Dr. William "Chuck" Thornbury, the CEO and Medical Director of Medical Associates of Southern Kentucky, gave one of the livelier and more passionate presentations at HIMSS13 this week. The Glasgow, Kentucky-based primary care doctor discussed how offering his patients online visits and consultations over the phone has helped him mitigate the primary care provider shortage in his area -- and how a simple setup like that could help primary care providers meet increasing demands around the country -- while cutting costs.

Thornbury told MobiHealthNews in an interview following his presentation at HIMSS that the idea for "mobile e-visits" came after he trained in the "lean" strategy principles pioneered and championed by automaker Toyota, at the University of Kentucky three-day Lean Executive Leadership Institute program. After attending the program a few days ago Thornbury's team began discussing ways to fix the growing problem of having so many patients that they had to turn people away.

After trying real-time online visits with patients, Thornbury decided the process was too cumbersome and that a more elegant solution would only require that he or another physician use their smartphone. The patient could have the flexibility to access the online questionnaire via their PCs or mobile devices. In Thornbury's practice most patients do choose to use their home or office computer, he said.

Thornbury began a one-year study of the offering, which asked established patients to pay $32 per e-visit in lieu of an in-person visit at his clinic. Patients were educated about the service's availability via handbills, websites, and telemarketing. Thornbury made the service available 24 hours, which is why sending it to his phone was crucial. After patients filled out a form online, a brief call (2 to 3 minutes on average) was scheduled with the doctor, who could then complete an assessment and contact the pharmacy if need be.

Thornbury noted that while the median age of the patients was about 43 years old, the range was from 16 to 89 years old. Typically, those on the older end of the spectrum were using the service with the help of an adult child, he noted. Perhaps not surprisingly, 78 percent of the e-visits took place after his normal office hours, however, very few patients contacted him very late at night. Thornbury said he believes his patients understood he worked hard and did not want to disturb him if it wasn't absolutely necessary.

In all, Thornbury studied the mobile e-visits offering at his practice for two years and believes the results are glowing. After two years, about 20 percent of his patients are using the service. At that adoption level, Thornbury said he has increased his capacity by 15 percent, which enables him to provide care for more patients or spend more time with those that need it. He said it works out to about an extra hour in his day. He also claims that the system has lowered per capita cost by 15 percent in his practice.

Interestingly, Thornbury has only used video visits on a handful of occasions over the past few years.

"If I really need to see the patient, I just ask them to come visit me in-person," he said. "Our platform allows for up to five photos that the patient can include, too."

Thornbury has leveraged his experience and the two years of study to launch a startup, called MeVisit, to make the platform available to other physicians.

MobiHealthNews coverage of the HIMSS13 event in New Orleans is sponsored by AirStrip Technologies.