"Telemedicine Should Focus on Chronic Disease Management; Physicians' Autonomy Must Be Guaranteed"

Professor Kim Heonseong: "We need to fill gaps in care between in-person visits"
Physicians' judgment should take precedence over uniform prescription limits

There have been calls to view telemedicine not only in terms of greater convenience or concerns about misuse, but also as a tool for managing chronic conditions such as hypertension and diabetes. The calls also stressed the need to respect physicians’ clinical judgment while strengthening their accountability, and to establish a care system based on medical evidence rather than imposing uniform regulations.

Kim Heonseong, a professor in the Division of Endocrinology at Seoul St. Mary's Hospital, The Catholic University of Korea, made the remarks at a lecture hosted by the Korea Medical and Bio Reporters Association on October 20. “Telemedicine is meant to manage patients during the periods when they do not need to visit the hospital. For example, they would continue to come to the hospital once every three months, while receiving care during the intervening periods,” he said.

Professor Kim identified chronic conditions such as hypertension, diabetes and dyslipidemia as key areas for telemedicine. Regular hospital visits alone make it difficult to continuously monitor patients’ day-to-day health, he explained. Analyzing data collected by medical devices such as continuous glucose monitors (CGMs) and providing appropriate feedback from medical professionals can help close gaps in care between appointments.

He said the need for telemedicine should not be dismissed simply because access to healthcare is high in South Korea. “When discussing accessibility, we must never focus only on distance. We need to consider access in terms of time and physical ability as well,” Professor Kim said. “Telemedicine can help office workers who find it difficult to make time for appointments and older people with limited mobility.”

He also emphasized that platforms, medical devices and feedback from medical professionals must work together to improve the quality of telemedicine. Diabetes management, in particular, requires more than video consultations; it also needs systems that analyze blood glucose data along with records of meals and exercise, and provide patients with personalized advice. “Doctors now need to consider how they should provide feedback based on these blood glucose readings,” Professor Kim said. “The process should go beyond collecting data from devices; medical professionals must be able to interpret it and use it to manage patients.”

Kim Heonseong, professor of endocrinology at Seoul St. Mary's Hospital, Catholic University of Korea

On the regulatory front, he argued that “physicians’ autonomy and discretion should be guaranteed.” Rather than uniformly limiting the number of days’ worth of medication that can be prescribed to first-time patients, physicians should be allowed to make decisions based on a comprehensive assessment of patients’ previous prescription history, test results and current condition. Restricting prescriptions for patients who have been taking medication for the same condition at another medical institution simply because their visit is administratively classified as a first appointment could lead to unnecessary follow-up visits and interruptions in treatment.

However, autonomy does not mean unrestricted permission. “Physicians should be given strong accountability in return for being granted autonomy,” Professor Kim said. “They should check patients’ previous prescriptions and test records, switch to in-person care when there is clinical uncertainty, and follow medical evidence and standard clinical guidelines.”

For telemedicine platforms, he proposed making use of private-sector technological capabilities while having the government oversee them through certification and guidelines. Some platforms’ commercial inducements may need to be regulated, but consolidating services into a single public platform could hinder service innovation and user convenience, he said.

“Telemedicine should be developed as a complement to, not a substitute for, in-person care,” Professor Kim said. “We need to accumulate pilot-program data based on patient safety and quality of care, and refine the system in stages.”

This content was produced with the assistance of AI translation services.