Brian T Walsh, a customer service executive at Tumblr, was having chest pains.

They were mild, so while he was worried, he didn't rush to ER. Instead, he visited his virtual doctor's office online. There, he described the pains to an on-call doctor, who assured him that it didn't seem like an emergency, but that Walsh should get checked out. "Within a few hours I was set up with an amazing doctor in Manhattan for the next business day," he says. "He has since become my primary care physician."

A year ago, Tumblr became one of the first companies to sign up with Sherpaa, the New York City-based healthcare consultancy that provides services such as 24-hour access to doctors over the internet. The consultancy analyzes companies' healthcare spending and suggests ways to save money, boost benefits and expand coverage to more employees.

It was founded by Dr Jay Parkinson and Cheryl Swirnow just last year. Parkinson, who trained in pediatrics and preventive medicine at St Vincent's and Johns Hopkins, previously had his own practice in Brooklyn, New York, that made house calls for patients who scheduled appointments online. Prior to starting Sherpaa, Swirnow worked in human resources for companies such as the Four Seasons Hotels and Resorts, Nike and The Barbarian Group.

The idea, co-founders Dr Jay Parkinson and Cheryl Swirnow say, is to make the healthcare system more efficient, improving employee health and reducing costs – and enabling employers to insure more people. In the US, with 48.6 million uninsured, employers carry much of the burden for providing healthcare. "After payroll, it's the second most expensive element the company pays for," Parkinson says. And healthcare costs keep soaring.

The high prices have led some employers to opt out – or limit their contributions. In September, for example, Walgreens announced it was shifting current employees into private health insurance exchanges with set company contributions.

As more companies limit their contributions, employees could carry more of the burden if costs continue to rise, which could lead to more people without insurance or with insufficient insurance – and, potentially, a less healthy populace. "Savings here helps make healthcare more sustainable," Parkinson claims, adding that Sherpaa has helped companies save "up to" $4,000 per employee per year.

To be clear, Sherpaa doesn't provide insurance. Instead, it works with companies to helps support their insurance plans.

Growing a client roster – but only in NYC

The consultancy seems to be gaining traction. It already boasts a client list of 56 companies, including Tumblr, General Assembly, Skillshare and PreHyp. While Parkinson wouldn't say how many employees Sherpaa serves, he said the company has three doctors, each of whom can serve up to 2,500 patients. And Parkinson says he expects one-year-old Sherpaa, which raised $1.85m from O'Reilly Alpha Tech Ventures, First Round Capital, SV Angel and Collaborative Fund in August 2012, to turn a profit in April 2014.

Sherpaa has saved Tumblr money, claims Lindsey Dole, a human resources executive at Tumblr. She declined to release any figures, but says the company plans to continue to work with Sherpaa. "Sometimes you need to go to your insurance provider before you can consult a doctor. Those aren't very easy conversations. With Sherpaa, we have access to doctors anytime we want."

The consultancy's operation aims for simplicity: Patients who need to go to the emergency room are immediately sent to the closest one, but – in some cases – a different approach can be faster. When one client complained of abdominal pain, for example, a Sherpaa doctor quickly realized he needed an appendectomy. The doctor sent the patient to a specialist and, within six hours of the first communication sent, the patient was home minus an appendix.

Sherpaa has its own network of full-time doctors and specialists. As the company's chief physician, Dr Susan Gonnella, puts it: "It helps build relationships without time constraints. This model frees you up to really focus on what you trained for – medicine and helping people get better." Gonnella was the head of corporate health at American Express for 15 years prior to joining Sherpaa.

For privacy, patients and doctors interact using internal messaging via Sherpaa's online app. "It's a lot like Facebook messaging," Parkinson says. "Email isn't always secure and private, so we keep the conversation within the walls of our app."

Costs and limitations

Offered only through employers, Sherpaa charges $50 per employee per month to access the virtual doctor's office service. Sherpaa says only 30% of their patients' need a specialist and, if referred by a Sherpaa doctor, they're fast-tracked to seeing one. The rest of the time – in 70% of cases – Sherpaa's doctors solve the problem without an in-person office visit, Parkinson says.

This not only cut costs, because fewer employees use the insurance, but also could reduce sick days, he claims. The average employee takes three days off work for doctors' visits each year, so cutting that by 70% could save two days of work, he says.

Still, Sherpaa has its limits. First of all, the network only operates in New York today. In addition, Sherpaa doctors can't do physical exams, which could limit their diagnoses – although Parkinson says they also can order tests. They also don't do any procedures, sending patients to in-person doctors for those. This also helps keep Sherpaa's costs down, given that the vast majority of malpractice cases stem from procedures.

Overall, Dr Geoffrey Joyce, director of health policy at the University of Southern California's Leonard D Schaeffer Center for Health Policy and Economics, says the idea of managing most primary care via online or telephone consults "makes perfect sense" and should save both money and time. However, he added, "the majority of healthcare costs are driven by specialty care and hospital services, so how well this service manages more downstream services will determine how big an impact it can have on reducing healthcare costs".

Paromita Pain, a former senior reporter with the Hindu Newspaper in India, is a PhD student at the University of Texas at Austin