Application of Information Technology: Effect of an Internet-Based System for Doctor-Patient Communication on Health Care Spending

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.

[1]  S N Forjuoh,et al.  E-mail communications in family practice: what do patients expect? , 2001, The Journal of family practice.

[2]  J C Wyatt,et al.  Commentary: measuring quality and impact of the world wide web , 1997, BMJ.

[3]  J. Pennbridge,et al.  Questionnaire survey of California consumers' use and rating of sources of health care information including the Internet. , 1999, The Western journal of medicine.

[4]  S. Singletary,et al.  Breast cancer on the world wide web: cross sectional survey of quality of information and popularity of websites , 2002, BMJ : British Medical Journal.

[5]  C. Morris,et al.  A Comparison of Alternative Models for the Demand for Medical Care , 1983 .

[6]  Howard Frumkin,et al.  Medical information on the internet , 1997, Journal of General Internal Medicine.

[7]  G Eysenbach,et al.  Responses to unsolicited patient e-mail requests for medical advice on the World Wide Web. , 1998, JAMA.

[8]  J. Reynolds,et al.  The next transformation in the delivery of health care. , 1995, The New England journal of medicine.

[9]  Robert Cunningham,et al.  Two Old Hands And The New New Thing , 2000 .

[10]  Petra Wilson,et al.  The quality of health information on the internet , 2002, BMJ : British Medical Journal.

[11]  Telecommunications Board,et al.  Networking Health: Prescriptions for the Internet , 2000 .

[12]  F Gerr,et al.  Medical information on the Internet: a study of an electronic bulletin board. , 1997, Journal of general internal medicine.

[13]  Steven J Katz,et al.  Bridging the electronic divide: patient and provider perspectives on e-mail communication in primary care. , 2002, The American journal of managed care.

[14]  N. Duan Smearing Estimate: A Nonparametric Retransformation Method , 1983 .

[15]  I. Magaziner,et al.  Two old hands and the new new thing. Interview by Rob Cunningham. , 2000, Health affairs.

[16]  P. Impicciatore,et al.  Reliability of health information for the public on the world wide web: systematic survey of advice on managing fever in children at home , 1997, BMJ.

[17]  G D Lundberg,et al.  Assessing, controlling, and assuring the quality of medical information on the Internet: Caveant lector et viewor--Let the reader and viewer beware. , 1997, JAMA.

[18]  Lee Rainie,et al.  The online health care revolution: how the web helps americans take better care of themselves , 2000 .

[19]  H. Christensen,et al.  Quality of web based information on treatment of depression: cross sectional survey , 2000, BMJ : British Medical Journal.

[20]  J C Wyatt,et al.  The origin, content, and workload of e-mail consultations. , 1998, JAMA.

[21]  I S Kohane,et al.  Growth and determinants of access in patient e-mail and Internet use. , 2000, Archives of pediatrics & adolescent medicine.

[22]  J D Kleinke,et al.  Vaporware.com: the failed promise of the health care Internet. , 2000, Health affairs.

[23]  A. Howe Rearranging the compartments: the financing and delivery of care for Australia's elderly. , 2000, Health affairs.

[24]  S M Dorman,et al.  Evaluating health-related Web sites. , 1997, The Journal of school health.

[25]  David Blumenthal,et al.  Doctors in a wired world: can professionalism survive connectivity? , 2002, The Milbank quarterly.

[26]  A. R. Spielberg,et al.  On call and online: sociohistorical, legal, and ethical implications of e-mail for the patient-physician relationship. , 1998, JAMA.