Clients Can Choose Between Email and Telephone

eDocAmerica, the Arkansas-based company that allows clients to ask questions of medical providers over the Internet, is adding a voicemail service this spring.

Piloted this fall, eDoc Voice will allow the Arkansas-based company’s 2.5 million clients to call directly into a toll-free number and record their medical questions. Within 24 hours – and often within two to four hours – they’ll get a return phone call with recorded answers from one of eDocAmerica’s medical providers.

The pilot phase allowed the company to iron out certain technical details, such as the amount of time allowed for a client to record a question or how long to wait after a client answers the phone before the provider’s recorded response begins. Smartphone applications should be available by the summer.

Matt Henry, the company’s director of client relations, said eDoc Voice presents the same advantages as eDocAmerica’s web-based service – namely, that clients can get timely and convenient medical information from a trusted source. “Our users have indicated over the years that they really value the asynchronous aspect of the service where, on their time when it’s convenient for them, they can call and leave that message,” he said.

eDocAmerica was founded in 1999 as a result of a conversation that Dr. Charles Smith, executive associate dean for clinical affairs at the University of Arkansas for Medical Sciences, had in the locker room at the Little Rock Athletic Club with a human resources executive at Acxiom, a data mining firm. Smith had become convinced that a third of the patients he saw could have stayed out of the doctor’s office had they been able to communicate with him beforehand. During the course of the conversation, the idea for creating a pilot program for Acxiom employees was born.

Launched through UAMS’ Bioventures program, the business went private about a year later and has since evolved into its present form, where clients log into a website and leave a message with the company’s medical team. Clients are alerted via email that the answer is available at the same secure site. One physician is always on call to answer questions, which can range from specific medical queries to general questions about health items in the news, such as whether to be vaccinated against the H1N1 virus.

The service has grown to encompass 13 physicians as well as psychologists, pharmacists, dentists, dietitians, and fitness trainers. Clients on the Web have access to a 3-D health encyclopedia and 250 health videos. Two health assessments are available – one geared for patient use and the other designed to provide feedback to employers. A 24-hour nurse phone line is available for urgent and emergency situations.

Now available in 50 states and more than 30 countries, the service is sold through employer insurance plans on a group basis. Clients can access it an unlimited number of times with no co-pays or additional costs – and yes, some clients, known jokingly within the firm as “e-chondriacs,” do take advantage of that fact. Individual plans also are available.

An independent study by Little Rock-based HISTECON Associates that was contracted by eDocAmerica found that the University of Arkansas System’s self-funded health plan saved $103,300 because of its relationship with eDocAmerica in 2004-05. The 16 percent of employees who took advantage of the service had annual claims that averaged $89 less than their fellow employees who did not use the service.

According to Henry, users self-report that the service saves them an unnecessary office visit about 25 percent of the time, and while he said that is not the primary goal, it is a positive byproduct. “On the flip side of that, I would say that it’s not uncommon for our medical team to tell somebody or encourage somebody to go see their doctor and to give them three, four, five questions that they need to ask when they go,” he said. “Sometimes we’re helping people catch things earlier, things that are more significant than they realize, encouraging them to get treatment.”

eDocAmerica’s providers do not have a doctor-patient relationship with their clients and have never been sued. Smith, eDocAmerica’s medical director, stresses that he and his fellow providers don’t provide medical advice or dispense prescriptions.

“It’s really just providing information to people, educated guidance, if you will, to them, that they can use to make decisions about their own health,” he said.

Doctors and clients often engage in back-and-forth discussions that ultimately end with the doctor suggesting what the problem might be, providing a website link, and encouraging the client to visit their personal physician. Freed from the time pressures that occur in the doctor’s office, physicians can research an issue and find relevant articles on the Internet.

Henry said he and his wife used the service themselves when she became pregnant and an ultrasound revealed a dermoid cyst on her ovary. Concerned, he contacted the service and was reassured by Dr. Kent Davidson, MD, that the condition likely had existed throughout her life.

Smith said the medical community is supportive of what eDocAmerica is trying to accomplish.

“We’ve had expressions of support and comfort level,” he said. “I think most people in the medical community know that we’ve been around a long time, they kind of know who we are and what we’re doing. And they trust what we’re doing to be in the best interests of their patients, and that we work to direct them back to their own doctors when it’s appropriate.”

eDocAmerica is the nation’s third largest company of its kind, and Smith said services like it will become more common as technology spreads and as the shortage of doctors, particularly primary care physicians, worsens. The Association of American Medical Colleges predicts that shortage to reach 91,500 doctors by 2020.

“I think this is going to be increasingly viewed as an attractive alternative to fill the gap in the health care system,” he said.

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