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Virtual Urgent Care: The Doctor Will Skype You Now

Telemedicine is rising to new levels of accessibility thanks to the increasing prevalence of smartphones, tablets and webcam equipped computers.

It has been around for a long time to connect rural health care providers to specialists in the big city.

This month, Tacoma-based Franciscan Health System took telemedicine to a broader realm. It became one of the first hospital networks in the country to offer "virtual" urgent care. A video chat could replace a hectic trip to a medical clinic for a patient who prefers this convenience.

Picture this: You're at home with a bad cold, aching face and your snot has turned green. That was Diana Rae's actual predicament recently. The nurse educator from the small town of Tenino, Washington demonstrates how she could have been seen by a doctor from the comfort of home with a wifi-connected iPad.

Dr. Ben Green, one of the doctors with Franciscan Virtual Urgent Care, connects with Rae using the free video-chat software Skype, now owned by Microsoft.

Dr. Green has Rae describe her symptoms. Then the difference video chat makes: The doctor performs a physical exam by mimicking what he wants his patient to do.

"Can I have you actually push on your cheeks and push on them quite firmly," Green says to Rae. "Tell me if that is causing you any pain, discomfort. Is that tender?"

Rae reponds, "Well, over here on the right side, it's not so bad. But over here on the left, it's sore... very sore right here."

Dr. Green diagnoses a sinus infection and is able to prescribe an antibiotic.

He tells me about 75 percent of the time, the patient's ailment can be treated remotely like this.

"Patient safety is really important to us," he says. "So if we feel like the patient is not safe to be treated in this manner, we're going to suggest other alternatives for them."

The Franciscan Health System charges $35 for the virtual house call. Administrators say the cost is not covered by insurance. If your health coverage includes a nurse hotline, that phone consultation by contrast is usually free. On the other hand, a registered nurse by law can't diagnose or write prescriptions.

Either option is certainly way cheaper than going to the ER or urgent care.

For Diana Rae's original sinus infection, she got help over the phone. But after trying out the video conference she says she'd pay the $35.

"I would've paid twice that for the convenience of getting taken care of without having to sit in a waiting room, wait, and get exposed to everyone else's germs," Rae says.

Franciscan contracted with a Seattle-based tele-health company called Carena to add virtual urgent care delivered via Skype or phone. Carena is one of several companies doing this around the country.

But a company executive laments that state regulations haven't kept pace with telemedicine. The virtual urgent care staff has to be separately licensed in each state it does business in. Which means for now Carena can diagnose and treat in Washington and California, but not Oregon and Idaho.

On the Web:

"The doctor will see you anytime you want, via webcam" (Feb. 2013) - KPLU
"The online emergency room" (July 2012) - KUOW 
Virtual Urgent Care - Franciscan Health System 
Carena, Inc. - official site 

Now semi-retired, Tom Banse covered national news, business, science, public policy, Olympic sports and human interest stories from across the Northwest. He reported from well known and out–of–the–way places in the region where important, amusing, touching, or outrageous events unfolded. Tom's stories can be found online and were heard on-air during "Morning Edition" and "All Things Considered" on NPR stations in Washington, Oregon, and Idaho.