Journal of Digital Convergence (디지털융복합연구)

The Society of Digital Policy and Management (한국디지털정책학회)
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Issue Analysis on the Deregulation of Telemedicine in the Digital Convergence Era

디지털 융복합시대에 원격의료 규제 완화에 관한 쟁점 분석

  • Kim, Jin-Suk (Research Institute for Healthcare Policy, Korean Medical Association) ;
  • Oh, Su-Hyun (Research Institute for Healthcare Policy, Korean Medical Association)
  • 김진숙 (대한의사협회 의료정책연구소) ;
  • 오수현 (대한의사협회 의료정책연구소)
  • Received : 2020.10.28
  • Accepted : 2020.12.20
  • Published : 2020.12.28
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Abstract

The purpose of this study is to analyze various issues that may arise from the recent deregulation of telemedicine implemented by the government, propose initiative preparations for the implementation of telemedicine policies, and suggest implications for the basic conditions and direction of the deregulation of telemedicine. Recently, deregulation policy cases in telemedicine include that designation of a special zone for regulatory freedom in Gangwon Province, allowing physician-patient telemedicine and telephone counseling and prescription cases in the COVID-19 crisis. There are four main issues that could arise with the deregulation of telemedicine: safety, effectiveness, differences in access to health care and the economic industry, and legal responsibility. As a initiative preparation, this study proposed a pilot project for telemedicine and enhanced support for face-to-face care complementary tools, vitalizing remote co-operation, policy model that do not disrupt the medical delivery system, and legal maintenance. In conclusion, as a suggestion of basic premise and direction in the implementation of telemedicine deregulation, the implementation of initiative measures to address issues concerning telemedicine, the review and regulation of conditions to be considered in the implementation of telemedicine, and the establishment of a close communication and cooperative sturcture with medical providers.

본 연구는 최근 정부가 시행하고 있는 원격의료에 대한 규제 완화로 인해 발생할 수 있는 다양한 쟁점들에 대해 분석하여 원격의료 정책 추진 시 선제적으로 준비해야 할 사항을 제안하고, 원격의료 규제 완화시 기본전제와 방향성에 대해 시사점을 제시하는 것이 연구목적이다. 최근 원격의료에 대한 규제 완화 정책 사례로는 강원도 규제자유특구 의사-환자 간 원격의료 허용, 코로나-19 사태에서 전화상담 및 처방 사례를 들 수 있다. 이러한 원격의료 규제 완화와 관련하여 발생할 수 있는 쟁점들은 크게 4가지로 안전성, 유효성, 보건의료와 경제산업 접근 차이, 법적 책임소재로 정리하였다. 본 연구에서는 선제적 준비사항으로 원격의료 시범사업과 대면진료 보완 수단 지원 강화, 원격 협진 활성화, 의료전달체계를 교란시키지 않는 정책 모형, 법적 정비를 제안하였다. 결론에서는 원격의료 규제 완화 추진시 기본 전제와 방향성에 대한 시사점으로 원격의료에 대한 쟁점들을 해결하기 위한 선제적 조치 수행, 원격의료 추진시 고려해야 할 제한조건 검토와 규정화, 의료공급자와의 긴밀한 소통과 협력 구조 마련을 제시하였다.

Keywords

References

  1. CoronaBoard. COVID-19 Dashboard. (2020).(Online). https://coronaboard.com/
  2. The Ministry of Health and Welfare. (2020). Temporary Allowance of Telephone Consultation or Prescription and Substitution(Online). http://www.mohw.go.kr/react/al/sal0101vw.jsp?PAR_MENU_ID=04&MENU_ID=040102&CONT_SEQ=353269.
  3. Y. S. Jang. (2020). Korea Medical Association recommends the member to stop the prescription of telephone consultation entirely. Health focus. 2020. 5. 18. (Online). http://www.healthfocus.co.kr/news/articleView.html?idxno=95167.
  4. Y. S. Choi, (2020). A Study on the Introduction of Telemedicine-Coronavirus Disease 2019 and the Need for the Introduction of Telemedicine. International law review, 12(1), 113-137. DOI : 10.36727/jjilr.12.1.202005.005
  5. H. G. Kim & M. S. Lee. (2019). A Study on the Regulation Status and Improvement Method of Telemedicine - Focusing on User Perception Survey. karis. 22(1), 27-51. DOI: 10.22896/karis.2019.22.1.002
  6. Y. S. Choi. (2020). A Study on the Introduction of Telemedicine - Coronavirus Disease 2019 and the Need for the Introduction of Telemedicine. International law review, 12(1): 113-137. DOI: 10.36727/jjilr.12.1.202005.005
  7. H. J. Lee. (2018). A Study on the Realization of Tele-medicine and the Method of its Improvement. Korean Journal of Medicine and Law, 26(2), 25-50. DOI : 10.17215/kaml.2018.12.26.2.25
  8. D. H. Shin. (2020). 790,000 Non-face-to-face telephone treatment, Clinics 54.5% highest. medifonews.2020.10.20.(Online). https://www.medifonews.com/news/article.html?no=155991.
  9. J. S. Kim, S. H. Oh, S. Y. Kim & P. S. Lee. (2015). A Study on the Current Status of Telemedicine Policy. Seoul: Research institute for Healthcare Policy, Korean Medical Association.
  10. S. J. Han. (2003). Social Research Methods. Seoul: Daeyoung Munwhasa.
  11. S. Y. Lee et al. (2006). Economic analysis and trial project model development of telehealth. Sejong: Korea Institute for Health and Social Affairs.
  12. U. S. Department of Commerce in conjunction with The Department of Health and Human Services, Telemedicine Report to Congress, 1997.1.31. (Online). https://www.ntia.doc.gov/legacy/reports/telemed/index.htm.
  13. The National Law Information Center. (2020). Medical Service Act. no. 17472(Online). https://www.law.go.kr/LSW/lsInfoP.do?efYd=20181115&lsiSeq=204193#0000.
  14. The Ministry of Health and Welfare. (2013). Physicianpatient telemedicine action plan for clinics [Online]. http://www.mohw.go.kr/react/al/sal0101vw.jsp?PAR_MENU_ID=04&MENU_ID=040102&CONT_SEQ=353269
  15. Y. Y. Jeung. (2006). A Study on the Civil Liability of Telemedicine and Some Legislative Proposals. The Korean Society of Law and Medicine, 7(1), 323-386.
  16. S. H. Joung & J. R. Park. (2012). The Current Legal Problems and Improvements of Telemedicine, Proceedings of the Korean Society of Computer Information Conference, 20(2):123-126.
  17. K. H. Baek & Y. H. Chang. (2014). Study on Telemedicine and Duty of Explanation -Focusing on the April 2, 2014 Medical Law Revised Bill-. Hannam Journal of Law&Technology, 21(2): 53-84. DOI : 10.32430/ilst.2015.21.2.53
  18. H. A. Bae. (2015). Articles : Changes in Health Care Service Delivery Means Considering the Quality of Life and the Correspondence of Laws: Focusing on Telemedicine, Korean Law & Society Association, 50: 185-220. DOI:10.1089/tmj.2020.0293
  19. C. J. Kim. (2016). Comparative Legal Analysis of Korean and Japanese Telemedicine and Legislative Assignment, Civil Society & NGO, 14(1): 213-249. UCI : G704-002083.2016.14.1.007
  20. J. Y. Moon et al. (2013). Review on the physician-patient telemedicine in legal and social systemic aspect, Korean Journal of Medicine and Law, 21(2): 202-220. UCI : G704-001448.2013.21.2.005
  21. H. S. Choi & K. Y. Park. (2015). The Critical Study on the Physician-patient Telemedicine in Legal Systemic Aspect -Focused on the Welfare of The Aged Act. Law & Policy Review, 21(1): 297-324. DOI : 10.36727/jjlpr.21.1.201503.011
  22. Y. M. Lee. (2016). A debate about telemedicine in South Korea. J Korean Med Assoc. 9(11):828-831. DOI:10.5124/jkma.2016.59.11.828
  23. H. S. Cho. (2017). The Significance and Condition of Telemedicine's Expansion from the Perspective of Law and Policy, IT & LAW REVIEW, 15: 251-279. DOI: 10.37877/itnlaw.2017.08.15.8
  24. D. H. Kim. (2020). Considerations on Untact Healthcare, Another Name for Telemedicine, Korean J Med, 95(4). 228-231. DOI:10.3904/kjm.2020.95.4.228
  25. K. H. Baek & S. J. Park, (2020), A Study on whether telemedicine is permitted and its scope during the pendemic, Soongsil Law Review, 48, 341-369.
  26. J. C. Kwon, Y. J. Choi & Y. G. Choi. (2014). A Study on Legal and Regulatory Improvement of Telemedicine Service. Journal of service research and studies, 4(1), 83-93.
  27. A. J. Choi &, Y. G. Jung. (2015). Improvement of medical law regulations for telemedicine services. Journal of the Convergence on Culture Technology, 1(2), 85-89. DOI:10.17703/JCCT.2015.1.2.85
  28. M. S. Park, D. Y. Koh & H. S. Chung. (2016). The Effects of Deregulating Telemedicine on Consumer Welfare. Journal of Regulation Studies, 25(1), 25-53. UCI : G704-001058.2016.25.1.002
  29. C. I. Jo. (2017). A Study on the Legislative Framework and Regulations regarding ITC Convergence in Healthcare Field-with a focus on the Telemedicine. Journal of Social Science, 43(2), 1-22. DOI: 10.15820/khjss.2017.43.2.001
  30. B. Stanberry. (2001). Legal ethical and risk issues in telemedicine, Comput Methods Programs Biomed, 64(3):225-233. DOI: 10.1016/s0169-2607(00)00142-5
  31. Hyler, S. E. & Gangure, D. P.(2004). Legal and ethical challenges in telepsychiatry, J Psychiatr Pract, 10(4):272-276. Doi: 10.1097/00131746-200407000-00011.
  32. Arne, J. L. (2014). Ethical and legal aspects of telemedicine, Bull Acad Natl Med,.198(1):119-30.
  33. Veslemoy et al(2014). Patient safety risks associated with telecare: a systematic review and narrative synthesis of the literature, BMC Health Serv Res,14:588. Doi: 10.1186/s12913-014-0588-z.
  34. G. Willians et al. (2000).Safety and risk issues in using telecare, J Telemed Telecare, 6(5):249-62. Doi: 10.1258/1357633001935833
  35. Granja C et al. (2018). Factors Determining the Success and Failure of eHealth Interventions: Systematic Review of the Literature, J Med Internet Res,20(5):e10235. Doi: 10.2196/10235.
  36. Nkiruka D. E et al. (2020). Telemedicine in the OECD: An umbrella review of clinical and cost-effectiveness, patient experience and implementation, PLoS One, 15(8):e0237585. Doi: 10.1371/journal.pone.0237585
  37. Y. S. Choi et al. (2017). A Study on the Regulatory Reform for Promoting the Fourth Industrial Revolution: Focusing on the Sharing Economy and Digital Healthcare. Seoul: The Korean Institute of Public Administration.
  38. J. Y. Moon & Y. H. Park. (2020). Review on the implementation strategy of telemedicine. Future medicine & Humanities, 3(1), 9-20.
  39. Y. C. Yoon. (2019). The government allows doctor-patient telemedicine in Gangwon-do, launches 7 free regulatory zones. Medigate news 2019. 7. 24. (Online). https://www.medigatenews.com/news/1242992937.
  40. Centers for Medicare & Medicaid Services (CMS). (2020). Covered telehealth services for PHE for the COVID-19 pandemic, effective March 1, 2020 (online). https://www.cms.gov/Medicare/Medicare-General-Information/Telehealth/Telehealth-Codes
  41. The Ministry of Health and Welfare. Japan, Wholehearted implementation of physician-patient telemedicine. (2016). (Online). http://www.mohw.go.kr/react/al/sal0301vw.jsp?PAR_MENU_ID=04&MENU_ID=0403&CONT_SEQ=330791&page=1
  42. Ministry of Health, Labour and Welfare. Online treatment based on the spread of the new coronavirus infection (online). https://www.mhlw.go.jp/stf/seisakunitsuite/bunya/kenkou_iryou/iryou/rinsyo/index_00014.html
  43. The guardian. GPs told to switch to digital consultations to combat COVID-19. 2020.06.22. (online) https://www.theguardian.com/world/2020/mar/06/gps-told-to-switch-to-remote-consultations-to-combatcovid-19#maincontent
  44. K. H. Lee et al, (2015). A study on establishing a technical safety assessment system for the Korean telemedicine system, Journal of the Korean Medical Association, 58(12): 1159-1170. DOI: 10.5124/jkma.2015.58.12.1159
  45. J. S. Kim & S. Y. Oh.(2018). A Comparative Analysis on Current Status of Telemedicine Policy: Focused on United states, Japan, Korea,The Korean Journal of Health Economics and Policy, 24(1): 1-35.
  46. J. Y. Kim & G. Y. Lee. (2020). Advantages and Necessities of Telehealth Care Service, Korean J Med, 95(4):217-227. DOI: 10.3904/kjm.2020.95.4.217
  47. The Lancet, (2018), Measuring performance on the Healthcare Access and Quality Index for 195 countries and territories and selected subnational locations : a systematic analysis from the Global Burden of Disease Study 2016 [Online]. https://researchprofiles.canberra.edu.au/en/publications/measuring-performance-on-the-healthcare-access-and-quality-index-.
  48. J. K. Kim, (2013). The Concept and Contents of Constitutional Right to Health, The Yonsei law review, 24(4), 89-131. UCI : G704-002101.2013.23.4.003
  49. The Ministry of Health and Welfare. (2019). Implementation of administrative disposal of 94 training hospitals not complying with the major medical Resident Law[Online]. http://www.mohw.go.kr/react/al/sal0301vw.jsp?PAR_MENU_ID=04&MENU_ID=0403&page=10&CONT_SEQ=347770.