Virtual Fracture Clinic Model in India: A Technological Innovation

Iyengar, Karthikeyan P; Jain, Vijay Kumar; Nallakumarasamy, Arulkumar; Jeyaraman, Madhan

doi:10.1007/s43465-022-00763-9

Cited by 5 publications

(3 citation statements)

References 20 publications

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“…Almost all health care professionals would like to continue using DD after its implementation. This finding complements current literature showing the widespread implementation of DD protocols and VFCs in the United Kingdom, Australia, New Zealand, and India [8,33,42,43]. This further strengthens the idea of at least adequate acceptance and the general applicability of this concept in different countries.…”

Section: Comparison With Existing Literaturesupporting

confidence: 84%

Health Care Professionals’ Experiences With a Mobile Self-Care Solution for Low Complex Orthopedic Injuries: Mixed Methods Study

Spierings,

Willinge,

Kokke

et al. 2024

JMIR Mhealth Uhealth

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Background To cope with the rising number of patients with trauma in an already constrained Dutch health care system, Direct Discharge (DD) has been introduced in over 25 hospitals in the Netherlands since 2019. With DD, no routine follow-up appointments are scheduled after the emergency department (ED) visit, and patients are supported through information leaflets, a smartphone app, and a telephone helpline. DD reduces secondary health care use, with comparable patient satisfaction and primary health care use. Currently, little is known about the experiences of in-hospital health care professionals with DD. Objective The aim of this study was to explore the experiences of health care professionals with the DD protocol to enhance durable adoption and improve the protocol. Methods We conducted a mixed methods study parallel to the implementation of DD in 3 hospitals. Data were collected through a preimplementation survey, a postimplementation survey, and semistructured interviews. Quantitative data were reported descriptively, and qualitative data were reported using thematic analysis. Outcomes included the Bowen feasibility parameters: implementation, acceptability, preliminary efficacy, demand, and applicability. Preimplementation expectations were compared with postimplementation experiences. Health care professionals involved in the daily clinical care of patients with low-complex, stable injuries were eligible for this study. Results Of the 217 eligible health care professionals, 128 started the primary survey, 37 completed both surveys (response rate of 17%), and 15 participated in semistructured interviews. Health care professionals expressed satisfaction with the DD protocol (median 7.8, IQR 6.8-8.9) on a 10-point scale, with 82% (30/37) of participants noting improved information quality and uniformity and 73% (27/37) of patients perceiving reduced outpatient follow-up and imaging. DD was perceived as safe by 79% (28/37) of participants in its current form, but a feedback system to reassure health care professionals that patients had recovered adequately was suggested to improve DD. The introduction of DD had varying effects on workload and job satisfaction among different occupations. Health care professionals expressed intentions to continue using DD due to increased efficiency, patient empowerment, and self-management. Conclusions Health care professionals perceive DD as an acceptable, applicable, safe, and efficacious alternative to traditional treatment. A numerical in-app feedback system (eg, in-app communication tools or recovery scores) could alleviate health care professionals’ concerns about adequate recovery and further improve DD protocols. DD can reduce health care use, which is important in times of constrained resources. Nonetheless, both advantages and disadvantages should be considered while evaluating this type of treatment. In the future, clinicians and policy makers can use these insights to further optimize and implement DD in clinical practice and guidelines.

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Section: Comparison With Existing Literaturesupporting

confidence: 84%

Health Care Professionals’ Experiences With a Mobile Self-Care Solution for Low Complex Orthopedic Injuries: Mixed Methods Study

Spierings,

Willinge,

Kokke

et al. 2024

JMIR Mhealth Uhealth

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“…Sumargono et al [ 27 ] and Kauta et al [ 44 ] demonstrated how virtual supervision and co-management by orthopaedic teams through WhatsApp referral groups enabled non-specialist physicians to successfully treat a significant portion of traumatic fractures at community health clinics. This not only facilitated timely and efficient care but also minimized the need for in-person consultations, which was particularly advantageous during the pandemic[ 45 ].…”

Section: Non-clinical Applications Of Whatsapp In Healthcarementioning

confidence: 99%

Advancing orthopaedic trauma care through WhatsApp: An analysis of clinical and non-clinical applications, challenges, and future directions

Saini,

Jeyaraman,

Jeyaraman

et al. 2024

World J Orthop

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The integration of WhatsApp, a widely-used instant messaging application (IMA), into the realm of orthopaedics and trauma surgery has emerged as a significant development in recent years. This paper explores the multifaceted role of WhatsApp in orthopaedics, focusing on its clinical and non-clinical applications, advantages, disadvantages, and future prospects. The study synthesizes findings from various research papers, emphasizing the growing reliance on mobile technology in healthcare. WhatsApp’s role in orthopaedics is notable for its ease of use, real-time communication, and accessibility. Clinically, it facilitates triage, teleconsultation, diagnosis, treatment, patient advice, and post-operative monitoring. Non-clinically, it supports telemedicine, teleradiology, virtual fracture clinics, research, and education in orthopaedic surgery. The application has proven beneficial in enhancing communication among healthcare teams, providing quick responses, and motivating junior physicians. Its use in educational settings has been shown to improve learner’s understanding and patient care. However, the use of WhatsApp in orthopaedics is not without challenges. Risks include the potential spread of misleading information, privacy concerns, and issues with image quality affecting diagnosis and treatment decisions. The paper acknowledges the importance of maintaining professional boundaries and the need for oversight measures to ensure content accuracy. Looking forward, the potential of WhatsApp and similar IMAs in orthopaedics lies in their ability to streamline data collection and retrieval, improve doctor-patient communication, and address challenges like bureaucratic red tape and limited resources. The paper suggests that future orthopaedic practice, particularly in emergency departments, will increasingly rely on such technologies for efficient patient management. This shift, however, must be approached with an understanding of the ethical, legal, and practical implications of integrating social media and mobile technology in healthcare.

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“…(6) As the strain on healthcare resources is increasing, addressing these issues in non-operative management may be essential in sustaining high-quality orthopedic trauma care. (7) The Virtual Fracture Care (VFC) model has emerged as a reorganizational solution for non-operative management musculoskeletal extremity injuries, adopted by various countries in several variations (8)(9)(10)(11)(12). Typically, the VFC model comprises two components: 1) a Direct Discharge protocol facilitating the direct discharge of patients with uncomplicated and stable injuries from the ED, and 2) a VFC review protocol, referring patients in need of further treatment to the most suitable healthcare professional.…”

Section: Introductionmentioning

confidence: 99%

The effects of a Virtual Fracture Care review protocol on secondary healthcare utilization in trauma patients requiring non operative treatment: a retrospective cohort study

Willinge,

Salentijn,

Spierings

et al. 2024

Preprint

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Background The strain on healthcare resources in the Dutch trauma care system is rising. In response, a Dutch adaptation of the Virtual Fracture Care (VFC) review protocol, designed to optimize trauma care quality within resource constraint, has been implemented to sustain high-quality trauma care. This study aimed to evaluate the influence of the VFC review protocol on the utilization of secondary healthcare resources in adult trauma patients who received non-operative treatment for musculoskeletal extremity injuries.Methods This retrospective cohort study assessed the impact of a VFC review protocol on secondary healthcare utilization in adult trauma patients treated non-operatively for a musculoskeletal extremity injury. Patients treated between July 1, 2018 – December 31, 2019 (pre-VFC group), and January 1, 2021 – June 30, 2022 (VFC group) were included. Outcomes included follow-up appointments and involved healthcare professionals, radiographic imaging, and emergency department (ED) reattendances.Results A total of 3791 patients were included, comprising 1819 pre-VFC patients and 1972 VFC patients. Following VFC review, the number of follow-up appointments was reduced by 8% and a shift towards remote delivery of care occurred. Furthermore, VFC review led to a 9% reduction in follow-up radiographs and a 29% decrease in ED reattendances.Conclusion Utilization of a VFC review protocol for management of adult patients with a musculoskeletal extremity injury requiring non-operative treatment improves reduces secondary healthcare utilization compared to traditional treatment protocols. This protocol results in a reduction of follow-up appointments, a transition from face-to-face to remote care delivery, fewer follow-up radiographs, and a reduction of ED reattendances.

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Virtual Fracture Clinic Model in India: A Technological Innovation

Cited by 5 publications

References 20 publications

Health Care Professionals’ Experiences With a Mobile Self-Care Solution for Low Complex Orthopedic Injuries: Mixed Methods Study

Health Care Professionals’ Experiences With a Mobile Self-Care Solution for Low Complex Orthopedic Injuries: Mixed Methods Study

Advancing orthopaedic trauma care through WhatsApp: An analysis of clinical and non-clinical applications, challenges, and future directions

The effects of a Virtual Fracture Care review protocol on secondary healthcare utilization in trauma patients requiring non operative treatment: a retrospective cohort study

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