What to Know About Telehealth for Fractures

Defined simply, telehealth is health care delivered from a distance. The term generally refers to the use of telecommunications technology to provide care.

The idea has been around for a while and started out with programs which connected patients to nurses over the phone. As technology evolved, so has telehealth, and healthcare providers make use of videoconferencing, mobile health apps, emails, and secure texts to deliver care to their patients.

The COVID-19 pandemic has spurred an expansion in telehealth services. Conditions which have not traditionally been treated remotely are now being addressed, at least in part, via telehealth.

For example, care of fractures (broken bones) has historically been delivered in face-to-face patient encounters. But the pandemic has accelerated the use of virtual fracture clinics, in which part of the care for broken bones is moved online.

female doctor giving online consultation

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Using Telehealth for Fractures

Though fracture care may not seem to be an obvious candidate for telehealth, orthopedic practitioners have found ways to do much of it online. X-rays may be transmitted to a distant physician for diagnosis of fractures, and local practitioners may be able to perform simple procedures under the guidance of a remote specialist.

Telehealth can be particularly useful for triage, in which patients who require more advanced care are selected for transfer to trauma centers. If a face-to-face encounter is required, telehealth services may be employed for postoperative care, follow-up visits, and rehabilitation.

If you have experienced an acute injury with suspected fracture, you will probably need to be seen at a local medical facility to be evaluated by a healthcare professional and obtain X-rays. After that, it will be determined whether you need consultation with an orthopedist. Some nondisplaced fractures (a fracture where the bone maintains its alignment) may be managed remotely on an outpatient basis.

You will need to be seen in person by an orthopedic practitioner if you have sustained an acute fracture requiring surgery or reduction, or if you have an unstable joint or acute disruption of a ligament or tendon. A suspected dislocation may also require in-person consultation. If surgery is anticipated, a preoperative visit can be conducted via telehealth, as long as you have had good-quality X-rays, which enable surgical planning.

After surgery or reduction of a fracture, telemedicine may facilitate follow-up care. Wound checks may be performed by videoconferencing. After that, a home health aide or visiting nurse can remove drains, sutures, or skin staples.

You will need to be seen in person if a brace complication is suspected or a cast change is required. Concern for acute infection, new swelling, or other complications may also necessitate an in-person visit. Later on, rehabilitation can be performed through home health visits by a physical therapist.

Benefits and Challenges

During the COVID-19 pandemic, telehealth allows for safe, high-quality patient care to continue while conserving healthcare resources and helping to minimize transmission risk. Because of this, the Department of Health and Human Services (HHS) has relaxed some of the requirements on acceptable telecommunications, while the Centers for Medicare and Medicaid Services (CMS) has expanded Medicare coverage of telehealth visits.

The telehealth approach to fracture care works especially well if you live in a rural area, far away from a trauma center or orthopedic specialists. Telehealth allows patients, many of whom have mobility issues, to avoid a long-distance commute.

Because access to healthcare resources may be limited for some, telehealth can help reduce wait times before being seen. Many studies have shown that telehealth fracture clinics are cost effective, with good rates of patient satisfaction.

Nevertheless, fracture care cannot be moved completely online. As discussed above, many patients with acute fractures will need an in-person visit for surgery, closed fracture reduction, or splinting. Suspected complications after surgery may also be best evaluated in person.

Although orthopedic practices across the country have rapidly expanded their telehealth services during the COVID-19 epidemic, in many practices, telehealth is not considered a standard service. Potential barriers to the widespread adoption of telehealth include the need for additional communications equipment, training of staff, education of patients, and the inability to perform in-person physical examination.

Nevertheless, the benefits of telehealth are undeniable, and there is much ongoing research looking into how best to improve and streamline care in virtual fracture clinics.

How to Prepare for a Telehealth Visit

If you sustain a fracture and require consultation with an orthopedics practitioner, speak to your doctor to ask if telehealth is available, whether it is a good option for your injury, and how to schedule a visit. Your health insurance company website may also be able to help you find telehealth practitioners who treat fractures.

Another option is telehealth companies that work through web-based portals or apps that you can access on your phone or other devices. If you do not have health insurance, community health centers may be available to see patients regardless of their ability to pay. You can search for community health centers in your area via the telehealth website of the HHS.

Ideally, before a telehealth visit with an orthopedics practitioner, you will need a phone or computer with video capabilities so that you can interact with the nurse, doctor, or other professional on the other end of the line. You will likely also need some method of transmitting X-ray images, like email, secure messaging, or high-quality photos of hardcopy radiographs.

Depending on the telehealth practice, you may need to download an app on your device beforehand. Test your device to make sure the video and messaging functions work. If all else fails, your orthopedist may be able to get some information through a phone call.

Think of the questions you would like to ask, and note whether you need new prescriptions or refills. During the visit, the injured body part should be visible, a fact to keep in mind when choosing your clothing. The practitioner may conduct a virtual physical exam, which may involve assessing for deformity, signs of inflammation, and range of motion.

After the visit, your doctor or nurse may schedule additional X-rays, a follow-up telehealth visit, or a visit by a home health aide.

A Word From Verywell

Breaking a bone during a global pandemic is doubly frightening. You may be anxious about what care you will need to heal the fracture and regain function.

At the same time, you may be reluctant to go to a crowded hospital or clinic to get in-person care. If you don’t have health insurance or live in a remote area, it may also be challenging to access the care you need.

One small consolation is that the rapid growth of telecommunications technology has enabled doctors and nurses to care for their patients via telehealth. Many resources exist so that patients in remote areas or with limited mobility or no insurance can find high-quality care.

Orthopedic practices around the world are quickly finding creative ways to deliver care that is safe and effective. Research has shown that patients have been satisfied with fracture care delivered via telehealth.

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