Virtual fracture care Evaluation and innovation of the trauma follow-up care system

The Dutch healthcare system faces increasing strain due to rising demand and limited resources. The Virtual Fracture Care (VFC) project aims to improve efficiency and patient-centered care by reducing unnecessary healthcare utilization.
This project consists of three phases, with the latter two phases being the main focus of this thesis.
1. Direct Discharge: Patients with simple fractures are discharged from the emergency department (ED) directly with self-care instructions, which already proved to significantly reduce secondary healthcare utilization.
2. VFC review protocol: Implemented during COVID-19, this protocol improved care coordination for more complex fractures which required hospital follow-up in addition to the already implemented Direct Discharge. Studies in thesis showed an 8% reduction in follow-up visits, a 9% decrease in radiographs, a 29% reduction of ED reattendances and a shift toward remote consultations (from 2% to 25%) for non-operatively treated patients. In operatively treated patients, follow-up visits dropped by 21%, radiographs by 7%, ED reattendances by 56% and time to surgery improved.
3. Digital treatment pathways: These pathways allowed real-time patient feedback to guide appointment scheduling, in addition to the treatment protocols of VFC review. Patients reported increased engagement and satisfaction, with reduced unnecessary follow-ups. However, improvements in user-friendliness were suggested to optimize adoption.
Overall, the VFC protocol successfully reduces healthcare utilization without compromising quality. Further research is needed to identify necessary improvements of the digital landscape, assess cost-effectiveness, confirm external validity, and identify factors necessary to ensure sustainable integration into general Dutch healthcare.