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Effect of an Internet-Based System for Doctor-Patient Communication on Health Care Spending

Affiliations of the authors: Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA (LB); National Bureau of Economic Research, Cambridge, MA (LB, PG); Cisco Systems (formerly Blue Shield of California), San Francisco, CA (JR); Haas School of Business, University of California, Berkeley, CA (PG, KR).

Correspondence and reprints: Laurence Baker, PhD, Department of Health Research and Policy, HRP Redwood Building, Room 110, Stanford University School of Medicine, Stanford, CA 94305-5405; e-mail: <laurence.baker{at}stanford.edu>.

Received for publication: 12/20/04; accepted for publication: 04/28/05.

We studied the effect of a structured electronic communication service on health care spending, comparing doctor office and laboratory spending for a group of patients before and after the service became available to them relative to changes in a control group. In the treatment group, doctor office spending and laboratory spending fell in the period after the service became available, relative to the control group (p < 0.05). A rough estimate is that average doctor office spending per treatment group member per month fell $1.71 after availability of the service, and laboratory spending fell roughly $0.12. Spending associated with use of the electronic service was $0.29 per member per month. We conclude that use of structured electronic visits can reduce health care spending.