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Doctor will see you anytime you want, via webcam

Carena

The days of using an emergency room when you have a confusing late-night or weekend illness may be numbered. New telemedicine services are expanding in Washington – which allow you to see a doctor using a webcam.

"We can do everything we need to do clinically," says Ralph Derrickson, CEO of a Seattle health-care company called Carena. "It’s more convenient for the patient. They can stay in their pajamas, and they never need to leave the comfort of their home."

Carena has been providing on-call doctors, who make house calls, for over a decade for employees at Microsoft and Costco. This week, Carena launches a service anyone can join, called CareSimple, by paying either a monthly subscription or a non-member fee per visit. The memberships run $35 a month for families, and each visit costs $5; without a membership, the fee is $85.

%22Sometimes%20you%20don%27t%20know%20if%20you%20need%20to%20go%20in%20to%20the%20emergency%20room%20...%20maybe%20it%27s%20a%20very%20superficial%20thing%20where%20a%20Bandaid%20would%20work%2C%22%20says%20Dr.%20Ben%20Green

Like a house-call, using the internet

Carena has 15 doctors and nurse practitioners on staff. They can diagnose a long list of ailments, and can tell you if an injury needs medical treatment or if it's okay to handle at home.

"Sometimes you don’t know if you need to go in to the emergency room. Maybe you don’t need stitches, maybe it's a very superficial thing where a Bandaid would work," says Dr. Ben Green, the medical director for Carena. "With a webcam we can look at the cut, evaluate it, and help you make the right decision."

For someone who has flu-like symptoms, the doctor can show them how to place their fingers on certain pressure points, such as the sinuses. Then, he asks if it feels sensitive or not. Dr. Green says he'd do something very similar if he were evaluating someone in-person.

How it works

The service should feel familiar if you’ve ever been on a web tele-conference or done video-chatting. You send an email or call by phone, and the company replies (usually within ten minutes) with an email that contains a link to a private video conference. The doctors and nurses employed by Carena all work from home, but the company sets them up with a virtual office, so the background looks like a real doctor's office.

Diagnosing using a webcam does raise plenty of questions. In the last few years, the fledgling industry seems to have worked out most of the details, such as how to ensure the webchats are private and secure. Companies such as Carena and American Well, a Boston firm that's one of the pioneers of telemedicine and provides the back-end support for numerous medical groups and insurance companies, have worked out protocols for what a web-consult can cover, and what's off limits.

Companies are springing up all over the country, with names like TeleDoc and MeMD. And each version is slightly different.

Existing medical groups are also dipping in their toes. For example, Multicare Health System of Tacoma has a service just for pregnant women – so they can have some of their routine checkups via webcam.

Some insurance companies nowinclude web-consultation as a benefit.

If you're wondering how to evaluate which of these services is trustworthy, the American Telemedicine Association advises that you should only use services that list their doctors by name, so you can check-out their backgrounds in advance.

Keith Seinfeld is a former KNKX/KPLU reporter who covered health, science and the environment over his 17 years with the station. He also served as assistant news director. Prior to KLPU, he was a staff reporter at The Seattle Times and The News Tribune in Tacoma and a freelance writer-producer. His work has been honored by the American Association for the Advancement of Science (AAAS) and the Knight Science Journalism Fellowships at Massachusetts Institute of Technology.