1Research Institute of Korean Medicine Policy, The Association of Korean Medicine
2Medical Association of Pharmacopunture Institute
3College of Korean Medicine, Kyung Hee University
4College of Korean Medicine, Dongshin University
Correspondence to: Dongsu Kim, College of Korean Medicine, Dongshin University, 67, Dongsindae-gil, Naju-si, Jeollanam-do, Republic of Korea, Tel: +82-61-330-3258, E-mail: dskim20@dsu.ac.kr
Received January 3, 2024 Revised February 13, 2024 Accepted February 16, 2024
Abstract
Objectives
Following the global COVID-19 pandemic, with the escalation of remote medical care formalization in Korea, there is a pressing need for objective data in the Korean medicine field to respond to remote treatment medical care policies. This study aims to investigate the perceptions and acceptance of remote treatments among Korean Medicine Doctors (KMDs).
Methods
After expert reviews and pilot testing, the 31-question survey covered participant characteristics, experiences, forms, intentions, and perceptions related to Remote Treatments. The survey was electronically distributed to members of the Association of Korean Medicine, and 662 clinical KMDs provided valid responses.
Results
Among respondents, 76.1% engaged in remote treatments, utilizing various platforms. Those with experience in Remote Treatments showed a significantly higher willingness to continue participating during the institutionalization process (p<0.001). 49.7% of respondents stated that traditional Korean medicine is competitive in remote treatments, with the main reasons being the ability for regular management after herbal medication(26.1%) and increased patient satisfaction due to sufficient counseling compared to Western medicine(25.2%). Respondents preferred Remote Treatment conditions with a treatment time of less than 10 minutes(47.6%) and equivalent fees to in-person visits(45.6%). Regarding suitable intervention tools during Remote Treatment, respondents favored non-covered herbal prescriptions(39.0%), covered herbal granules(24.6%), and non-covered herbal granules(23.0%).
Conclusion
This study investigated the perceptions and acceptance of KMDs regarding remote treatments. These findings provide valuable insights for policymakers aiming to establish effective policies for Remote Treatments suitable for the Korean medicine healthcare environment.
Gender, Age, Durations of clinical experience, Affiliation, Clinical training, Area of residence
Experience and form of participation in remote treatment
Remote treatment for diseases, Satisfaction with remote treatment, Reasons for not remote treatment
Intention and perception of using remote treatment
Benefits of remote treatment, Concerns about remote treatment, Disease groups suitable for remote treatment, Appropriate time required for remote treatment and mediation tools, Appropriate medical expenses for remote treatment, Desired platform for remote treatment, Readiness and competitiveness of remote treatment in Korean medicine
Table 2
Demographic Characteristics of Subjects
(N=662)
Classification
N(%)
Gender
Male
474(71.6)
Female
188(28.4)
Age group
20–29
42(6.3)
30–39
223(33.7)
40–49
242(36.6)
50–59
121(18.3)
60>
34(5.1)
Durations of clinical experience(year)
<10
225(34.0)
10–19
239(36.1)
20–29
147(22.2)
30>
51(7.7)
No clinical experience
0(0.0)
Affiliation
Korean medicine clinic
497(75.1)
Korean medicine hospital
112(16.9)
Nursing hospital
26(3.9)
Public health center·Public health center branch
19(2.9)
The others
8(1.2)
Clinical training
General practitioner
476(71.9)
Specialist
186(28.1)
Internal medicine of Korean medicine
51(27.4)
Acupuncture & Moxibustion medicine
41(22.0)
Rehabilitation medicine of Korean medicine
26(14.0)
Gynecology of Korean medicine
24(12.9)
Neuropsychiatry of Korean medicine
13(7.0)
Sasang constitution medicine
10(5.4)
Ophthalmology, Otorhinolaryngology & Dermatology of Korean medicine
13(7.0)
Pediatrics of Korean medicine
8(4.3)
Area of residence
Seoul
213(32.2)
Gyeonggi·Incheon
172(26.0)
Daejeon·Chungcheong·Sejong
62(9.4)
Gangwon
15(2.3)
Busan·Ulsan·Gyeongnam
79(11.9)
Daegu·Gyeongbuk
61(9.2)
Gwangju·Jeolla
53(8.0)
Jeju
7(1.1)
Table 3
Remote treatment experience
(N=662, Multiple Response)
Classification
N(%)
Total
Experience
Yes
504(76.1)
662(100.0)
No
158(23.9)
Participation form
COVID-19 telephone counseling center or Korean medicine center operated by the Association of Korean medicine
89(17.7)
504(100.0)
Telephone, internet, or messenger at affiliated medical instructions
467(92.7)
Remote treatment mediation platform
31(6.2)
Others
5(1.0)
Targeted medical condition
Musculoskeletal disorders
85(16.9)
504(100.0)
Health prevention and management condition
329(65.3)
Internal disease
226(44.8)
Management of sequelae after traffic accidents
22(4.4)
COVID-19 and related sequelae
212(42.1)
Chronic conditions such as hypertension and diabetes
35(6.9)
Others
65(12.9)
Time of treatment
Initial visit
171(33.9)
504(100.0)
Follow-up
333(66.1)
Table 4
Requirements for remote treatment
(N=662)
Classification
N(%)
Appropriate treatment time (minutes)
<10
315(47.6)
10–19
312(47.1)
20–29
32(4.8)
30>
3(0.5)
Appropriate treatment fee (rate of in-person visit fee)
<10
122(18.4)
<20
62(9.4)
<30
32(4.8)
Equal
302(45.6)
10>
54(8.2)
20>
35(5.3)
30>
53(8.0)
Others
2(0.3)
Suitable inter vention tool
Covered herbal granules
163(24.6)
Covered herbal prescriptions
51(7.7)
Non-covered herbal granules
152(23.0)
Non-covered herbal prescriptions (including decoctions and pills)
258(39.0)
Determination after In-depth Examinations
25(3.8)
Others
13(2.0)
Preferred platform
Private platform
Actively using existing platforms (such as Ddocdoc, Goodoc, Doctornow)
60(9.1)
Reluctantly using existing platforms
99(15.0)
Public platform
Willing to use a public platform developed by the government or the Association of Korean medicine
481(72.7)
Others
22(3.3)
Characteristics of patients mainly visited
Chronic conditions such as hypertension and diabetes
61(9.2)
Common ailments such as cold
163(24.6)
Musculoskeletal disorders such as degenerative joint diseases and gonarthrosis
21(3.2)
Patients seeking non-covered herbal prescriptions for diseases prevention and health management
189(28.5)
Patients seeking non-covered herbal prescriptions for cosmetic purposes or diet
221(33.4)
Others
7(1.1)
Preparations essential for Remote Treatment in the Korean medicine field
Development of remote treatment manuals or guidelines
262(39.6)
Development of clinical guidelines to address In-depth Examinations
34(5.1)
Establishment of facilities and acquisition of equipment necessary for remote treatment
45(6.8)
Education for Korean medicine doctors on remote treatment
40(6.0)
Development of a certified platform by the Association of Korean medicine
86(13.0)
Development of diagnostic technologies in Korean medicine applicable to remote treatment
34(5.1)
Nationwide promotion of remote treatment in Korean medicine
91(13.7)
Expansion of insurance coverage for prescribable herbal medicines
45(6.8)
Utilization and coverage expansion of diagnostic tests for the management of chronic diseases, such as blood test and urine test
20(3.0)
Table 5
Acceptance of remote treatment
(N=662, Multiple Response)
Classification
N(%)
Total
Preparedness for Remote Treatment in the Korean medicine field
Not well prepared
78(11.8)
662(100.0)
Not prepared
268(40.5)
Moderate
231(34.9)
Well prepared
63(9.5)
Very well prepared
22(3.30)
Competitiveness of Korean medicine in Remote Treatment
Very uncompetitive
27(4.1)
662(100.0)
Uncompetitive
82(12.4)
Neutral
224(33.8)
Competitive
245(37.0)
Very competitive
84(12.7)
Reasons for perceiving a lack of competitiveness
High probability of misdiagnosis due to limitations such as pulse and palpation
50(17.3)
291(100.0)
Constraints of traditional Korean medicine focused on face-to-face procedures like acupuncture, moxibustion, cupping, etc.
78(27.0)
Patient concentration in certain medical institutions
35(12.1)
Limited awareness among patients about Remote Treatment services in Korean medicine
41(14.2)
Perceived limitations in Korean medicine treatments for chronic diseases outlined by the government
53(18.3)
Difficulties in establishing collaborative systems between medical institutions for remote consultations
32(11.1)
Other reasons
2(0.7)
Reasons for perceiving competitiveness
Increased patient satisfaction due to sufficient counseling compared to Western medicine
215(25.2)
859(100.0)
Regular management after herbal medication
223(26.1)
Strengths of Korean medicine treatment in sensitive conditions such as diet and gynecological diseases
172(20.1)
Resolution of medical blind spots
149(17.4)
Influx of new patients
95(11.1)
Other reasons
5(0.6)
Acceptance levels regarding Remote Treatment
Extremely negative (Absolutely unacceptable)
12(1.8)
662(100.0)
Somewhat negative (Only acceptable in unavoidable situations such as infectious diseases)
63(9.5)
Neutral
42(6.3)
Somewhat positive (Worth trying)
312(47.1)
Extremely positive (Proactive and comprehensive acceptance is necessary)
233(35.2)
Table 6
Intention to participate according to the experience of remote treatment (N=662)
Variables
Intention to Participate
Total
P-value
Yes
No
Participation Experience
Yes
478(94.8)
25(5.2)
504(100.0)
<0.001*
No
134(84.8)
24(15.2)
158(100.0)
Total
612(92.4)
50(7.6)
662(100.0)
† Statistically significant with p<.01, Result of chi-square test, Data are presented with frequency(ratio)
참고문헌
1. WHO ends global health emergency declaration for COVID-19. [cited 2023 May 5] Available from: URL: https://www.npr.org/sections/goatsandsoda/2023/05/05/1174269442/who-ends-global-health-emergency-declaration-for-covid-19
2. President Yoon Seok-ryul declares coronavirus pandemic after three years and four months. [cited 2023 May 11] Available from: URL: https://www.donga.com/news/article/all/20230511/119239280/1
3. 9 Future Predictions For A Post-Coronavirus World [cited 2020 Apr 3]. Available from: URL: https://www.forbes.com/sites/bernardmarr/2020/04/03/9-future-predictions-for-a-post-coronavirus-world/?sh=1789759a5410
4. Jin, S. (2020). A Study of Factors Affecting Use Intention of Untact Medical Diagnosis and Consultation Services. The Journal of the Korea Contents Association, 20(12), 180-197.
https://doi.org/10.5392/JKCA.2020.20.12.180
5. Deloitte. (2021). Global Health care Industry Outlook–A full-scale industry transformation in 2021,
6. Korea Health Industry Development Institute. (2023). Keyword Analysis of International Healthcare Trends 2023,
7. Two out of three Remote Treatments are not available, so they need to be modify according to reality. [cited 2023 Aug 09] Available from: URL: https://mpharm.edaily.co.kr/news/read?newsId=01331686635705680&mediaCodeNo=257
8. United States Department of Health and Human Services. Available at: https://www.hhs.gov/hipaa/for-professionals/special-topics/hipaa-covid19/index.htmlAccessed Apr. 20, 2023
9. Raza, T., Joshi, M., Schapira, R. M., & Agha, Z. (2009). Pulmonary telemedicine--a model to access the subspecialist services in underserved rural areas. International journal of medical informatics, 78(1), 53-59.
https://doi.org/10.1016/j.ijmedinf.2008.07.010
10. Sevean, P., Dampier, S., Spadoni, M., Strickland, S., & Pilatzke, S. (2009). Patients and families experiences with video telehealth in rural/remote communities in Northern Canada. Journal of clinical nursing, 18(18), 2573-2579.
https://doi.org/10.1111/j.1365-2702.2008.02427.x
11. President Yoon “will do my best to revise the non-contact medical treatment law”. [cited 2024 Jan 30] Available from: URL: https://www.khan.co.kr/politics/politics-general/article/202401301105001
12. Jeon, J., Park, S., Park, C., Shin, Y., Park, S., & Han, S. (2022). A Research on the intention to accept telemedicine of undergraduate students: based on Social Cognitive Theory and Technology Acceptance Model. Journal of Digital Convergence, 20(2), 325-338.
https://doi.org/10.14400/JDC.2022.20.2.325
13. Park, J., & Kim, J. (2023). Survey study of telemedicine-experienced physicians on the acceptability of telemedicine: using propensity score matching method. J Korean Med Association, 66(6), 393-401.
http://doi.org/10.5124/jkma.2023.66.6.393
14. Kim, J., Lim, J., & Kang, J. (2022). Physicians’ Perceptions and Policy Suggestions for Telemedicine after COVID-19. JOURNAL OF THE KOREA CONTENTS ASSOCIATION,, 22(12), 576-586.
https://doi.org/10.5392/JKCA.2022.22.12.576
15. Sim, C., Lee, E., & Lim, B. (2021). Korean Medicine Doctors’ Perception of Telemedicine. Journal of Society of Preventive Korean Medicine,, 25(3), 1-14.
https://doi.org/10.25153/spkom.2021.25.3.001
16. Kim, K. G., & Jin, X. G. (2021). Comparison of Telemedicine between Korea and China. Journal of China Area Studies, 8(1), 189-214.
https://doi.org/10.34243/JCAS.8.1.189
17. Korean Medical Association opposes allowing non-face-to-face medical first-time visits. [cited 2023 Sep 21] Available from: URL: http://www.newsmp.com/news/articleView.html?idxno=236316
18. Year Book of Traditional Korean Medicine. (2021). National Institute of Korean Medicine Development, The Association of Korean Medicine, The School of Korean Medicine at Pusan National University, Korea Institute of Oriental Medicine.
19. Kim, J. S., Lim, J. Y., & Kang, J. H. (2022). Non-face-to-face care requirements study. Korean Medical Association Research Institute for Healthcare Policy Research report, (2022). 15.
20. Kim D.(2022). Discrete choice experiment to measure consumer preference for the policy attributes of telehealth. Korea Institute for Health and Social Affairs;
https://doi.org/10.23060/KIHASA.B.2022.03
21. The number of ‘non-face-to-face’ treatments is “unusually high compared to other countries.”. [cited 2023 Aug 29] Available from: URL: https://www.docdocdoc.co.kr/news/articleView.html?idxno=3009020
22. Ministry of Health and Welfare. Over three years of non-face-to-face medical treatment, the health of 13.79 million people has been protected. [cited 2024 January 2] Available from: URL: https://www.mohw.go.kr/board.es?mid=a10503000000&bid=0027&cg_code=
23. Koivunen, M., & Saranto, K. (2018). Nursing professionals’ experiences of the facilitators and barriers to the use of telehealth applications: a systematic review of qualitative studies. Scandinavian journal of caring sciences, 32(1), 24-44.
https://doi.org/10.1111/scs.12445
24. Hiratsuka, V., Delafield, R., Starks, H., Ambrose, A. J., & Mau, M. M. (2013). Patient and provider perspectives on using telemedicine for chronic disease management among Native Hawaiian and Alaska Native people. International journal of circumpolar health,
https://doi.org/10.3402/ijch.v72i0.21401
25. Ensuring adequate pay for primary care to improve personalized medicine in Korean medicine. [cited 2020 Oct 15] Available from: URL: https://www.akomnews.com/bbs/board.php?bo_table=news&wr_id=41764
26. Kichloo, A., Albosta, M., Dettloff, K., Wani, F., El-Amir, Z., Singh, J., Aljadah, M., Chakinala, R. C., Kanugula, A. K., Solanki, S., & Chugh, S. (2020). Telemedicine, the current COVID-19 pandemic and the future: a narrative review and perspectives moving forward in the USA. Family medicine and community health, 8(3), e000530.
https://doi.org/10.1136/fmch-2020-000530
27. Reynolds, R., Dennis, S., Hasan, I., Slewa, J., Chen, W., Tian, D., Bobba, S., & Zwar, N. (2018). A systematic review of chronic disease management interventions in primary care. BMC family practice, 19(1), 11.
https://doi.org/10.1186/s12875-017-0692-3
28. Reynolds, R., Dennis, S., Hasan, I., Slewa, J., Chen, W., Tian, D., Bobba, S., & Zwar, N. (2018). A systematic review of chronic disease management interventions in primary care. BMC family practice, 19(1), 11.
https://doi.org/10.1186/s12875-017-0692-3