Anna Keyes, an employee at Mustang CAT, a Houston-based Caterpillar dealer, couldn't manage to shake the nagging congestion in her chest last August. So she walked down her office hallway to a room where she saw a doctor--on a video screen.

Keyes sat on a table as a clinical paramedic took her blood pressure and temperature and then assisted Dr. Barry Diner while he examined her remotely, from his office 20 miles away. The doctor listened to her chest with an Internet-connected stethoscope and examined her throat using a laryngoscope equipped with a handheld video camera. Twenty minutes later, Keyes walked back to her desk with a diagnosis of an allergy and a prescription for prednisone and an inhaler. "It was just so easy," she says.

Telemedicine isn't a new concept, but it has traditionally been reserved for people living in secluded areas of the country where physicians are not readily available. Employers, however, are now providing the technology to employees to help control health care costs, keep workers healthier, and boost productivity. A number of services, such as MeMD, Teladoc, MDlive, Consult A Doctor, NuPhysicia, and American Well, offer programs to employers that allow their workers to visit doctors (most of whom work on a contract basis) via computer, rather than leaving the office for an appointment.

For Keyes, the visit was free. In addition to providing traditional health insurance, Mustang CAT pays $22 per month for each of the 350 employees in its Houston headquarters to access a virtual clinic provided by NuPhysicia, a Houston-based medical-services company. The payoff for the company has been significant. When Mustang CAT renewed its health insurance plan last year, its premiums were initially set to increase 26 percent, but they instead rose just 15 percent. "The insurers were so pleased that we were taking steps for wellness that they dropped our premiums," says Doug Fisk, vice chairman of Mustang CAT.

Cost savings aren't the only benefit. Because the appointments are on-site and don't require hours of traveling and waiting in a doctor's office, employees are more likely to visit the doctor for what most assume are relatively minor health problems. But some Mustang CAT workers have discovered serious issues through a virtual doctor visit--including cardiac disease, high blood pressure, and heart murmurs. "A lot of us don't go to the doctor because of the aggravation," says Fisk. "With this, the aggravation is zero."

Not all telehealth services require companies to keep a health care worker on-site, as NuPhysicia does. Scottsdale, Arizona-based MeMD, for instance, allows workers to make appointments online and see a doctor via any computer's webcam--at home or at work. Payroll Experts, a provider of outsourced payroll services, also based in Scottsdale, pays $40 per visit for MeMD's virtual appointments for its 18 employees and their dependents. It passes $25 of those costs on to employees through a payroll deduction. Those costs are on top of what the company pays for traditional health insurance, which is about $335 a month per employee. 

CEO Jason Roth engaged Payroll Experts in an attempt to reduce health care premiums, which have climbed about 20 percent a year. He estimates MeMD saved the company about $750 per employee in 2012, because workers weren't going to urgent-care clinics or general practitioners for relatively minor complaints.

Payroll Experts's employees were initially skeptical about MeMD, voicing concerns about privacy and the quality of care available over the Internet. "I thought it was crazy," says Janice Wyss, the company's director of operations. "I mean, who sees a doctor online?"

Wyss changed her mind after using the service to successfully diagnose and treat an upper-respiratory infection. Since then, she has used the virtual clinic to address an allergic reaction to prescription medicines and, in the case of her 18-year-old son, a case of mononucleosis. "To me, the savings personally are phenomenal," Wyss says. "And as an employer, I love that our people can get more done."


The (Virtual) Doctor Will See You Now
Remote doctor services work in different ways and have varying fee structures. Here is how some of them are set up.

Cost: Employers pay $1-$2 per employee each month, plus an average of $35 per visit.
How it works: Employees complete an online medical-history form and can then visit with an online doctor from any computer.

NuPhysicia's Medicine at Work
Cost: Employers pay an average of $25 per employee, per month.
How it works: A paramedic is stationed at your office to assist a remote doctor in completing online exams.

Cost: Employers pay 75 cents to $1.50 per employee, per month, plus $38 per visit.
How it works: After completing a medical-history form online, employees connect to local doctors via phone or computer.

Cost: Up to $38 per consultation.
How it works: Employees complete an online medical-history form and then request a consultation via phone or computer. A doctor responds within an average of 22 minutes.