Necessity of Legislating Non-Face-to-Face Healthcare (Telemedicine) and Follow-up Tasks

1. Introduction: Current Status and Rationale for the Legalization of Telemedicine

Telemedicine refers to a form of medical service in which patients receive healthcare without direct, in-person contact with medical professionals, using various information and communication technologies (Han et al., 2024). Recently, active discussions have taken place in the National Assembly of Korea regarding the institutionalization of telemedicine through amendments to the Medical Service Act. Telemedicine, which was initially introduced on a temporary basis during the COVID-19 pandemic, was fully permitted starting in February 2024 to minimize gaps in healthcare services caused by prolonged collective actions by the medical community. As telemedicine has been positively evaluated for improving healthcare accessibility and service efficiency, discussions on establishing it as a permanent system have gained momentum.

Against this backdrop, on March 21, 2025, Rep. Choi Bo-yoon of the People Power Party, a member of the National Assembly’s Health and Welfare Committee, proposed an amendment to the Medical Service Act. The core of the bill is to allow telemedicine on a permanent basis and to establish a legal foundation for the management and supervision of online platforms that intermediate telemedicine services. According to Rep. Choi, the proposal was motivated by the fact that most OECD countries impose few restrictions on telemedicine and that the global trend emphasizes fostering telemedicine and pharmaceutical delivery industries (Welfare News, 2025). In addition, on April 18, Rep. Woo Jae-jun submitted a separate bill titled the “Partial Amendment to the Medical Service Act,” which seeks to clarify the scope, methods, and legal basis of telemedicine to further institutionalize the practice.

Alongside the legalization of telemedicine, pharmaceutical delivery has emerged as a highly contentious issue. Under the current pilot program, drug delivery is prohibited due to concerns over misuse and abuse of medications, and Rep. Choi’s proposed amendment does not include provisions allowing initial consultations or drug delivery. However, among patients who have experienced telemedicine, there is substantial demand for pharmaceutical delivery, and voices are growing that a truly comprehensive telemedicine system requires an environment in which medications can also be received remotely.

Sharp differences in perspectives persist among the medical community, pharmacists, and platform businesses. Both the medical and pharmaceutical sectors advocate for a cautious approach to the institutionalization of telemedicine, arguing that sufficient data analysis and safety verification through pilot programs must come first. In contrast, platform operators and industry stakeholders view telemedicine legalization as a growth opportunity for the digital healthcare industry. Given that this issue extends beyond convenience to encompass patient safety, quality of care, prevention of drug misuse, and the livelihoods of medical and pharmaceutical professionals, a prudent and balanced approach is essential. As legislative discussions continue, attention is focused on what form of consensus will ultimately emerge.

The debate over amending the Medical Service Act is not merely about convenience; it carries significant implications for improving healthcare accessibility, preventing the spread of infectious diseases, and enhancing the efficiency of the healthcare system. This report analyzes the necessity of permitting telemedicine from multiple perspectives and explores policy directions aimed at promoting public health and improving healthcare services.

2. Current Status of Telemedicine in Korea and the Global Market
◩ Growing Number of Telemedicine Users:

’20: 835,000 → ’23: 1.333 million (increase of 500,000 over three years)

Healthcare consumers primarily use applications such as Doctor Now, My Doctor, and GoodDoc to access telemedicine services. According to data on the “Current Status of Telemedicine” published by the Ministry of Health and Welfare covering the period from 2020 to 2024, cumulative telemedicine consultations exceeded 10 million cases, strengthening calls to foster the sector as an industry (Medical Times, October 1, 2024).

According to the “Evaluation Study on the Performance of the Telemedicine Pilot Program” recently published by the National Evidence-based Healthcare Collaborating Agency (NECA), user satisfaction with telemedicine services was relatively high. Among survey respondents, 60.2% reported being satisfied with telemedicine services. The primary reasons for satisfaction included ease of time management, convenience, and cost savings. Furthermore, 82.5% of telemedicine users stated that telemedicine was either as safe as in-person care (50.1%) or not more anxiety-inducing than face-to-face treatment (32.4%), while 91.7% expressed willingness to continue using telemedicine in the future (Ko et al., 2025).

Despite being operated in the form of pilot programs for approximately five years, telemedicine has yet to be fully legalized, resulting in frequent revisions to operational guidelines. This regulatory uncertainty has hindered active investment by platform companies and caused confusion among users, underscoring the urgent need for substantive discussions on the proposed amendments to the Medical Service Act.

◩ Global Telemedicine Market Outlook:

’22: KRW 147.3 trillion → ’32: KRW 1,276.7 trillion (projected 8.7-fold growth over ten years)

According to a 2023 report by market research firm Precedence Research, the global telemedicine market size is projected to grow from USD 102.9 billion in 2022 (KRW 147.3 trillion, based on the exchange rate of KRW 1,428.6 per USD as of April 23, 2025) to USD 893.7 billion in 2032 (KRW 1,276.7 trillion at the same exchange rate), representing an approximately 8.7-fold increase. The compound annual growth rate (CAGR) during this period is estimated at around 24%, reflecting strong expectations for the growth potential of the telemedicine market.

3. Comparison of Domestic and International Telemedicine Policies

In Korea, discussions are ongoing regarding the permanent allowance of telemedicine, the scope of initial consultations, and the permissibility of pharmaceutical delivery, while full legalization has yet to be achieved. Following the temporary authorization of telemedicine during the COVID-19 pandemic, the Ministry of Health and Welfare has implemented pilot programs that evolved from limited to comprehensive allowance.

During the three-year period of temporary authorization amid the pandemic, approximately 36 million telemedicine consultations were conducted. As the immediate need for infection prevention subsided, but consumer demand for telemedicine convenience remained, a first pilot program focusing on follow-up patients within six months was launched in June 2023. However, due to restrictive conditions and rising consumer complaints, questions regarding its effectiveness emerged.

Subsequently, as medical service disruptions occurred in early 2024 due to resident doctors’ strikes during the government’s healthcare reform efforts, the Ministry of Health and Welfare significantly relaxed telemedicine regulations. From February 23, 2024 onward, telemedicine was fully permitted for all patients and medical institutions (Ministry of Health and Welfare press release, February 23, 2024). Nevertheless, the legal basis for telemedicine within the Medical Service Act remains insufficient, and pharmaceutical delivery continues to be allowed only in a limited manner.

◩ Policy Trends and Implications from Major Countries

Following the COVID-19 pandemic, telemedicine policies have undergone significant changes worldwide. Most major countries have institutionally legalized telemedicine, implementing broad policies that include initial consultations, drug delivery, and insurance coverage. The United States and Japan permit both initial consultations and pharmaceutical delivery, while the United Kingdom provides free telemedicine services through the National Health Service (NHS). France has enhanced patient convenience through digital prescription systems, and Canada and Australia recognize telemedicine within certain parameters at the federal or provincial level.

These international cases offer valuable reference points for Korea in designing future telemedicine policies, particularly in balancing service scope with patient safety and determining whether to integrate ancillary services such as drug delivery.

4. The Necessity of Amending the Medical Service Act to Permit Telemedicine
◩ Improving Healthcare Accessibility

Allowing telemedicine enables individuals to access medical services regardless of geographic location or physical limitations. Residents of rural or remote areas often face difficulties visiting hospitals due to distance and limited medical facilities. Telemedicine can effectively address these challenges.

Moreover, elderly individuals, people with disabilities, and patients with chronic diseases can receive medical consultations without visiting hospitals. For conditions such as hypertension or diabetes, which require regular monitoring and prescriptions, telemedicine allows patients to consult physicians and receive prescriptions from home, reducing mobility burdens and mitigating healthcare blind spots (Kim & Kim, 2020).

◩ Enhancing Healthcare System Efficiency

Korea’s healthcare system faces congestion due to patient concentration at large hospitals, leading to long waiting times and increased workloads for medical staff. Telemedicine can alleviate these issues by enabling patients with mild symptoms to receive prompt remote consultations, allowing medical resources to be allocated more effectively to patients requiring in-person care.

From the perspective of healthcare providers, telemedicine facilitates more efficient patient management and helps reduce excessive workloads, thereby improving overall system efficiency (Kim & Kim, 2020).

◩ Preventing the Spread of Infectious Diseases

Telemedicine plays a crucial role in preventing the spread of infectious diseases by minimizing hospital visits. During the COVID-19 pandemic, telemedicine reduced infection risks within healthcare facilities and protected vulnerable populations. Its continued use can help mitigate similar risks during future outbreaks (Kim & Kim, 2020).

◩ Expanding Consumer Choice and Utility through Medical Innovation

Telemedicine represents a key innovation in the digital healthcare era, offering patients greater choice and convenience. It enhances continuity of care, particularly for chronic patients and individuals with limited mobility, while improving system-wide efficiency. This patient-centered approach signals a new standard for future healthcare delivery.

◩ Fostering the Digital Healthcare Industry and Creating Jobs

The expansion of telemedicine contributes to the development of a new industrial ecosystem, driving growth in medical platforms, remote monitoring technologies, and digital healthcare solutions. It also creates new jobs, such as healthcare data analysts and telemedicine coordinators, generating economic value beyond healthcare delivery itself (BioTimes, June 26, 2024).

5. Conclusion: Legalization of Telemedicine and Pharmaceutical Delivery and Future Tasks
◩ Korea as the Only OECD Country Without Telemedicine Legislation:

Urgent Passage of the Medical Service Act Amendment Required

Korea continues to operate telemedicine without a clear legal basis, relying on pilot programs, while pharmaceutical delivery remains highly restricted. In contrast, major OECD countries—including the United States, the United Kingdom, Germany, France, Japan, and Canada—have already legalized telemedicine and drug delivery. Korea remains the only OECD country without formal telemedicine legislation. Accordingly, the 22nd National Assembly should swiftly pass the proposed amendments centered on Rep. Choi’s bill within the current session.

◩ Follow-up Tasks: Transition from Positive Regulation to a Negative Regulatory Framework and Promotion of AI Integration

The current pilot program adopts a positive-list approach, permitting telemedicine only when strict conditions are met. As a follow-up measure, telemedicine should be broadly permitted under a negative regulatory framework, excluding only high-risk cases such as severe trauma or narcotic prescriptions, while establishing standardized clinical guidelines (Kim, 2024).

Additionally, integrating generative AI into telemedicine can enhance diagnostic accuracy and expand the digital healthcare market. Emerging developments include AI-enabled diagnostic devices, real-time consultation services, and AI-based pharmaceutical delivery platforms, highlighting the need for proactive policy support.

Korean version: https://www.cfe.org/20250424_27555