Virtual Acute Shoulder Clinic (VASC): A Safe, Sustainable and Cost-Effective Model

Telemedicine growth has rapidly integrated into trauma and orthopaedics through virtual fracture clinics. This study evaluates the impact of implementing a virtual acute shoulder clinic model led by an advanced physiotherapy practitioner (APP) for managing shoulder fractures on clinic re-attendance rates, patient outcomes, and satisfaction.

A retrospective analysis comparing two groups of sequential patients with shoulder fractures who attended face-to-face settings (Jan 2017-May 2019) versus virtual settings (Jan 2020-May 2022). Departmental and institutional databases were reviewed for relevant data. The Constant-Murley score was used to assess functionality, and satisfaction was assessed using a 4-point Likert score on a 6-month follow-up.

543 patients were seen in both settings, with 20.54% requiring surgery in the face-to-face and 18.9% in the virtual groups. The mean Constant-Murley scores were 67.17 and 69.28 for the preceded groups, respectively. A statistically significant difference in the Constant-Murley scores (p = 0.002) was observed, albeit below the minimal clinically important difference. At the 6-month follow-up, satisfaction was comparable between the two groups for all management options but higher in the virtual group for patients who underwent surgery (p = 0.001). The clinic achieved total cost savings of £41,400 over 30 months by avoiding unnecessary re-attendance and utilising virtual consultations in place of consultant face-to-face appointments.

The use of telemedicine in the form of a virtual acute shoulder clinic led by APP has shown to deliver comparable functional outcomes and patient satisfaction to conventional face-to-face clinics while being more sustainable and cost-effective.

Level 3.