Government's back and forth on guidelines leaves telemedicine providers concerned

Industry

Published: 23 May. 2023, 18:15

Government's back and forth on guidelines leaves telemedicine providers concerned

Jang Ji-ho, second from left, DoctorNow CEO, speaks during a press conference on March 15 in Yeouido, western Seoul. [YONHAP]

Telemedicine start-ups are up in arms over the Health Ministry’s decision to restrict virtual medical services, with just a week left before the ministry’s telemedicine pilot program kicks off.

Korea had temporarily allowed telemedicine services since 2020 amid the Covid-19 pandemic but plans to roll them back as daily cases dwindle.

When the national crisis level for Covid-19 will be lowered from the current “serious” level to the “alert” level starting in June, following a government announcement on May 11, the temporary permission for telemedicine services will be lifted.

The Ministry of Health and Welfare on May 17 announced a pilot program to allow telemedicine practices on a limited scale, which will take effect on June 1.

According to the Health Ministry’s guidelines, patients can receive telemedicine services starting from their second visit to a doctor. Some exceptions will be made for first-time visits such as patients over the age of 65, individuals with disabilities who have difficulty traveling, or patients with infectious diseases.

During the pandemic, even patients with no record of an in-person visit to a doctor could receive a non-contact medical diagnosis.

A telemedicine industry council under the Korea Startup Forum strongly criticized the upcoming pilot policy program, saying that the ministry’s decision “is a death sentence to telemedicine services,” and that the program “did not have an ounce of consideration for how telemedicine services actually operate,” in a statement released on Friday.

Telemedicine service providers and the medical community have been polarized over whether to allow telemedicine services for first-visit patients, especially younger ones.

In the Health Ministry’s initial announcement, telemedicine for first-visit pediatric patients during the night and over the weekend was permitted under the pilot program.

But the decision was revoked two hours later after the government held a meeting with President Yoon Suk Yeol’s People Power Party.

Minister Cho Kyoo-hong of Health and Welfare, center, speaks during a meeting with People Power Party lawmakers held on May 17 at the National Assembly in western Seoul. [YONHAP]

The Health Ministry said that “nothing has been decided” in regard to first-visit pediatric patients, and that the guideline “will be improved in consideration of opinions from the medical and pharmaceutical community and the industry.”

The ministry plans to finalize the guidelines by the end of May and run a test period for the program by August 31.

Advocacy groups for the medical community are strongly against first-visit non-contact diagnoses.

“Telemedicine should be used as a complementary measure to in-person diagnosis,” said the Korean Medical Association, Korean Dental Association and Korean Pharmaceutical Association in a joint statement on Friday.

“Pediatric and adolescent patients, by their nature, are required to receive an in-person diagnosis,” argued the groups in the statement.

Over the past three years, 13.8 million patients availed of telemedicine services through online channels such as mobile applications.

About 30 online telemedicine companies in Korea are start-ups founded after February 2020.

“The companies will gradually wither away under the current guidelines, which will make it too difficult for patients to receive non-contact medical services,” said a source for DoctorNow, the leading company in the industry.

The ministry’s guidelines allow telemedicine practices for patients that have a record of receiving in-person medical treatment at least once over the previous 30 days, but only for the same issue. This can be extended to one year if the patient has a chronic disease.

For example, if a patient has the flu but was diagnosed with a cold within the prior 30 days, the person will not be eligible for virtual treatment or diagnosis related to the flu symptoms.

The ministry mainly communicated with the medical community to create the latest guidelines, with the understanding from doctors’ advocacy groups that non-contact medical practices will be complementary to in-person ones.

Neither telemedicine service providers nor patients had a say during the process, the companies argued.

“Telemedicine companies were the ones that connected patients with medical services and delivered medications to home-quarantined patients free of charge, instead of the government and the public health centers during the peak of the pandemic,“ said a source from Korea Startup Forum’s telemedicine industry council.

“Are the telemedicine companies now being dismissed, with the pandemic coming to an end?”

Another anonymous source from the start-up scene said “If the companies that have been accumulating knowledge over the past three years cease to exist, patients will be the ones that suffer inconveniences when demand for telemedicine rises again in the future.”

Telemedicine companies are closely monitoring the ministry’s latest guidelines as they may serve as an indicator for related legislation in the future. Five bills related to telemedicine are currently pending in the National Assembly, but no lawmakers from either side of the political aisle have made active moves.

Moreover, the ministry’s guidelines do not allow medications to be delivered directly to patients without a visit to the pharmacy even after a virtual appointment.

The ministry initially said that elderly patients, people with disabilities, patients with infectious or rare diseases and those living in remote areas will be able to receive medications via delivery, but later withdrew that decision.

The Korea Pharmaceutical Association held a rally on May 14, demanding the Health Ministry call off the pilot program altogether.

However, some pharmacists are advocating for telemedicine services.

Recently, 201 pharmacists who participated in medication delivery services filed a petition to the National Assembly saying that “non-contact medical practices were the pillar of hope for mom-and-pop pharmacies that are facing harsher conditions every day,” and that “for young and upcoming pharmacists, they are an opportunity to show their competence.”

Japan recently decided on insurance costs for a first-time online telemedicine appointment. The country allows virtual diagnosis on the condition that a patient receives the service from a doctor they are familiar with.

In the United States, where telemedicine gained wider acceptance during the pandemic, the government will allow public health insurance to cover telemedicine appointment costs until the end of next year.

BY KWEN YU-JIN [shin.hanee@joongang.co.kr]