Legal Barriers to Implementing AI-Enabled Emergency Medical Services in Korea: Focus on the Medical Service Act,...

In prehospital and in-hospital emergency care, artificial intelligence (AI)-enabled emergency medical services (EMS) systems are reshaping clinical workflows through real-time triage, automated hospital assignment, telemedicine, and biometric monitoring. However, their implementation in Korea has revealed substantial legal and regulatory barriers. This study analyzed the structural incompatibilities between AI-enabled EMS and Korea's current legal framework, with particular attention to the Medical Service Act, Emergency Medical Service Act, and Personal Information Protection Act.

We conducted a statutory review and case analysis of pilot projects, including the Chungbuk Smart EMS Project, the AI HOTline in Ilsan, and Yonsei's AI-Ambulance model. We also performed a comparative assessment of foreign regulatory frameworks, including the US Health Insurance Portability and Accountability Act and the EU General Data Protection Regulation.

Key barriers included the restriction of remote care to interphysician communication under Article 34 of the Medical Service Act, the lack of legal mandates for real-time hospital capacity sharing under the Emergency Medical Service Act, and limits on real-time sensitive-data processing caused by vague emergency clauses in the Personal Information Protection Act. These barriers constrain the scalability of AI-enabled EMS in Korea.

To support lawful and secure integration of AI-driven emergency care in Korea, we propose legislative revisions that establish emergency exceptions for remote AI-supported guidance, require hospital resource disclosure, and provide safe-harbor protections for healthcare professionals who rely on certified AI tools. A harmonized legal infrastructure is essential for realizing the potential of digital transformation in emergency care.