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First published May 19, 2005 as JAMIA PrePrint; doi:10.1197/jamia.M1778
Journal of the American Medical Informatics Association 2005;12(5):530-536
© 2005 American Medical Informatics Association

A more recent version of this article appeared on September 1, 2005
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Submitted on December 20, 2004
Accepted on April 28, 2005

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

Laurence Baker PhD1*, Jeffrey Rideout MD2, Paul Gertler PhD3, and Kristiana Raube PhD4

Affiliation of the authors: 1 Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA; National Bureau of Economic Research, Cambridge, MA; 2 Cisco Systems (formerly Blue Shield of California), San Francisco, CA; 3 National Bureau of Economic Research, Cambridge, MA; Haas School of Business, University of California, Berkeley, CA; 4 Haas School of Business, University of California, Berkeley, CA

* To whom correspondence should be addressed.

We studied the effect of a structured electronic communication service on health care spending, comparing doctors office and lab 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, MD office spending and lab spending fell in the period after the service became available, relative to the control group (p<.05). A rough estimate is that average MD office spending per treatment group member per month fell $1.71 after availability of the service, and lab 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.






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