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.