American Well, an ambitious startup designed to provide virtual health/medical transactions between patients and doctors, has been invited to present its product overview in a thoroughgoing way–a deep dive, in Health 2.0 patois.

In this liveblog, I need to control the depth, of course. I’ll try to boil this into five (5) key points about American Well:

1. Unlike other industries, health so far hasn’t succeeded in doing transactions (Amazon, Expedia, eBay, etc.) on line. Imagine Expedia if, instead of buying a ticket, all you got was a picture of your plane. What’s missing? In health, it’s the real care transaction.

2. American Wellness is essentially a brokerage system for online wellness services–real services, not just information. Connecting consumers with providers and, as important, the money–which is to say insurance reimbursement systems. Patients, docs, money, all tied together.

3. Consumers can access specialists, from anywhere, for a fee. Their calls, e-mails, etc. are aggregated and distributed to the appropriate specialists in real time.

[The liveblogger anticipates the big question: How does this provide continuity of care?

And the answer comes immediately–the AW marketplace delivers only specialists, not a primary care doctor. The tradeoff of getting someone with whom there is no existing relationship to have immediate access to care. ]

4. What’s the transaction like? The demo shows a consumer’s entry into the system. [The interface is very clean–you can tell they usability tested this really well.] First, consumer looks for a doctor. [PowerPoint slide joke: Doctor profile that comes up is an OB whose name is given as Otto Matic.]

Doctors presented with bios, videos, etc. Ratings? Yes, but not clinical ratings. Just consumer satisfaction ratings. [Needless to say, this is one of many services attempting to aggregate patient evaluations of doctors.]

Part of summary is–price transparency! The cost of the anticipated consult is listed. Patients can fill in their health background to let docs understand the situation more fully. Then doctors, in real time, review request and decide if it’s appropriate that they take it on.

Then: When patient and doctor both agree to a clinical encounter online, an interactive console pops up –the interaction can be live video via webcam, live  audio or typing chat, on-screen notes and documents, etc. Lab information, with patient permission, can be added. While it’s a virtual interaction, it’s a rich-media virtual encounter.

5. And the consumer’s regular doctor? Patient can send doctor report of entire transaction.

[The liveblogger’s question: What will the patients’ internists have to say about this?]

Other point: Insurer AIG has developed a new malpractice insurance product–per transaction, not annual. It’s embedded in the service.

Will this save money in healthcare? AW argues that by providing some care in the home, and keeping some transactions at lower cost, insurers, payers and patients can save money. This can keep people out of the ER, maybe.

The AW plan–essentially disconnecting care from a physical location–raises all kinds of questions not dealt with, even in this deep dive: Privacy? Coordination of care? How to deliver service of real value without risking misdiagnosis, etc. How will insurers ultimately reimburse this care? How different/better/worse will this be compared to in-store retail clinics? What conditions or situations is this kind of virtual care best suited to?

And finally, when will this launch? In 2008, CEO Roy Schoenberg, MD assures us.