A system for telephone and secure email consultations, with automatic billing.

Doctors have traditionally provided medical advice during face-to-face consultations. A new remote consultation service has been developed based on an interactive voice response system and Internet-based technologies. If the doctor is unavailable, a return call can be requested at a mutually convenient time. The patient's credit card is billed automatically. All that is required of the doctor and patient is access to any telephone. A dial-in dictation and transcription facility allows documentation. The service was launched in late 2003. After six months, there were approximately 55 doctors registered in five Australian states and approximately 500 patients registered. Two hundred and fifty consultations were selected randomly for analysis. Of these, 84% were conducted by telephone and 16% by email. The mean fees charged were AUS$17.11 for telephone and AUS$12.93 for email consultations. The mean duration of telephone consultations was 4.3 min. Call duration ranged from a few seconds to 20.5 min.