Applications of telemedicine in the management of patients with hip fracture: a scoping review

Abstract

Background

Hip fracture is a significant global health issue, posing challenges in terms of disability, socio-economic costs, and mortality. In this context, telemedicine, as a series of remote medical information exchange tools, emerges as a promising solution. This study aimed to identify the potential applications of telemedicine in managing patients with hip fractures, offering insights that could significantly impact healthcare practices.

Methods

This scoping review was conducted in 2023 through a combined search of keywords related to telemedicine and hip fracture in Scopus, PubMed, and Web of Science without time limitation and in English. Article selection was conducted based on predefined inclusion and exclusion criteria, including but not limited to relevance, availability, and full-text availability in English. Data gathering was done using the data extraction form, and the findings were summarized and reported based on the study’s objectives in tables and graphs.

Results

Out of 341 articles, 23 studies were included in the study. Telerehabilitation and mHealth, each accounting for 31%, emerged as the most widely used types of telemedicine in hip fracture care. The telemedicine interventions for hip fracture were classified into five categories: patient education, communication between patients and healthcare providers, fracture management, patient follow-up, and patient monitoring, further divided into 19 subcategories. Additionally, the outcomes of using telemedicine were grouped into seven categories: increasing patient motivation, improving healthcare quality, enhancing rehabilitation, facilitating patient monitoring and follow-up, improving healthcare provider performance, facilitating patient education, and reducing healthcare costs, with 19 associated subcategories.

Conclusion

Telemedicine services could be able to have positive outcomes for hip fracture patients, and support their rehabilitation process. It could be able to enhance patient motivation, improve healthcare quality, and facilitate remote monitoring and follow-up. Additionally, telemedicine supports patient education, reduces healthcare costs, and improves provider performance, ultimately contributing to better recovery and overall patient well-being. However, to fully realize its potential, there is a need to strengthen the infrastructure and allocate sufficient funds for its use.

Clinical trial number

Not applicable.

Supplementary Information

The online version contains supplementary material available at https://doi.org/10.1186/s12911-026-03581-3.

Background

Hip fracture is one of the most common and debilitating fractures, imposing a significant burden on societies due to its severity, functional dependence, socio-economic costs, and associated mortality. It represents a critical public health challenge [1, 2]. By 2050, an estimated six million hip fractures are projected to occur annually, with a substantial proportion of these occurring in Asia. This global issue predominantly affects the female population, with about 18% of women and 6% of men impacted. These statistics underscore the urgent need for effective management strategies for hip fractures [3].

The healthcare system encounters significant challenges in managing hip fractures, including prolonged hospitalization and the consequent escalation of healthcare expenditures [4]. Furthermore, the shortage of specialized healthcare professionals, inadequate access to healthcare services, and regional disparities in access to specialized care are issues that demand the focused attention of healthcare managers and health policymakers. Therefore, the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) have recommended the use of telemedicine to complement or replace in-person consultations [5].

According to the WHO, telemedicine is defined as the delivery of healthcare services by healthcare professionals, where distance plays a critical role. It utilizes information and communication technologies to facilitate the exchange of accurate information for diagnosis, treatment, prevention, research, evaluation, and education [6]. Telemedicine serves as a tool to enhance healthcare delivery by enabling both synchronous and asynchronous consultations. By leveraging information technology and remote communication, it addresses challenges related to geographical barriers, functional limitations, and access to care. Furthermore, telemedicine enhances the quality, productivity, efficiency, and effectiveness of healthcare services, ultimately reducing costs across various domains [7, 8].”

The use of information and communication technology, including Internet-based media or programs, computers, video conferencing, smartphones, and applications to provide telerehabilitation services can prevent unnecessary delays in receiving care, and the impact of shortages reduces physical therapy and rehabilitation specialists in deprived areas [9]. In 2021, Peters et al. showed in a study that telemedicine interventions can be proposed to eliminate or reduce healthcare costs by reducing hospital services. Therefore, a small to moderate reduction in the use of hospital services can be one of the surprising achievements of these interventions [10].

Therefore, researchers have conducted many studies in this field in recent years, considering the great benefits of telemedicine in solving the challenges raised in providing services for people with hip fractures. A 2019 study by Yadav et al. showed that telerehabilitation systems could empower patients to overcome physical problems and show significant physical and social activity [11]. In 2023, a study by Hofmann et al. revealed that the primary reasons for caregivers and their family members to opt for a remote rehabilitation program were the convenience it offered, the knowledge gained for home management, and the increased recovery after a fracture. The ability to perform exercises at home, a testament to the suitability and ease of telemedicine, was also a significant factor [12]. Also, a study published by Backman et al. in 2023 investigated the effectiveness of digital health interventions in hip fracture management, primarily focused on evaluating the clinical and economic outcomes of specific interventions, such as mobile applications and videoconferencing [13]. In contrast, this scoping review not only provides a detailed examination of various telemedicine interventions but also highlights the critical need for developing advanced infrastructure and innovative technologies to support their implementation. Consequently, this study complements the findings of Backman et al. by offering a broader and more holistic perspective, thereby enhancing the understanding of telemedicine applications in hip fracture management.

Despite the abundance of studies conducted on telemedicine in hip fractures, no comprehensive review has been performed to systematically examine and categorize the applications of telemedicine in this context. Our study addresses this gap by offering a novel, systematic approach that synthesizes existing evidence, identifies emerging trends, and provides actionable insights for future research and clinical practice. Therefore, this study aimed to identify the applications of telemedicine in patients with hip fractures.

Study questions

Six main questions were considered to achieve the study objectives, as below. However, the study was wider than these questions.

1. What has been the trend of using telemedicine for hip fracture patients?

2. Who are the main beneficiaries of using telemedicine for hip fractures?

3. What are the telemedicine modalities in hip fractures?

4. What are the types of telemedicine in hip fractures?

5. What are the interventions for using telemedicine in a hip fracture?

6. What are the main outcomes of using telemedicine for hip fractures?

Methods

This scoping review was conducted following the Joanna Briggs Institute guideline, which provides methodological guidance for conducting scoping reviews and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) [14]. According to this guideline, the study’s main participants were patients or healthcare providers who used telemedicine in any healthcare-providing center.

Search strategy and data sources

The current research is a scoping review study in which all the articles related to the subject indexed in PubMed, Scopus, and Web of Science databases until March 20, 2023, were retrieved and analyzed. According to the purpose of the research (to identify the applications of telemedicine in patients with hip fractures), suitable keywords were identified for searching in the databases. The search was conducted based on the combination of related keywords in the mentioned databases, without a time limit, and in English until March 20, 2023.

Table 1 shows the study search strategy. After retrieving the articles from the databases, the items with duplicate titles were removed from the study, and the remaining studies were reviewed from different aspects of the title, abstract, and full text by two authors (M.K & A.G). If the selection, quality assessment, and data extraction from the articles had disagreements, they were reviewed by another author. The found studies were reviewed and selected in three stages.

Table 1.

Search strategy

Databases	PubMed, Scopus, web of science
Limitations	Full text in English.
#1	(Telemedicine OR “Tele medicine” OR “Tele care” OR Telecare OR Telehealth OR “Tele health” OR “Tele referral” OR Tele-referral OR “Mobile health” OR mhealth OR “m health” OR eHealth OR “e health” OR Telecommunication OR Teleconsultation OR “Tele consultation” OR “Telephone consultation” OR “Electronic consultation” OR “Online consultation” OR e-consult* OR Telerehabilitation OR Telemonitoring OR “Virtual medicine” OR Teleconferenc* OR Videoconferenc* OR “Video conference*” OR “Video consultat*” OR “Remote consult*” OR Teleorthopaedic OR “Tele orthopaedic” OR Teleorthopedic OR Teleorthopedic OR Tele-orthopedic)
#2	(hip OR intertrochant* OR “femur neck” OR “femur head” OR “femoral neck” OR “femoral head” OR subcapital OR intracapsular OR pertrochant* OR subtrochant* OR trochant* OR “proximal femoral” OR collum)
#3	(fracture*)
Search strategy	#1 AND (#2 AND #3)

Inclusion criteria

The study selection process was conducted following the PRISMA guidelines. Articles were included based on the following criteria: Studies focusing on the application of telemedicine in managing healthcare provided to patients with hip fractures. Studies involving individuals with hip fractures or relevant stakeholders (e.g., healthcare providers and caregivers) were included. Articles must be available in full text and written in English. To ensure consistency and minimize bias, the initial screening and selection of articles were independently performed by two authors. Any discrepancies or disagreements between the two authors were resolved through discussion or consulting a third author for arbitration.

Exclusion criteria

Articles that were not related to the research objectives, or their full text was not available or were not in English, were excluded from the study. Conference articles, dissertations, books, short articles, review articles, unstructured articles, and letters to the editor were also removed.

Data extraction and data items

After article selection, we removed duplicate and unrelated articles. Then, by assessing the abstract, the articles related to the project’s main purpose were selected. In the third stage, by reviewing the full text, articles that were completely related to the inclusion criteria were selected. Data extraction was done by two authors independently using a data extraction form. The form has four parts of bibliographic information about the articles (including the title, names of the authors, year of publication, and the name and quality of the journals), methodological information of the studies (type of study, purpose of the study, location, method of sampling and data analysis), related information to the participants (beneficiaries), information related to the type of interventions (including intervention tool, kind of modality and method and goal of the intervention), information related to the comparisons made (in intervention studies) and information associated with the resulting outcomes.

Articles quality assessment

Two authors (M.K. and N.A.) independently used the Newcastle-Ottawa Scale [15] to assess the quality of the articles. If there were disagreements, another author reviewed them (A.G).

Data analysis

Thematic analysis, provided by Braun and his college, was used to analyze the data. This approach has a six-step process, including familiarization with the data, code generating, identifying themes, reviewing themes, defining themes, and producing the final report [16]. Then, the results were summarized and reported in tables and figures according to the study objectives.

Results

The results were categorized into distinct categories aligned with the study objectives, systematically synthesized, and subsequently presented in tables and figures to enhance clarity and facilitate comprehensive interpretation.

Selection of articles

Initially, 341 articles were retrieved from the databases. After removing duplicates, screening studies, and considering inclusion and exclusion criteria, 23 articles were selected for final review (Fig. 1).

Fig. 1.

Study selection process according to the PRISMA

The quality of the articles was assessed to prevent any possible bias, and the selected articles had the necessary quality to be included in the study according to the quality assessment tools. Based on the quality assessment of the study, all included articles met the required quality standards; therefore, no articles were excluded at this stage.

Features of included studies

Table 2 offers a detailed summary of the selected studies, including their sources, year of publication, study objectives, type of telemedicine intervention, and most importantly, their main findings. These findings consistently highlight the crucial role of telemedicine in managing fractures, with a specific focus on the pelvis.

Table 2.

The selected articles

Author, year, & Country	Type of Study	Study objectives	Stakeholders	Telemedicine intervention tools	Type of modality	Main results
Li CT, et al. 2022 Hong Kong [17]	Randomized controlled study (Interventional)	The authors investigate the effects of telerehabilitation of home occupational therapy through a smartphone in increasing functional and motor efficiency and effectiveness.	Healthcare Provider and recipient	Our home-based program utilizes the Caspar electronic health system and a reliable smartphone application to ensure effective and consistent patient support.	Hybrid	This study investigates the potential application of remote rehabilitation through smartphones as an alternative home program for occupational therapy practice with the elderly. It has the potential to significantly increase functional and motor skills and is effective in boosting confidence and balance in hospitalized patients after hip fracture surgery.
Kampe K, et al. 2017 Germany [18]	Developmental study (Observational)	Description of rehabilitation program for patients with fear of falling after hip fracture	Patients	By phone call	Hybrid	This study showed that patients with hip fractures can experience less fear of falling when cognitive behavioral interventions are provided through telephone calls.
Jensen CM, et al. 2019 Denmark [19]	Qualitative Study (Observational)	We are investigating whether telehealth can support self-care and empower patients with hip fractures.	Patients	By an application	Asynchronous	This study showed that healthcare professionals can support the information and education of hip fracture sufferers by using an application program and promoting health knowledge.
Prieto-Moreno R, et al. 2022 Spain & Belgium [20]	Feasibility study (Observational)	Feasibility trial of ActiveHip with accompanying health in older adults after hip surgery	Patients (older adults) and Healthcare Provider	ActiveHip+ mHealth system	Hybrid	This study showed that the ActiveHip + mHealth system is a practical and useful tool for rehabilitation in the elderly after hip surgery.
Pfeiffer K, et al. 2020 Germany [21]	RCT (Interventional)	Investigating intervention effects to reduce fear of falling and increase physical activity during hip fracture rehabilitation	Patients	By phone call	Hybrid	The study showed that the intervention improved mental and physical performance indicators but did not increase daily walking duration. Therefore, the duration and equipment used to enhance physical activity after discharge should be reconsidered.
Pol MC, et al. 2019 Netherlands [22]	RCT (Interventional)	The study tested the effects of an intervention, including sensor monitoring-based mindful occupational therapy and coaching-based cognitive behavioral therapy (CBT), on daily functioning in elderly patients after hip fractures.	Healthcare recipients (patients) and healthcare providers	CBT-based occupational therapy or CBT-based occupational therapy with sensor monitoring	Synchronous	This study showed that among elderly patients with hip fractures, the conscious occupational therapy rehabilitation program based on sensor monitoring effectively improves daily performance and performs better compared to conventional methods.
Langford DP, et al. 2015 Canada [23]	RCT (Interventional)	Feasibility of patient education, rehabilitation, and telephone follow-up after hip fracture	Developers, providers, and recipients	By phone call	Hybrid	The results showed that telephone training significantly improves mobility and knowledge and provides social support after hip fracture.
Ortiz-Piña M, et al. 2021 Spain [24]	single-blinded, non-randomized clinical trial (Interventional)	Investigating the effect of multidisciplinary rehabilitation program on improving the performance of elderly people with hip fractures compared to home-based rehabilitation	Healthcare recipient	Using the telerehabilitation program called @ctivehip	Hybrid	The proposed telerehabilitation intervention is a valuable treatment option in the healing process of elderly people with hip fractures.
Ariza-Vega P, et al. 2021 Spain [25]	Qualitative Study (Observational)	Describing the experiences of family caregivers regarding the telerehabilitation program @ctivehip	Caregivers	@ctivehip	Synchronous	This study found that family caregivers enrolled in the @ctivehip telerehabilitation program were satisfied with the program. It stated that its use was manageable and beneficial for improving function in older adults after hip fracture.
Kauta NJ, et al. 2020 South Africa [26]	Content analysis (Observational)	Evaluation of the use of WhatsApp as a mobile health platform to support fracture management by non-orthopedic surgeons in Cape Town, South Africa.	Healthcare Provider and recipient	WhatsApp program as a tool for mobile health programs	Synchronous	The researchers of this study showed that the Orthopedic Referral WhatsApp Group provides a platform for free remote guidance for non-orthopedic physicians to manage traumatic fracture cases successfully in community health clinics. It can also be used in other environments with limited resources if the disease burden is high and there are few specialists.
Kalron A, et al. 2018 Israel [27]	randomized controlled study (Interventional)	Investigating the effect of telerehabilitation on mobility in people undergoing hip surgery	People (patients)	Remote rehabilitation based on video clips of common rehabilitation exercises focusing on the lower limbs	Asynchronous	This study demonstrates the potential of telerehabilitation as a complementary physiotherapy treatment, with significant implications for improving mobility after hip surgery.
Anthony CA, et al. 2018 USA [28]	prospective investigation (Interventional)	The authors evaluate the possibility of communicating with orthopedic trauma patients after surgery using an automated mobile messaging platform.	Patients and providers	Automated mobile messaging bot	Asynchronous	The researchers of this study showed that in orthopedic trauma patients, the automated mobile messaging platform can be used to obtain pain data and drug consumption after trauma.
Gani LU, et al. 2022 Singapore [29]	pilot study (Interventional)	The authors assess the use of telecare programs to monitor the osteoporosis treatment process.	Healthcare providers and patients	telecare programs	Hybrid	This study showed that a telecare program may be useful in monitoring the treatment of osteoporosis after hip fractures in the elderly population.
Wu WY, et al. 2023 China [30]	randomized controlled study (Interventional)	Investigating the therapeutic effect of remote home rehabilitation program on hip function and functional independence after surgery.	Healthcare providers and patients	Internet-based telerehabilitation management system	Synchronous	The researchers of this study showed that the Internet-based rehabilitation management system can not only promote patients’ physical rehabilitation but also has a positive role in psychological rehabilitation and prevention of complications. It can also provide new ideas and methods for clinical rehabilitation.
Zhang YY et al. 2022 China [31]	randomized controlled study (Interventional)	Investigating the effect of home-based telerehabilitation and its outcomes after hip fracture surgery	Healthcare providers and patients	Phone and Internet-based remote rehabilitation management system	Hybrid	This study showed that the Internet-based telerehabilitation management system used for home rehabilitation of elderly patients with hip fractures can improve hip function and increase the ability to perform physical activities and daily life to a certain extent.
Anthony CA, et al. 2020 United States [32]	randomized controlled study (Interventional)	The authors assessed the effect of acceptance and commitment therapy provided by a computerized companion messaging robot on reducing postoperative drug abuse in patients with hip fractures.	System developers, patients, and other healthcare providers	Automated mobile messaging bot	Asynchronous	This study showed that providing an intervention based on acceptance and commitment therapy through an automatic mobile messenger robot in the acute period after surgery has reduced drug use in patients with orthopedic trauma. These patients reported less pain after two weeks of surgery.
Ariza-Vega P, et al. 2021 Spain [33]	secondary study, non-randomized clinical trial (Interventional)	The authors assessed the perspective of family caregivers on the recovery process of older adults with hip fractures. They described caregivers’ experiences using online intervention or home care provided by Andalusia’s public health care system.	Caregivers, policymakers	Online telerehabilitation intervention	Synchronous	The researchers showed that the remote rehabilitation program (tel rehab) could effectively provide recovery after fracture, achieving knowledge for management and making it easier to perform exercises at home.
Crozier-Shaw G, et al. 2022 Ireland [34]	Developmental study (Interventional)	To assess how communication improvements through a data protection-compliant messaging program can influence time-dependent key performance indicators for hip fracture management.	Healthcare providers and patients	Instant messaging app compliant with data protection regulations	Synchronous	This study showed that social media messaging has helped reduce hip fracture sufferers’ surgery time. Facilitating communication through messaging services is also critical to improving the care of hip fracture patients in healthcare settings and beyond.
Bedra M, et al. 2015 USA [35]	Feasibility study (Observational)	Evaluating the effect of home-based telerehabilitation of the elderly during rehabilitation after hip fracture on mobility, psycho-behavioral factors, quality of life, and satisfaction with care, estimating the acceptance of the telerehabilitation system and adherence to the exercise program.	Healthcare providers and patients	Remote management system	Hybrid	The study showed a statistically significant improvement in sports self-efficacy, mobility, quality of life, and patients’ satisfaction after hip fracture within 30 days.
Gilboa Y, et al. 2019 Israel [36]	study protocol for a randomized controlled trial (Interventional)	Investigating the effectiveness of an intervention program based on telerehabilitation on daily life activities, quality of life, depression, and burden of caregivers in comparison to in-person visits at home and routine care of older adults living in the community after hip fracture and estimating the cost-effectiveness of the intervention programs.	Patients and healthcare providers	a) Videoconferencing b) Telerehabilitation system c) Cognitive Orientation to daily Occupational Performance (CO-OP)	Synchronous	The current research has increased access to home rehabilitation services, improving performance and reducing economic burden.
Pol MC, et al. 2017 Netherlands [37]	study protocol of a three-arm stepped wedge cluster randomized trial (Interventional)	Investigating the effects of sensor monitoring in the rehabilitation program for older adults after hip fracture	Healthcare Provider and recipient	A monitoring system for occupational therapy	Synchronous	This study introduces a novel approach, combining sensor monitoring and occupational therapy training as part of a rehabilitation program. It aims to enhance the independence of elderly individuals in performing daily activities after a hip fracture, sparking interest in its potential impact.
Ipsen JA, et al. 2022 Denmark [38]	study protocol for a cluster-randomized stepped-wedge trial (Interventional)	Evaluation of the impact of continuous rehabilitation and care in different departments for older adults after hip fracture	Patients	Video conference phone and digital health program	Hybrid	This study showed that patients in the intervention group have better physical performance than patients after routine care.
Jähne-Raden N, et al. 2019 Germany [39]	Developmental study (Observational)	Development of a specialized system to detect escaping the bed and prevent falls in the geriatric department.	System developers, Patients and Providers	INBED system	Synchronous	This study showed that falls in the elderly, which often lead to hip fractures, have significant medical consequences. Therefore, to solve or improve these problems, a system called INBED was designed, which can help significantly reduce the number of nursing staff and help injured people to move independently.

Articles trend

The selected articles were published between 2015 and 2023. According to Fig. 2, the trend of article publication has been upward.

Fig. 2.

Publication trends

The included articles were from the journals Age and Aging, International Journal of Environmental Research and Public Health, and Orthopedic Surgery, with two articles having the highest number. It should also be noted that Journals with Q1 and Q3 scores (32% each) had the largest share among others.

Type of study

Regarding study type, we divided the studies into two general categories: interventional and observational. In total, 15 studies have been conducted in interventional form, and 8 studies have been undertaken in observational form.

Type of fracture

According to the results, 9 studies used telemedicine for traumatic hip fractures, 3 studies for non-traumatic fractures, and 11 studies did not mention the type of fracture.

Stakeholders of using telemedicine in hip fracture

The users of telemedicine in hip fracture included patients, caregivers, physicians, nurses, health care professionals, physiotherapists, and other stakeholders (including emergency physician consultants, interns, department managers, etc.), which respectively numbered 20, 4, 3, 2, 1, 1 and 1 articles.

Telemedicine modality

Based on the results, 9 studies mentioned telemedicine for hip fractures synchronously, 4 were done asynchronously, and 10 were referred to as the combined type.

Type of telemedicine

All the articles are classified into 6 groups according to the type of telemedicine service, among which telerehabilitation and mHealth were the most frequent compared to other services. The distribution of articles based on the type of telemedicine service is shown in Fig. 3.

Fig. 3.

Distribution of articles based on the type of telemedicine service

Interventions of using Telemedicine in hip fracture

The types of interventions provided to patients with hip fractures using telemedicine are shown in Table 3. These interventions are placed in 5 main categories: patient education, patient HCP communications, fracture management, patient follow-up, and patient Monitoring.

Table 3.

Types of intervention through telemedicine for hip fracture

Row	Category	Subcategories	References
1	Patient education	Lifestyle and behavior modification education	[22, 32, 37]
		Self-care management education	[17, 19, 23, 29]
		Recovery Education	[18, 31, 35]
		Preoperative and postoperative education	[32]
		Geriatric patient education	[20]
2	Patient HCP communications	Postoperative communication	[17, 27, 28, 31, 32]
		Post-discharge communication	[18, 21, 23, 38]
		Geriatric care communication	[20–36]
3	Managing the fracture	Rehabilitation and physical therapy for fractures	[20–35]
		Pain management for fractures	[28, 31, 32]
		occupational therapy management	[17, 22, 37]
		Emotional and psychological support during fracture recovery	[30]
4	Patient follow-up	Postoperative follow-up	[17, 27, 28, 32]
		Rehabilitation follow-up	[18, 27–30, 36]
		Pain management follow-up	[28]
		Emotional support, counseling, and coaching	[22, 23, 29, 35, 37]
5	Patient monitoring	Fall monitoring	[17–19, 37, 39]
		physical monitoring and mobility	[20–22, 27–29]
		Psychological monitoring	[25]

Outcomes of using telemedicine in hip fracture

Table 4 presents the outcomes of using telemedicine for hip fracture in 7 categories, including increasing patient motivation, improving healthcare quality, enhancing rehabilitation, facilitating patient monitoring and follow-up, improving HCP performance, and decreasing healthcare costs.

Table 4.

Outcomes of applying telemedicine for hip fracture

Row	Category	Subcategory	References
1	Increasing patients’ motivation	Decreasing opioid use	[28, 32]
		Increasing the acceptance and commitment of patients to treatment	[32]
		Improving pain management	[20, 28, 32]
2	Improving the quality of healthcare	Improving patients’ quality of life	[23, 24, 31, 35–37]
		Preventing post-operative complications	[27, 30]
		Reducing mortality	[31]
		Accurate, safe, and effective access to care	[25, 27, 34, 36, 39]
3	Enhancing rehabilitation	Improving functional status and physical performance	[20–35]
		Improving psychological rehabilitation and support	[21, 30, 33, 35]
		Facilitating occupational therapy	[17, 22, 37]
4	Facilitating patients’ monitoring and follow-up	Improving emotional support, counseling, and coaching	[20, 23, 26, 29, 31, 37]
		Facilitating fall monitoring and follow-up	[17, 18, 21, 23, 37, 39]
5	Improving HCPs’ performance	Facilitating geriatric care communication	[17, 20, 23, 29, 39]
		Facilitating postoperative communication	[17, 27, 28, 31, 32]
		Facilitating post discharge communication	[18–21, 23, 38]
6	Facilitating patient education	Extensive education for patients with hip fractures (Tele-education)	[20, 23]
		Self-care management education	[17, 19, 23, 29]
		Lifestyle and behavior modification education	[22, 23, 37]
7	Reducing healthcare costs	Reducing costs of healthcare services	[26, 28, 36, 39]

Discussion

The establishment of telemedicine in the health system has caused a huge change in providing healthcare services. While telemedicine is not intended to replace traditional in-person healthcare delivery, it can function as a complementary tool and a viable alternative when access to face-to-face services is limited or unavailable [40]. According to the study results, increasing patients’ motivation to reduce drug consumption, improving pain management, and increasing patients’ acceptance and commitment to treatment among patients with hip fractures are some of the consequences of using this technology [32]. One of the other consequences of telemedicine is that it improves health care quality and rehabilitation [41]. In such a way, the study of Langford DP and colleagues has brought these results through improving the physical performance of patients in rehabilitation and improving their quality of life in general [23].

Improving patient rehabilitation and psychological support has always been one of the most important issues for providing patient services. Telemedicine can serve as an effective tool for delivering certain rehabilitation services [42]. In this study, the results showed that the Internet-based rehabilitation management system can improve patients’ physical rehabilitation and positively affect psychological rehabilitation and the prevention of complications [30]. Physicians can prescribe Telehealth as an effective method to support patient recovery following treatment and surgery. However, broader adoption of such an approach requires further interventional studies to facilitate more evidence-based decision-making. Telemedicine plays a pivotal role in improving healthcare providing [39], facilitating the access of individuals and providers to health services, and, importantly, reducing health system costs [5, 8]. According to the results, telemedicine in providing services to patients with hip fractures, especially in areas with limited access to health services, is a suitable option for health officials, offering a promising solution to the financial challenges of healthcare.

Monitoring and follow-up of patients is one of the other measures taken to improve community health and treatment [43]. Depending on the type of monitoring and follow-up, patients and treatment staff can observe the illness and recovery process. For example, in a similar study, patients were monitored and followed up using telemedicine regarding fall prevention and emotional support, counseling, and education [22]. Patients with chronic conditions need follow-up after discharge, and if there is no effective follow-up, they may sometimes face irreparable complications. Information technologies in the health system in the field are suggested for use in monitoring and follow-up services for this category of patients, ensuring the continuous care and support needed by patients with hip fractures after discharge.

Also, as mentioned in Jensen et al.‘s study, patient education, one of which is self-care management education, can involve the patient in his recovery process [19]. Information technologies, specifically telemedicine, have provided a suitable platform for patient education and have brought training during treatment and after discharge into a new phase [44]. Given the critical need for self-care education and continuous communication with healthcare providers among patients recovering from hip fractures, telemedicine offers a secure and standardized platform for delivering educational resources and facilitating information exchange.

Telemedicine for people with hip fractures has the potential to revolutionize healthcare delivery. One of its key advantages is that it provides consultation services. Pfeiffer et al. [21] demonstrated in their study that providing counseling and conducting cognitive behavioral interventions through telephone calls effectively reduced the fear of falling in patients with hip fractures. The nature of telemedicine and its ability to facilitate the exchange of information between different specialists suggests a bright future for its use in providing health services to people with hip fractures while ensuring all ethical and legal considerations are met.

Considering all the aspects mentioned in the selected studies, our study deals with the applications of telemedicine in patients with hip fractures and mentions the types of telemedicine services, including simultaneous, asynchronous, and combined, and also types of service delivery methods such as telerehabilitation, health companion has mentioned tele counseling; Therefore, the study is in line with the selected articles, but this study achieved more comprehensive findings using a systematic review approach.

In this study, despite a thorough search strategy, some relevant articles will likely be missed due to publication in other journals, indexing in other databases, and differences in terminology used to describe telemedicine and hip fracture. Also, the results only describe the current state of the published literature on telemedicine applications in hip fracture patients, and this may be subject to change due to advances in medical research. Therefore, after concluding the study, it is suggested that more studies be carried out to achieve more accurate results. Also, it suggested doing more review articles in this field to fulfill this study and categorize the latest applications of telemedicine in hip fractures. In addition, future studies could focus on conducting meta-analyses, examining specific subgroups, assessing telemedicine performance, and assessing long-term outcomes of telemedicine in hip fractures. Additionally, exploring advanced technologies such as virtual reality and regional/cultural differences is recommended. Developing evidence-based clinical guidelines for telemedicine in hip fracture management is also essential.

Conclusion

Telemedicine, which provides healthcare services in various fields, including rehabilitation, remote education and consultation, companion health, monitoring, and follow-up of patients, is developing day by day. In addition, this technology has brought an opportunity to continue and improve the education process and changing health behaviors. It can provide fairly fair access to health and treatment services in all regions. Therefore, it is considered a good alternative to providing services in person. According to the results, telemedicine services can have significant positive outcomes for hip fracture patients, and support their rehabilitation process. It could be able to enhance patient motivation, improve healthcare quality, and facilitate remote monitoring and follow-up. Additionally, telemedicine supports patient education, reduces healthcare costs, and improves provider performance, ultimately contributing to better recovery and overall patient well-being.

Experience has shown that telemedicine for hip fracture patients is considered a cost-effective and innovative approach. Therefore, good plans must be made regarding the preparation of service providers and the creation of the required infrastructure and policies to encourage the beneficiaries to use this technology for diagnosis, treatment, and care.

Electronic Supplementary Material

Below is the link to the electronic supplementary material.

Author contributions

Ali Garavand: Writing – original draft, Supervision, Writing – review & editing, Formal analysis, Conceptualization. Maryam Kordi: Data curation, Writing – review & editing, Formal analysis, Writing – original draft. Mahnaz Samadbeik: Methodology, English editing of the manuscript, ConceptualizationNasim Aslani: Data curation, Writing – review & editing, Data curation, Conceptualization.

Funding

The present study results from a research project with code 3254, approved by the Research Vice-Chancellor of Lorestan University of Medical Sciences.

Data availability

Relevant data are available at a reasonable request from the corresponding author.

Declarations

Ethics approval and consent to participate

The present study was approved by the Research Vice-Chancellor of Lorestan University of Medical Sciences ethical committee, which has a code of ethics for IR.LUMS.REC.1403.106.

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.