The second meeting of the Health 2.0 Conference kicked off today in San Diego. The weather is pleasant in this town, and so is the crowd. The excitement engendered at the first Health 2.0 Conference held in September 2007 in San Francisco continues to grow at this meeting, which is focused on how consumers-people-patients can connect with providers, payors, and employers using Web 2.0 tools.

American Well trated us to a “deep dive” into their new service, which will go live in June 2008. Roy Schoenberg, MD, MPH, the CEO of American Well, demonstrated their concept of the “online health care marketplace.”

Roy provided the context for American Well, saying that consumers have adopted interactive applications online for entertainment, travel, retail, selling, and banking — he noted the market leaders of iTunes, Expedia, Amazon, eBay and e-Trade as emblematic of this reality. Roy asked, “why not in health care?”

American Well is his analogue to these consumer-friendly models. As an online marketplace, AW plays the role of a brokerage system for online health care services — specifically, for booking visits to doctors by phone, online or online via video conference. AW is also built on convenience — both the consumer and the doctor can be consulting from home — or even from their cars.

It’s a “marketplace” because the consumer-physician visit culminates in a transaction of payment and followup “agenda” for the consumer–a sort of to-do list featuring prescriptions, tests, and even articles to read for some information therapy. The payment is based on the patient’s health plan’s copay and visit fee (e.g., $10 copay for the patient, and $60 visit fee to the physician).

This is a real-time service — not asynchronous as e-visits can be. Roy calls this, “the promise of immediacy with service.”

In this early phase of market introduction, AW is working with health plans who could view the service as a way to triage patients in their home before they undergo more expensive, and potentially unnecessary, services. Roy said that large provider groups are also interested in American Well as a model for providing on-call services.

One of the rationales physicians have had for not conducting e-type visits has been the potential for malpractice. American Well has done breakthrough work on this by allying with AIG/Lexington. The reinsurers have put together a purpose-built malpractice program for American Well wherein each patient visit is covered for liability. This is an important milestone which breaks down one critical physician adoption barrier.

“This is not replacing health care,” Roy told us. “It’s making health care more proximate” to the consumer.

Health Populi’s Hot Points: American Well has conducted market research on which to build its strategy. The company found that 51% of physicians surveyed were likely to use the service. What’s intriguing for American Well going forward is that providers could be able to set their own prices when dealing with uninsured populations or situations where an insured patient is willing to pay for a second opinion. Consider the cancer specialist in New York City who might charge $250 for 10 minutes’ consultation time to provide a quick second opinion to a consumer in Cleveland. Roy calls this, “geographically unbound access.” There remain some unanswered questions about how this service will be welcomed in the market, but one thing is clear: American Well is well designed, well-informed, and well positioned to be a disruptive force in U.S. health care.