Jan. 21--Michiganders now have 24-7 access to a nurse practitioner and about 200 common prescriptions through a new online medical service -- the latest in a world driven by speed, convenience and what can be obtained by keyboard.

Officials of Minnesota-based www.virtuwell.com say their online clinic can save time and money -- not to mention a trip to a germy, crowded waiting room. Michigan is the third state in which the service has been launched. The cost is $40 per visit.

Services are covered by some insurers in Wisconsin and in Minnesota, including Blue Cross Blue Shield plans in those states; virtuwell officials are now pursuing similar agreements in Michigan.

Although virtuwell's nurse practitioners may be answering your questions from their home computers, each are experienced practitioners and licensed to practice in Michigan, according to the company, which was launched last week by Bloomington, Minn.-based HealthPartners, a commercial health plan and group of health care companies that primarily services customers in Minnesota and Wisconsin.

"I talk to moms all the time," said Gwen Verchota, virtuwell's care delivery coordinator, and head of the team of 15 nurse practitioners who have taken more than 40,000 calls since virtuwell launched in 2010.

"We found that we save consumers about 2 1/2 hours a week," she said.

Very often, the ache or pain or itch, especially if the patient has experienced it before, is far from a medical mystery, Verchota said.

A parent knows the sound of a toddler's ear infection when it breaks the 3 a.m. stillness for the umpteenth time, just as a woman with chronic bladder infections recognizes the sense of urgency that precedes searing pain.

"It's midnight. She's in bed and she recognizes the condition," Verchota said. "She's miserable."

Rather than having to dress and find shoes, drive to an emergency room, wait, see a doctor, and then return home exhausted several hours later, the woman can now pull up to her keyboard, answer an online questionnaire, possibly talk to a nurse practitioner, and the prescription may be sent online to the local pharmacy the woman selects.

An option to upload a photo -- say, of that oozing sore between your toes or of your toddler's bloodshot eyes -- can help confirm the diagnosis, Verchota said.

"We use images a lot. Right now it's a cold sore season, and it's hand eczema season, too. It's cold and the air is dry and the skin is dry," she said.

For the most part, prescriptions are for antibiotics, anitviral and antifungal medicines, Verchota said.

This new adaptation of health care may not be for everyone. And there's a concern from some doctors about those who prescribe medications or dispense medical advice to a patient with whom there is no relationship, said Dr. Michael Zaroukian, vice president and chief medical information officer at Lansing-based Sparrow Health System and co-chairman of the health information technology committee at the Michigan State Medical Society.

In his own practice, Zaroukian said he uses a Skype-like technology for e-visits with some patients long-distance, but only after first developing an in-person doctor-patient relationship with them.

That way, he said, he has an established record of their family history, past health care, even a better understanding of the way they communicate.

Still, like other forms of telemedicine or even clinics found inside chain store pharmacies, www.virtuwell.com might be a practical alternative for someone with a simple malady who doesn't have quick access to a doctor.

"They make no bones about the fact they're here to help with the simple things," Zaroukian said. "The key question is, 'Do I trust it to be safe and effective and to give me the kind of service I'm looking for?' "

Kevin Palattao, virtuwell's vice president, is clear: The company doesn't prescribe painkillers or addicting narcotics, and it makes no profit from prescriptions. In short, there's no incentive to push unnecessary drugs.

In many cases, consumers are advised to seek medical attention in person from a local health provider.

"We have a fairly narrow menu of items," Palattao said. "The things we treat are the things that can accurately diagnose with the appropriate online interview."

Verchota calls them the Big Three -- sinus infections, bladder infections and pinkeye. And toss in a significant number of cases of swimmer's ear for the summer and flu during the winter, she said.

Contact Robin Erb: 313-222-2708 or rerb@freepress.com

More Details: Conditions that can be diagnosed

"What do you think you have?" That's the first question that nurse practitioners at www.virtuwell.com ask users, and they might request a photo, too.

Among the conditions they can diagnose:

--Acne

--Bladder infection

--Breast infection

--Bronchitis

--Burn and sunburn

--Chlamydia, gonorrhea and trichomoniasis

--Cold, cough and allergy

--Deer tick bite

--Ear pain

--Eczema

--Flu

--Lice

--Shingles

--Cold sores

--Chicken pox

--Athlete's foot

--Ringworm

--Ingrown toenail

--Impetigo (a bacterial skin infection)

--Intertrigo (a fungal infection)

--Hives

--Lyme disease

--Poison oak, poison ivy --Diaper rash

--Yeast infection

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