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

OBJECTIVES: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.