Telemedicine and related technologies in South Korea:report of a DTI-supported overseas mission to South Korea in March 2001

摘要

The mission was sponsored by the University of Portsmouth, home of the UK National Database of Telemedicine and co-host of the UK Telemedicine Information Service. The aim of the mission was to explore opportunities for co-operation between UK and Korean organisations in the field of telemedicine and related health informatics areas. Our primary aim was to find out what they are doing, but equally to let them know what is going on in the UK. The mission visited Seoul in South Korea between 5th and 9th March 2001. We made 14 visits to organisations, and met some of the leaders of the medical informatics community and some political policy makers in the health sector.South Korea does a large amount of trade with the USA and Japan, but is looking to increase its relationships with China, Southeast Asia (including Malaysia) and Europe. The UK is Korea's 10th biggest trading partner, with the balance of trade being firmly on the Korean side. However Koreans like and respect the British and remain grateful for the UK's commitment during the Korean War. Rapprochement with North Korea has started after a long period of zero contact. That may lead to some new challenges and opportunities for the South.The technical infrastructure in Korea is excellent. 50% of the population have Internet access, ISDN lines are virtually universal and South Korea is the fastest growing market in the world for broadband access.The Korean health sector has many interesting features. Korea spends a lower proportion of GDP on healthcare than the UK. 98% of the populace are members of a national insurance scheme that pays the cost of many healthcare services. Most hospitals are private, and organised into groups, often centred on a teaching hospital in Seoul. It is not unusual for an individual to visit several doctors to seek multiple opinions on his/her condition – in some cases we were told possibly as many as 10-15. As a consequence, it often happens that a patient is subjected to the same test or investigation many times over. The healthcare sector in Korea is very enthusiastic about IT solutions. However, like other service industries, the healthcare industry in Korea has always been relatively underdeveloped, and therefore could benefit from UK expertise on topics such as service delivery.Telemedicine in Korea is generally of the "real-time" type, with most consisting of a videoconferencing link between doctor and patient. We saw or heard of examples where it is used to link patients at remote sites to regional centres, or to specialists at hospitals in Seoul. A project to provide telecare support to the housebound and mentally ill is underway.Much effort has been put into the development and installation of hospital information systems to manage patient records and radiology images. We saw a number of these in operation, some of Korean manufacture, some from overseas. Because of the prevalence of patients seeking multiple medical opinions, much work is going into enabling the sharing of patient information.Our impressions of the political and economic environment were generally positive. South Korea is a country with a phenomenal success rate for economic expansion. It has a successful IT sector that is leading the way in the sort of economic reforms that are necessary for the long-term growth to be sustained. Although the political and governmental systems do not work precisely like our own, it is possible to make things happen there.There are a number of reasons why telemedicine offers good business opportunities in Korea:•Patients' desires for multiple diagnoses.•Patients' increasing desire to seek diagnoses from centres of excellence rather than their nearest doctor.•The need to link rural areas to specialist centres in the big cities.•The difficulties in moving around the big cities.•The government's intention to remove the legal barriers to the use of telemedicine.As the result of our mission, we make the following recommendations:1.Steps should be taken to encourage contacts between the UK and Korean health sectors. We recommend that key players in Korean healthcare be identified and invited to the UK to see how we do things.2.We did not see first-hand any examples of telecare in Korea. This may provide an untapped market for UK expertise and we recommend a follow-up visit by a small group to explore that in more detail.3.We were not able to find out as much as we would have liked to about the use of smart cards in Korea. This may be a topic for a future mission to explore.4.It is unlikely that in the short term any British company would be able to break into the Korean market for hospital information systems, PACS systems or basic videoconferencing – the Korean market for these is relatively well established. Better opportunities may exist in other Asian countries.5.However, Korea does have the technical infrastructure in place that is necessary to underpin a wide variety of service-driven activities. We believe that in the areas of education, consultancy and the provision of service-supporting IT systems, Korea has much to learn from UK companies. Support should be provided, perhaps in the form of a trade mission, for the development of further contacts in this field.