e-Health in South Korea

In contrast to its e-government and general e-service strategies, Korea’s e-health program was regarded by the WHO as only moderately effective in 2006. Despite starting in 2003 the Korean Program has only now beginning to gain momentum.

Up until 2008 the e-Health Association has developed led by the Ministry of Commerce, Industry and Energy have focused on developing on what it sees as the five core pillars for a successful u-Health industry by 2013. These areas are:

Despite some work by the various Ministries on defining their domestic requirements in terms of electronic health records , e-prescriptions, etc., there has been little real progress on e-health in Korea and many healthcare facilities lack appropriate ICT based information tools.

According to a consumer survey in 2007 the poor level of informatization in healthcare this apparent lack of progress can be attributed to the fact that e–health was not seen as part of the overall e-government strategy and the structure and parlous state of the health sector in Korea following the rapid introduction of universal health insurance.

Following the reorganization of government ministries in 2008 (under the new government administration); e-health attention has begun to focus on e-health as an important growth industry for the Korean economy (like e-government and e-cities before it).

Consequently, relevant government ministries now have more concrete and robust action plans for realization of e-health in effect.

Once again the hand of the Chaebol can be seen to be at work. The strategic planning by the e-Health Association between 2004 and 2007 has been unashamedly commercial – seeking ‘global domination’ of the e-health market and reflecting the lessons learned from a similar ‘blue ocean’ strategy development for e-government.

The Korean government, health solution providers and the telecommunication giants are now seeing an enormous untapped domestic and international market.

It remains to be seen whether Korea can improve on its commercial exploitation of its e-government and e-cities expertise – one thing for sure is that it will be pursued with the same dogged determination.

The government has been investing heavily in recent years in the five areas identified by the e-health association.

Korea’s approach extends the e-health concept to ubiquitous or u-health. Whereas e-health typically concentrates on information sharing between patients (patient access to their records and participation in their health outcomes), healthcare professionals (knowledge and information based decision support systems), solution providers (interoperability) and the general public e.g. health portals – u-health dramatically shifts the place where health care and health procedures takes place from traditional institutions, e.g. clinics and hospitals, to the work place and home.

Whilst the Korean u-health concept embraces and extends the more traditional e-health agenda, it remains to be seen whether Korea can offer any fresh approach or more effective solutions to the problems they observe in other large country e-health initiatives – like the UK’s Care Records initiatives; given a disparate local healthcare landscape dominated by the private sector and with a higher proportion of specialists (80%) to general practitioners than in most countries.

Most likely Korean industry will use overseas ‘green field sites’ in places like North Africa or the Caribbean to develop their expertise in these more mundane areas of e-health, using the well tried inter-government collaboration mechanisms (now helped by Korean government funding programs).

In typical Korean ‘blue ocean’ strategy style - industry and government will almost certainly seek to develop their expertise and market in the area of telemedicine – the proper deployment of which promises to reduce healthcare costs as much as more traditional e-health initiatives, by establishing an early lead in the development of policy reform and standardization.

Despite significant pioneering contributions, e.g. DMB, Wibro, etc., to international standards development over recent years – Korea has largely failed to gain international acceptance of these standards and gain the hegemony it sort in sectors like e-government and e-cities.

In the case of e-health, Korea has stepped up its engagement with standards bodies, particularly in Europe, to gain greater acceptance for Korean technologies and de-facto standards on the world stage and hence gain ICT share of the u-health market.

The development of Korean and international standardization systems for medical system solutions is a stated ‘success factor’ in their e-health strategy.

A recent Ministry of the Knowledge Economy (Korea) sponsored event with the European Union’s Directorate on the Information Society is indicative.

At this 2008 event Korea proposed wide sweeping cooperation and collaboration with the EU in such key e-health areas as:

In addition the global partnership program runs an ICT Policy Assistance Program in some eighteen countries along with ICT learning programs, ICT cooperation centers, Internet volunteer schemes – and promotes itself as the world’s best partner for digital prosperity.

Analysis

The Korean u-health program faces a dual challenge:

Findings and Analysis

The main strengths of Korea’s e-health program are:

Korea has also reflected on its inability to translate its impressive world e-government rankings, numerous awards for innovative services like e-people, innovative holistic concepts like e-cities, inter-government collaborative agreements and pioneering efforts in establishing ground breaking standards, e.g. DMP (iTV) and Wibro (mobility) standards into commercial success overseas.

As a result it has a greatly strengthened global program to back its blue ocean strategies, particularly in u-health.

The Korean government has also moved quickly this time to address the soft issues of u-health; developing and enacting leading-edge laws and policies to deal with the new issues that arise from practicing healthcare outside of traditional healthcare environments, e.g. in the home, where less robust (cheaper) medical instrumentation may be deployed or where healthcare services are sold to overseas hospitals – laws will need to be enacted to both protect patients and provide limited liability for instrument manufacturers and health care professionals.

Its increased (well funded) collaboration with world bodies, particularly key directorates of the European Union and joint Asia Pacific forums will help Korea to better understand the cultural differences that might impact acceptance of Korean notions of healthcare. Korea’s late start at addressing the fundamental information sharing aspects of more traditional e-health developments like electronic care records in Korea may prove to be the Achilles heel of Korea’s commercially based e-health strategy unless it is able to leapfrog some of these requirements in innovative ways.

For example e-health has traditionally required fixed broadband infrastructure (e-readiness), however many of the newer, less developed countries, of the EU are using their ‘late starter advantage’ to use much improved wireless technologies to catch-up and overtake their more developed neighbors. Korea may be able to do this at home.

Once again, the opportunity is for global hegemony in the new area of telemedicine exists for Korea and Korean industry in the advanced areas of u-health as it did with e-government and e-cities. Time will tell as to whether the significant refinements to the Korean approach will effect the desired outcomes, i.e. an advanced u-health environment at home driven by commercial leadership internationally.

Korea also has a ‘late-starter’ advantage in the difficult e-health areas of participatory decision making and consultation.

Clearly lessons have been learned from the significant challenges faced by countries (particularly the UK) in securing the support and confidence of healthcare professionals and the public for measures designed to protect patient privacy, confidentiality, and the central storage and processing of sensitive patient health information electronically. The long up-front consultative process with clinicians and companies coupled with increasingly sophisticated and convenient cross-government e-inclusion mechanisms for policy making and participation may help smooth the process of change and adoption in the e-health arena. Possibly the greatest threat to Korea’s u-health program is also one of its strengths – harnessing the power of the Chaebol. Despite the undisputed technological capacity of Korean conglomerates, they have often been criticized for their ethical standards and their cozy relationship with government. In addition, the diverse nature of the conglomerates leads to a lack of brand power in any one sector.

Korea u-health strategy will depend heavily on its ability to quickly establish trusted ethical and technical brand identity in the health sector for both large and small specialist companies – this will not be easy to achieve.

Though Korea’s government and industry is probably better prepared for a ubiquitous healthcare revolution than most – it may well find itself pioneering and educating a world that ultimately turns to its own (often more trusted, better known and less linguistically challenging) health sector providers to supply their needs.

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