It's 2 a.m., and your newborn is crying up a storm. The infant's cheeks feel hot, but you're not sure if it's because he's been inconsolable for the last two hours, or maybe he's sick. Still, you're hesitant to wake your pediatrician in the middle of night with another nervous first-time-parent call.

If Boston-based startup American Well system's plan pans out, instead of waking your doctor, you'll have the option of contacting a pediatrician or any accredited medical specialist live, 24-hours a day, via the Web or phone to help you determine whether your issue can be worked out at home, should be followed up with an office visit, or warrants an urgent trip to the emergency room.

The American Well online health care marketplace, which launched this week, provides a secure, Web-based, voice-over-IP enabled platform that facilitates for patients on-demand, real-time "virtual consultations" with medical professionals any time of day. Patients and clinicians can communicate through phone, Web cams, video conferencing, secure messaging, or secure chat.

"You can buy books, purchase airline tickets, and download music on the Web," says American Well CEO and co-founder Dr. Roy Schoenberg. "Now, for the first time, you can now do this with health care."

American Well's business model has it partnering with health insurers and health plans that will reimburse member doctors for virtual consultations with patients. Doctors will be paid a lower amount for virtual consultations compared with office visits, but among the pluses for physicians is that the remote interactions with patients can be done from the clinician's home, office, or anywhere that's most convenient for him or her. The same is true for patients.

Hawaii Medical Services Association, part of the Blue Cross Blue Shield Association, is one of the first health plan and insurers in the United States preparing to provide the virtual consultations as benefits to member patients and their dependents, Schoenberg says. HMSA will begin offering the virtual consultation benefit to members during the upcoming open enrollment season and will reimburse member doctors for providing the services to patients.

"Online health care is an innovative consumer health solution," said Michael Stollar, HMSA VP of marketing and communication, in an e-mail to InformationWeek. "It is easy to use and convenient and will fill an immediate need in Hawaii's health care industry and improve access to health care statewide."

HMSA discussions so far with local doctors indicate that most physicians are likely to participate in the service, said Stollar.

Meanwhile, health care providers in other states also have started signing up to participate as online clinicians offering their consultation services on the American Well site.

Lehigh Valley Hospital and Health Network CEO Dr. Elliot Sussman says he expects "a couple hundred" of the organization's doctors to participate in the American Well network once the marketplace is ready to go live, probably later this year, in Pennsylvania. The hospital is located about 50 miles north of Philadelphia and 80 miles west of New York City, and includes a physicians group of 450 doctors, he says.