BACKGROUND
Digital health interventions have the potential to improve the integration of health care at all system levels. Hip fracture is a serious injury for older people and integrated post-surgery care for hip fracture is vital for good recovery.
OBJECTIVE
The aim of this study was to understand and characterise digital health interventions used for hip fracture post-surgery care, and further to examine the extent to which of these digital health interventions address the six domains of the World Health Organisation (WHO) integrated care for older people framework.
METHODS
A scoping review was conducted, by searching the literature from English and Chinese electronic databases and trial registries, including Medline, EMBASE, ProQuest, PsycINFO, The Cochrane library, CINAHL, Open Science Framework, Clinicaltrials.gov, VIP, China National Knowledge of Infrastructure (CNKI) and Wanfang. Keywords used in the English database included hip fracture, post-surgery care and digital health interventions, while Chinese keywords included “Kuan Bu Gu Zhe (hip fracture)”, “Shu Hou Kang Fu (post-surgery care)” and “Shu Zi Jian Kang (digital health)”. Interventional, observational, qualitative studies as well as case reports and study reports were included in this study. We used a combined framework, the WHO integrated care for older people and WHO digital health intervention classifications, to support data synthesis.
RESULTS
A total of 4,542 articles were identified, of which 39 studies were included in the analysis. We identified only six randomised controlled trials. Digital health interventions were mainly used to help doctors provide clinical care and facilitate service delivery between the patients, caregivers and health providers. No studies focused on health workforce, financial policy or the development of infrastructure. The primary users of digital health interventions were limited to healthcare providers and patients, with no studies involving healthcare managers or the use of data services to support the data collection, management, use and exchange. From the post-surgery care perspective, most digital health interventions focused on physical therapy, bone protection and falls prevention. The functionalities of digital health interventions were mainly limited to health education or promotion and providing remote services. There were limited interventions implemented in low-and middle-income countries.
CONCLUSIONS
There are opportunities to expand the use of digital health for post-surgery care of hip fracture patients, but this requires a stronger evidence base, including high-quality larger-scale studies, more focus on application in resource-constrained settings, expanding to more users and capabilities of interventions, and exploring the role of digital health for the integrated care model to mitigate health system challenges.