At Duke University Hospital, an innovative initiative is transforming how osteoporosis is treated. The Duke Fragility Fracture Clinic, established two years ago, not only enhances outcomes for patients with hip, spine, and other fragility fractures but also sets a new national standard for post-fracture care.
For Dr. William J. Richardson, Professor of Orthopaedic Surgery, the clinic marks a significant shift from traditional care models. “Based on the American Orthopaedic Association’s Own the Bone Fracture Liaison Service, our clinic ensures timely evaluation and treatment for patients with fragility fractures,” he explains. “Without this kind of program, most patients aren’t started on treatment and face a high risk of future fractures,” he adds.
Kathleen Moreland, AGNP-C, a provider in the Osteoporosis and Bone Health Clinic, highlights how the clinic has reduced the time between a patient’s initial fracture and their osteoporosis assessment. “Patients are now seen within 6 weeks to 3 months, compared to the 6–9 month wait typical in traditional models,” she states. “This faster care helps prevent future fractures and enhances long-term outcomes.”
The clinic’s multidisciplinary approach has already changed lives. One example: a 72-year-old woman who fractured her femur at home was treated surgically by Dr. Christian Pean. Eight weeks later, she was evaluated in the Osteoporosis and Bone Health Clinic, where she received a complete assessment, including lab work and a DXA scan. She started weekly oral medication and worked with a physical therapist to rebuild her strength. One year later, she reports feeling like her pre-fracture self—an outcome made possible through coordinated, patient-centered care.
Dr. Pean, Executive Director of Artificial Intelligence and Information Technology Innovation, has overseen the clinic’s integration of AI-driven care navigation. “One in five patients encounter barriers like transportation or housing insecurity,” he notes. “By addressing these challenges, we’re reducing no-show rates and improving outcomes—especially for underserved populations.”
Moreland notes that mobile technology has been a game-changer. “AI allows us to send appointment reminders, educational materials, and videos directly to patients’ phones,” she explains. “It also enables two-way communication, so patients can ask questions and stay engaged in their care—even if they can’t attend in person.”
The clinic’s success is built on teamwork. From orthopedic surgeons and physical therapists to radiologists and care managers, the team works smoothly together to find, treat, and support patients at every step. “Having a system to identify and refer patients with fragility fractures reduces future risk,” says Dr. Richardson. “It’s a model that works.”
As healthcare evolves—with new CMS models like TEAM holding hospitals accountable for 30-day episodes of care—Duke’s approach is more than innovative; it’s essential. By combining fracture management, bone-strengthening therapy, and social risk navigation, the Duke Fragility Fracture Clinic helps preserve mobility, independence, and quality of life for millions.
There’s a significant care gap between a patient’s first osteoporotic fracture and when they receive treatment,” Moreland notes. “Our clinic bridges that gap with a focused, multidisciplinary approach. For institutions looking to replicate this model, close collaboration between APPs, orthopedic teams, and endocrinology is key.
“If you or a loved one over 50 has experienced a fracture,” Dr. Pean urges, “send them to us. We are committed to providing the highest level of care through surgical excellence and innovative initiatives like this one.”