Enhancing Orthopedic Care with Telemedicine: Assessing Feasibility and Patient Engagement in Early Discharge Pathways

Background: To investigate the feasibility of telemedicine-enabled functional assessments using a patient-reported outcome questionnaire based on the International Classification of Functioning Disability (ICF) and Health in elderly subjects following a program of early home discharge for femur fracture. Design: A questionnaire consisting of 59 items associated with the appropriate ICF categories and including the condition of functioning, activity and participation, and relevant contextual factors was developed to define the patient function profile one month after hospital discharge. Subjects/Patients: Elderly patients who underwent surgery for femur fracture were recruited from an orthopedic unit of the hospital. Methods: The questionnaire, together with an assessment of patients' satisfaction, was administered through a telemedicine platform. Results: Only 75.9% (22 subjects, age = 79 +/- 9.7 years, 73% female) of the recruited participants completed the questionnaire within the designated timeframe. Walking impairments and difficulty in climbing stairs were reported as the most affected activities. Regarding the patients' satisfaction, most of the patients were satisfied with the proposed tele-evaluation, although 73% were against further remote evaluation. Conclusions: The findings emphasize the challenges of elderly patients' adherence to tele-evaluation, highlighting difficulties in the use of new technologies within specific patient cohorts.