The study, conducted by Hanbit Jin, Eunji Ahn, Ji-eun Yu, Yohan Choi, and Dongsu Kim of the College of Korean Medicine at Dongshin University, followed the Joanna Briggs Institute methodology for scoping reviews and reported its findings in line with the PRISMA-ScR guidelines. The team searched five databases, PubMed, Embase, the Cochrane Central Register of Controlled Trials, the Korea Citation Index, and the Research Information Sharing Service, from their inception through 16 March 2026, supplementing the search on 18 March 2026 and screening reference lists of included studies. The review protocol was registered on the Open Science Framework before data collection began, a step that strengthens the transparency of the approach.

The eligibility criteria were deliberately broad in one dimension and strict in another. The researchers included original empirical studies conducted in South Korea, but only when the implementation of a defined Korean medicine-related target sat at the center of the study. Crucially, they allowed two very different kinds of targets. The first was the kind familiar to most implementation scientists: discrete clinical or public health interventions, such as a specific treatment delivered to patients. The second was arrangements, the organizational and policy structures through which care or policy is organized, such as clinical pathways, collaborative practice agreements, or public programs. Two reviewers independently selected, charted, and coded every study, reducing the risk that individual judgment would skew the classification.

After screening, twenty-two studies made the final corpus. What happened next is the most striking finding of the review. In post-inclusion coding, all twenty-two studies turned out to be arrangement-focused. Not a single study was intervention-focused, and none combined both orientations. In other words, when South Korean researchers study the implementation of Korean medicine, they are almost never asking how a specific therapy spreads into routine use. They are asking how the scaffolding around Korean medicine services and policies can be made to work at all.

The distribution of targets within that arrangement-focused corpus tells its own story. Clinical pathways already in use were the most common implementation target, appearing in eight of the twenty-two studies. Programs and collaborative practice arrangements followed, with four studies each. The remaining studies addressed other kinds of organizational or policy arrangements. This hierarchy suggests that the practical questions animating Korean medicine implementation research in South Korea concern how existing service structures operate and connect, rather than how novel interventions can be pushed into new settings.

The review also classified studies by their primary implementation focus, drawing on established conceptual distinctions in implementation science. Operationalization, the work of making an arrangement function in practice, was the dominant focus, appearing in eleven studies. Diffusion or adoption, coordination, and formal incorporation each accounted for three studies, while legitimation, the process of securing institutional acceptance, was the primary focus in two. Perhaps most telling is what was absent: no study focused primarily on sustainment, the long-term maintenance of an implemented arrangement. For a field where institutional survival is a persistent concern, that gap is notable.

The contextual features that recurred across the studies form a coherent portrait of the environment in which Korean medicine implementation unfolds. Public-sector incorporation, demands for legitimacy and evidence, the professional and organizational separation between Korean medicine and conventional medicine, and the boundaries set by reimbursement and regulation appeared again and again. These are not incidental background conditions. In a dual medical system, the very definition of an implementation problem is shaped by the fact that two parallel professional worlds must coexist, each with its own institutions, funding streams, and evidentiary expectations.

The authors conclude that, within this corpus, Korean medicine implementation has been studied as the work of making service and policy arrangements workable, and in some studies of supporting their continuation or institutional legitimacy, rather than as the spread of discrete interventions. That framing has consequences. Implementation science, as it has developed largely in Western, conventionally dominated health systems, tends to take the intervention as the unit of analysis and to measure outcomes such as adoption rates, fidelity, and reach. The South Korean literature, by contrast, treats the arrangement itself as the thing to be implemented, which shifts the relevant questions toward governance, coordination, and institutional acceptance.

Why does this matter beyond South Korea? The authors argue that their findings support examining the arrangements enabling service delivery alongside intervention uptake in other institutionally differentiated systems. Many countries grapple with how to integrate traditional, complementary, or integrative medicine into mainstream health care, and the World Health Organization has increasingly emphasized evidence-informed integration. The South Korean case suggests that in such contexts, implementation research that focuses exclusively on discrete interventions may miss the structural work that determines whether those interventions can function at all. A clinical pathway, a reimbursement rule, or a collaborative practice agreement may be the true bottleneck, and studying the therapy alone would never reveal it.

The methodological rigor of the review lends weight to these conclusions. The dual independent screening and coding, the pre-registered protocol, the multi-database search spanning both international and Korean-language sources, and the adherence to recognized scoping review standards all reduce the likelihood that the pattern is an artifact of selective inclusion. At the same time, the authors are careful to frame their conclusions as applying within this corpus of twenty-two studies, acknowledging that scoping reviews map the landscape rather than establish causal claims. The work was supported by the Korean Medicine Innovation Technology Development Program, funded by the Ministry of Health and Welfare and the Korea Health Industry Development Institute, though the funder had no role in the design, analysis, or reporting of the study.

For implementation scientists, the review offers a conceptual provocation: the field’s standard toolkit, built around intervention spread, may need extension for systems where professional and organizational boundaries fragment the terrain. For policymakers in countries considering the integration of traditional medicine, it offers a caution and a roadmap in one: the arrangements matter as much as the therapies. And for the Korean medicine community itself, the identification of sustainment as an unstudied focus points toward a clear research agenda. As health systems worldwide experiment with pluralistic models of care, the South Korean experience, now systematically mapped, provides one of the most instructive natural experiments available.

Subject of Research: Implementation targets and problem framing in Korean medicine within South Korea's dual medical system

Article Title: Implementation targets and problem framing in Korean medicine in South Korea: a scoping review

Article References: Jin, H., Ahn, E., Yu, J.-E., Choi, Y., & Kim, D. (2026). Implementation targets and problem framing in Korean medicine in South Korea: a scoping review. BMC Health Services Research. https://doi.org/10.1186/s12913-026-15714-5

Image Credits: AI Generated

DOI: 10.1186/s12913-026-15714-5

Keywords: Korean medicine, implementation science, scoping review, dual medical system, health services research, South Korea, clinical pathways, collaborative practice, health policy, traditional medicine integration, institutional legitimacy, BMC Health Services Research