The traditional venues for retail health are found in pharmacies, grocery chains, and on the ground floor storefronts in hospitals. Joining these bricks-based models are digital, online health ventures that are expanding the definition and space of retail health.

This week, two announcements illustrate this phenomenon, from American Well and Active Doctors. American Well, which launched in 2008, is an online physician consultation service in the U.S. that has successfully worked with health plans to channel consults to patients in Hawaii, Minnesota, and New York, among other local programs. Last year, American Well went live with the Rite Aid pharmacy chain in Pennsylvania. This week, American Well brought telehealth to doctors with its Online Care for Providers suite. With this program, doctors can meet up online with patients via two-way video, secure text chat, and/or phone. American Well says that the data generated through these online visits can be sent into doctors’ electronic health record systems.

Activ Doctors, which first launched in Europe as Activ’Santé, offers second opinions from a worldwide panel of physicians and specialists coupled with a personal health record. Their website cites a connection with Mayo Clinic in Jacksonville, FL. In addition, Activ Doctors says it’s recruited doctors “trained at eight of the top ten medical schools in the country, as rated by U.S. News and World Report in 2010,” which include the University of Pennsylvania, the Mayo Clinic, Duke University, Harvard University, and the Memorial Sloan Kettering Cancer Institute of Cornell University. The company’s press release dated April 22, 2011, can be found here.

Health Populi’s Hot Points:  These two announcements demonstrate the multi-faceted nature of primary care, and the changing roles of both physicians and payments in this limbo-phase of health reform implementation in the U.S. In the private sector, regardless of the Affordable Care Act’s provisions, health costs for employers and insured workers continue to grow. Employers off-load additional costs to patients while continuing to seek ways to conserve money in medical trend. Insureds and those seeking care on their own are looking for cost-effective, convenient modes of care that embody quality and service.

American Well and Activ Doctors look to serve this market for both insured health citizens as well as for people who pay full cost at health in retail settings – those who may currently frequent clinics co-located with pharmacies and grocers, urgent care centers, and, when required, emergency departments at hospitals. Watch for more retail health options to expand in the era of accountable care, where primary care physicians need to find ways of ‘cloning’ their footprint due to physician shortages. The online mode of telehealth is one way to skin that cat. It can be done well when (1) the criteria for selecting consulting physicians is made transparent and based on quality standards, and (2) the services are underpinned with an electronic health record that’s interoperable with medical homes’ HIT systems.