Physiotherapist lead TeleHealth fracture care: Understanding an Australian model for the Virtual Fracture Clinic

Mr Piers Truter1,2, Ms Louise Giglia-Smith1, Mr Simon Rosser1, Ms Pippa Flanagan1

1Fiona Stanley Hospital, Murdoch, Australia, 2University of Notre Dame Australia, Fremantle, Australia

Introduction: We launched a virtual fracture clinic (VFC) at a Tertiary Hospital in Perth in May 2020. This is advanced scope physiotherapist (ASP) lead TeleHealth fracture care embedded in the Orthopaedic outpatient service. Since November 2020, the VFC receives hand surgery clinic referrals. The VFC operates 5 mornings a week and was designed following principles from mature NHS services in the UK. We have worked with patients in prison, aged care and regional WA.

Method: This is a retrospective audit from WEBPas (Patient management system) and a bespoke REDCap database. WEBPAS appointment data covers December 2020 – March 2021, while VFC REDCap data covers 18 May 2020 – 5 April 2021. REDCap delivers outcome measures at first appointment and 6 months.

Results: 978 patients have been seen by the VFC. We have treated 226 children and 84 older adults (<65yo). Patients average 1.3 appointments and we have delivered 538 appointments (420 referrals) in 4 months. 80% of appointments are TeleHealth. Our DNA rate is 11%. We have high patient satisfaction. We are starting to identify patients we can discharge directly from the ED (providing no appointments). We have seen fractures in the hand (116), feet/ankle (550), upper limb (247) and other (65). From our 6 month follow up we are starting to develop a profile of patient recovery, which is helping us to identify patients in need more care.

Conclusions: The VFC shows promise as a convenient cost-effective patient-centred model of care. Our review shows similar injury profiles to established UK clinics.


Biography:

Piers is a clinical academic who splits his time between co-ordinating the post-graduate program in the School of Physiotherapy and working in two advanced scope of practice roles at Fiona Stanley Hospital. He completed his original physiotherapy degree in Brisbane and after working in rural and remote Queensland, moved to Perth to complete his master’s degree in Clinical Physiotherapy at Curtin University. He is currently completing his PhD, investigating the contemporary conservative management of fractures. His research interests include; TeleHealth, Fracture Care, Emergency Department musculoskeletal care and Health Service Improvement.

As a physiotherapist, Piers has experience working in Private Practice, various hospital in-patient settings, Indigenous clinical settings, TeleHealth, Emergency Department, Aged Care and with Sports Teams. He has worked as an Advanced Scope Physiotherapist in the Emergency Department setting since 2014, at Fiona Stanley Hospital, SJOG Midland (Clinical Lead) and Gold Coast University Hospital. In 2020 he developed and launched a physiotherapy lead ‘Virtual Fracture Clinic’ (orthopaedic fracture care TeleHealth) at Fiona Stanley.

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