A new digital healthcare service from Rush Medical Center in Chicago lets patients with non-emergency issues get an electronic diagnosis from doctors.

But unlike a traditional office visit or a telehealth consult, the new service does not include any initial one-on-one interaction between doctor and patient.

Rush, which operates a 664-bed academic medical center that includes hospital facilities for adults and children, calls the new service SmartExam. With SmartExam, patients with relatively minor, walk-in clinic maladies can use their desktop computer or mobile device to have a Rush-affiliated physician conduct a medical evaluation online.

The service is designed for such minor complaints as acne, bladder infection, burn or sunburn, cough, cold or allergy, ear pain, flu, rashes and other skin conditions, sinus pain or pressure and sore throat.

With SmartExam the only communication the doctor initially has with the patient is through the data collected from the survey and by text message or e-mail. If a Rush physician determines that a SmartExam patient can’t be treated effectively solely via electronic communication, the patient is advised to schedule a regular office visit, says Rush director of population health Amanda  Tosto

If a patient is too sick for a SmartExam visit and is advised to come in for an office visit, the patient will not be charged, Rush says. Patients also will be directed to set up an appointment through MyChart, the hospital’s digital portal. “If a patient has a condition that requires more thorough, personal analysis and examination, we will advise the patient to see a provider in person,” says Tosto. 

SmartExam allows a patient to conduct an electronic consultation with a Rush physician, who will determine a diagnosis and treatment plan that may include prescriptions. Rush begin offering SmartExam earlier this month.

Rush patients access SmartExam through the Rush Medical digital healthcare portal called MyChart. Patients age 18 and older who have an established primary care physician at Rush and have visited that doctor at Rush within the last year can use the service, says Rush chief medical officer Dr. Anthony Perry,

After logging into MyChart and selecting the SmartExam feature, each patient answers approximately 25 to 75 questions that gather information about the patient’s symptoms. The questionnaire typically takes patients 12 minutes on average to complete.

Once a questionnaire is completed, SmartExam sends it to a Rush doctor, who will receive a text message alerting the physician that a patient is waiting to receive care.

The Rush doctor then can log in from any device and review the information gathered from the patient, along with a computer-generated diagnosis. The diagnosis uses the information gathered from the patient questionnaire and provides physicians with personalized information about the patient and their condition to support a final diagnosis and recommended treatment. The doctor decides on the best course of treatment, and then SmartExam e-mails the patient a link to the summary. Any prescriptions that are issued as a result of the visit are sent to a pharmacy designated by the patient, and the patient then is charged for the visit, Rush says.

The digital visit is completed in less than an hour and costs $30, payable by credit card. The system collects the patient’s card number at the beginning of the session but does not charge the card until diagnosis and treatment is delivered. Insurance c0-payments are included, Rush says.

A SmartExam digital medical evaluation with Rush physicians are available between 8 a.m. and 7 p.m., Monday through Friday, and 8 a.m. to 3 p.m. on weekends, excluding holidays. “Patients will be able to get a medical evaluation electronically from the comfort of their home for non-urgent conditions commonly treated by a primary care physician,” Perry says.

SmartExam is different than a telehealth or a digital doctor visit, Perry says. Telehealth generally involves a video consults between a doctor and a patient while SmartExam does not.

A telehealth visit also typically is conducted by an on-call doctor who isn’t the patient’s primary care physician or in the patient’s health network. Telehealth visits are often more expensive than a SmartExam consult, ranging in price $49 to $75 per visit.

With SmartExam Rush patients are seen by an in-network Rush doctor, Tosto says.

Rush Medical is using technology from brightMD, a Portland, Ore., developer of digital and telehealth applications, to implement its SmartExam program.