00:01Yeah, so our Sydney Virtual Hospital started back in 2020, and the virtual fracture clinic
00:07started about October at that point in time. So ideally, what happens is when someone injures
00:12themselves during sports or at school, they would normally see their GP or their general
00:17practitioner, or in this case, the urgent care centre, whereby they'll get an x-ray and a
00:21medical assessment of their injury. And if it's deemed a simple fracture, something that don't
00:26need plaster or surgery, they can be managed in a boot or a sling that is removable, then
00:32the clinician or the GP in this case will refer to our clinic, whereby we will screen the referrals
00:36with the surgeons, just to make sure that this is indeed a simple fracture. And the physiotherapist
00:42like myself or my colleagues will give the patient a call within one or two days after the referral,
00:46just to give them some care and organise a follow-up after that. Our world first trial, so this
00:51clinic is not by any means new in terms of technology. This clinic, like a virtual fracture
00:58has started in England, in Amsterdam, in India, even in Australia itself. But what we had was that
01:04we are the first clinic to test this out in terms of a clinical trial. And what we found is
01:10that in
01:11the 2012 patients that had a simple fracture referred to us, they either get a virtual care clinic
01:17follow-up with a physiotherapist, or they would be randomised to the in-person CLER clinic, which is
01:23here at RPA Hospital, to see the surgeons. What we found at 12 weeks is that patients at the virtual
01:29clinic had better physical function outcomes. Basically, these are activities that were important
01:35to them in terms of going back to work, going back to sports, caring duties, daily activities. So they
01:40were a little bit better in terms of that reported outcome compared to patients at the in-person
01:45clinic. However, we also found, quite interestingly, that there were less adverse events like
01:51hospitalisations or surgery for patients at the virtual clinic. At the virtual clinic, patients
01:57had fewer x-rays done during their care period, and also reported better experience with care.
02:03One of the things we were looking at from this trial, and also with our other qualitative interviews
02:09with clinicians and patients alike, we found that it is the time and access to a clinician
02:15that is what patients really value. So at the virtual clinic, we spent roughly about half an hour
02:25with the patient through a video call just to explain to them what the injury is, show them
02:29the x-ray, explain what they can and can't do in the next couple of weeks, exercises to start
02:33them off. And then at any point in time, if they were a bit worried about their condition, they can
02:38definitely
02:38email, phone call us straight up. Whereas at the in-person clinic, because it's a much busier clinic,
02:44as we already know, there's a business clinic in Australia, it's a much busier clinic, the surgeons
02:49are under the pump to see all the patients within that time frame. So typically, they will only get about
02:5310 minutes with the surgeon to really do the assessment, ask questions, and then that's all they get after that.
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