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California Firm and Its 800 Number Poised for Health Care Changes : Medicine: Staff of 120 work around the clock in a Sacramento suburb to provide information by telephone, anywhere in the U.S. Service is likened to banks' 24-hour teller machines.


SACRAMENTO — A woman in St. Louis, Mo., has something in her eye. She calls an 800 number and a nurse advises her to see a doctor, giving her a list of physicians in her neighborhood.

The nurse, however, is not in that neighborhood, in St. Louis or even in the Midwest. And she is not wearing a white uniform and hat. She wears ordinary clothes and sits at a computer console 2,000 miles away in Rancho Cordova, a suburb of Sacramento.

The nurse is one of 120 working around the clock in a black glass building for Access Health, a firm that provides health information by telephone and is well positioned to grab more business as health care changes in this country.

"If you're going to expand access to health care to 35 million people who don't have access to health care, you're going to have to have a more convenient and cost-effective way to do it," company President Ken Plumlee said. "Using the telephone to provide access to health care is a pretty dramatic idea."

Plumlee likens health care to banking. Not long ago, he said, people had to drive to a bank during certain hours to conduct business. Now they can bank anytime over the phone or at automatic teller machines.

To get health care, people have to get in their car and drive to a doctor's office during certain hours and wait a long time to spend 120 seconds talking to a doctor, he said.

Or they head to an emergency room for another long wait. One-third to one-half of the patients in emergency rooms don't need to be seen, Plumlee said.

Although Access Health is not the only firm nationwide offering telephone health information, Plumlee says its six-year history makes it "one of the best-positioned companies out there" as employers and insurers seek more cost-effective health care.

Plumlee in 1986 developed Ask-A-Nurse for Referral Systems Group, an affiliate of Adventist Health System-West. Two years later, Plumlee led a buyout of the division and established Access Health. The firm opened its national call center in 1990.

Ask-A-Nurse, still the largest part of the current firm, is run through hospitals, which contract for the telephone information services. The hospitals buy an entire referral and information system, which can either be run by Access Health nurses in Rancho Cordova or by the hospitals themselves.

The firm develops a data bank for a contract hospital or group of hospitals, giving the nurses computerized referrals to doctors affiliated with the hospitals plus community organizations like Alcoholics Anonymous or food closets. The nurses also can look in their computers for general or diagnostic information on any ailment or complaint mentioned by callers.

A hospital that buys the service then publicizes the telephone number in the community, allowing anyone who needs information or referrals to call.

The 200 hospitals using the system took 5.5 million calls in 1992, most of them in the hospital-based centers. The Rancho Cordova call center took in 380,000 calls last year and Plumlee expects that number to double this year.

The firm in 1989 added Cancer HelpLink, which provides specialized cancer information for hospitals and cancer centers that buy the service. This is staffed by registered oncology (cancer) nurses.

Last November, Access Health started its latest project, aimed at insurance firms and large employers who want managed care. The firm is now in every state except Alaska with one or another of its products.

The managed care option is called Personal Health Advisor and works somewhat like Ask-A-Nurse, but with more features. About 250,000 people are enrolled in this program through insurers such as Blue Cross and Blue Shield of Oregon, which started it on July 1.

Members get a kit in the mail with a card, telephone stickers and magnets containing their 800 number. They can either call to talk to a nurse when they need a doctor or have a question or can call to hear prerecorded messages on health topics 24 hours a day.

The firm's 220 employees include not only the nurses, but also people who research and write the latest health information.

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