Virtual House Calls

When North Seattle mom Maggie Taylor developed sinus infection symptoms, including a headache and sinus pressure late one evening, she didn’t wait for an appointment with her doctor in the middle of her full-time workday. Instead, she called CareSimple, a service that allows patients to connect with a primary care doctor or nurse by phone or webcam any time.

Fifteen minutes later, Taylor was describing her symptoms to a nurse via phone at Seattle-based health care company Carena, which helped her choose medication and gave her a diagnosis and prescription that same evening. “For something that’s simple and easily diagnosed,” Taylor says, “it’s a lot easier than getting in a car and driving to a doctor.”

Carena launched CareSimple in December, a for-the-public extension of the phone, webcam, email and house call services it has been providing employees of corporations such as Microsoft since 2000. “We’re a primary care provider that doesn’t have a waiting room,” says CEO Ralph Derrickson of Carena, Inc. The service isn’t intended to replace a patient’s primary care doctor (who receives a summary of the visit), but instead handles routine issues, like Taylor’s sinus infection or colds, when seeing a regular doctor is more of an inconvenience. Carena’s doctors are hired and trained by the company and most work there full time.

Carena isn’t the only local company innovating ways for patients, faced with rising costs and increasingly limited time, to access health care. Portland-based Sprig Health, which last year opened a Seattle office, works with a network of local health care providers that patients can tap into via the company’s website and choose services, schedule same or next-day appointments (which happen in-person) and fill out paperwork.

Perhaps the biggest lure for patients plugging into CareSimple and Sprig Health, however, is financial. They know the cost of using both of these services upfront—and it’s often less than traditional in-office medical services, partly due to lower operating costs. Taylor’s consultation cost $10, and any additional visits would have cost $85, which is the non-member rate. Patients who pay the monthly membership fee of $25 to $35 pay just $5 per virtual doctor visit. Sprig’s cost structure is a bit different. There is no membership fee and patients prepay online for their chosen service, which lowers administrative costs for providers. While a women’s health exam can typically cost $425 without insurance, it can be as low as $150 through Sprig Health.

The service also saves health institutions time. “All the administrative details are taken care of,” says Dr. Andrew Appelbaum of Overlake Family Medicine, where patients can book appointments via Sprig Health. “Overlake Family Medicine does not have to bill insurance or the patient.”

Based in Seattle with locations in Tacoma, Kent and Bellevue, Qliance, which opened its first Seattle clinic in 2007, focuses on making doctors extra available to patients. Because Qliance doctors’ incomes aren’t based on the number of patients they see, each doctor sees about 800 patients, compared to a conventional roster of about 2,500, allowing them more time with individuals, who can consult them by email and phone. Patients pay a monthly fee—$65 to $69 on average. “That was one of our goals from the beginning,” says CEO and President Dr. Erika Bliss, “to give the power back to the patients, so they could drive their health care.” It has been a great choice for Don MacPhee, a retired Kirkland resident, and his wife. They began using Qliance when their primary care doctor joined the company. “The freedom is well worth the small fee we pay to Qliance, in addition to our regular health care,” says MacPhee. While other local health care and insurance companies are beginning to offer similar services as add-ons for members, what makes these companies unique is that patients needn’t have insurance to use them, and though they are not intended to replace primary health care services, the lower costs, personalized service, and convenience make the decision to browse an online menu of services, rather than sit in a doctor’s office with the sniffles, far easier.