Abstract

This study identified clinical domains suitable and unsuitable for telemedicine in Korea and explored safeguards for its phased implementation. A three-round modified Delphi study was conducted from September 8 to November 18, 2022, involving 21 experts nominated by five professional organizations. Panelists evaluated 20 candidate service domains, six exclusion domains, and 16 specialty-specific domains using a four-point Likert scale. Consensus was defined as a convergence index of ≤0.5 and a consensus index of ≥0.75. Positive consensus emerged for functions related to chronic disease follow-up and monitoring, infectious disease monitoring, community-based home care, disability-related care, services in medically underserved areas, and clinically stable neurological or neurosurgical populations. Conversely, negative consensus was reached regarding long-term care hospitals, urolithiasis, and ophthalmic consultations. Four exclusion domains achieved consensus: emergencies or urgent conditions, invasive or other face-to-face interventions, new conditions or injuries requiring direct care, and suspected postoperative complications. While most experts preferred to exclude cases requiring computed tomography (CT), magnetic resonance imaging (MRI), or laboratory confirmation, this criterion did not meet the predefined threshold. Therefore, telemedicine should be gradually introduced for low-risk, clinically stable populations as a complement to in-person care, underpinned by clear accountability, digital access, and pathways for in-person assessment.