Mr Min Jiat Teng1,2, Dr Tessa Copp3, Dr Kristen Pickles2, Mr Michael Wai1, Mr Vincent Cram1, Prof Christopher Maher2, Dr Joshua Zadro2, A/Prof Adrian Traeger2
1RPA Virtual Hospital, Sydney Local Health District, Camperdown, Australia, 2Institute for Musculoskeletal Health, The University of Sydney, Camperdown, Australia, 3Sydney Health Literacy Lab, The University of Sydney, Camperdown, Australia
Biography:
Min Jiat Teng is the Physiotherapist Coordinator at RPA Virtual Hospital and a PhD candidate at the Institute for Musculoskeletal Health. As a clinician researcher, his work focuses on leveraging virtual care to improve access to quality care for patients with musculoskeletal conditions. He is a recipient of a Sydney Research Scholarship and a MRFF grant scholarship to pursue his clinical trial in evaluating whether a virtual fracture clinic model is effective, acceptable and sustainable compared to an in-person fracture clinic. Min Jiat was awarded the 2023 Researcher of the Year by RPA Virtual Hospital.
Abstract:
Physiotherapist-led virtual fracture clinics (VFCs), which provide follow-up care for patients with simple fractures by telehealth, are increasing in popularity in Australia and globally. No study has investigated what influences clinical decisions to refer a patient to a VFC. Our qualitative study aimed to understand clinicians’ decision-making and willingness to refer patients with simple fractures to a VFC. Participants were purposively sampled. Data were analysed thematically using framework analysis. We interviewed 30 clinicians (21 doctors, 8 physiotherapists, 1 nurse) who work at a metropolitan (n=25) or rural (n=5) health setting. When referring patients to VFCs, clinicians relied on their ‘gut feeling’ about the patient’s demeanour, patient’s access and ability to navigate technology, patient’s characteristics, and the safety nets within the service to identify serious injuries and escalate care in a timely manner. The type of clinician providing care (physiotherapist vs surgeon) was not raised as a consideration factor. Some participants reported that newly inducted clinicians and many general practitioners are unaware of the service, which highlights the limited reach and adoption of the service. In conclusion, clinicians rely on their experiences, consider patient and injury factors, and the robustness of the virtual service, to guide their willingness to refer to a virtual fracture clinic. However, to ensure ongoing adoption, the service will need to provide ongoing awareness and education to referring clinicians so that patients can receive equitable care.