the following year.
However, former lawmaker Jeon included exceptions in the bill to allow initial visits for residents in remote areas and emergency medical vulnerable areas, soldiers, patients with infectious diseases, patients who inevitably cannot receive treatment on holidays or at night, minors under 18, and seniors over 65.
This reflects the fact that our society has entered an ultra-aged society and takes into account the situations of office workers, self-employed individuals, and dual-income parents. However, there are also criticisms that this point is out of touch with actual demand. According to the intermediary platform Doctor Now, over the past five years, 70% of all users have been in their 20s and 30s.
There are also opinions that the exclusion of medication delivery from this bill is regrettable. Jeong Ji-yeon, Secretary General of the Korea Consumer Agency, stated, "Since patients who usually have difficulty visiting hospitals receive non-face-to-face treatment, medication delivery should be an essential accompaniment." She added, "Receiving treatment non-face-to-face while picking up medication directly at a pharmacy undermines the convenience for patients."
In the medical community, opinions on this bill are divided. While physician groups fundamentally oppose non-face-to-face treatment, some believe it should be fully allowed in a self-regulated manner.
The Korean Medical Association expressed concerns regarding whether "the exceptions for initial visits in Jeon Jin-sook’s bill have sufficiently considered patient safety," and remarked, "Currently, non-face-to-face treatment in the country often prioritizes convenience over actual health needs."
On the other hand, there are voices advocating for self-regulated non-face-to-face treatment without distinction between initial and follow-up cases. Baek Nam-jong, president of the telemedicine society and professor in the rehabilitation department at Bundang Seoul National University Hospital, stated, "For now, it is important to legislate with a focus on follow-ups, but it could lead to complicated and ambiguous situations on-site due to the distinction, so it is necessary to proceed in a way that entrusts the judgment to medical professionals and patients to achieve more effective non-face-to-face treatment."
In fact, countries like Japan, France, and Germany have left the law open for medical professionals to exercise their judgment. Choi Yong-jae, president of the Korean Pediatric Association and director of Uijeongbu TunTun Children's Hospital, emphasized, "Globally, the trend is toward allowing non-face-to-face treatment, and we should place greater significance on expanding patients' choices according to medical accessibility," adding, "Non-face-to-face treatment could also work to improve the quality of healthcare."
Patients who have experienced non-face-to-face treatment have also indicated high satisfaction, which supports the call for full allowance. Since non-face-to-face treatment was implemented in the country in February 2020, 15 million people, or one-third of the entire population, have received it. According to the Korea Health and Welfare Research Institute's evaluation study on the pilot project for non-face-to-face treatment last year, 82.5% of 1,500 patients who received at least one non-face-to-face treatment reported that its safety was similar to (50.1%) or not concerning (32.4%) compared to in-person treatment.
Previously, the People Power Party also introduced amendments to the Medical Law for the legalization of non-face-to-face treatment. The amendments proposed by lawmakers Choi Bo-yoon of the Welfare Committee and Woo Jae-jun from the Environment and Labor Committee were relatively broad in scope. The amendments fundamentally allow non-face-to-face treatment without distinguishing between age or type of treatment (initial or follow-up), delegating specific criteria to be determined by the Minister of Health and Welfare.