Objective To explore the effect of "Internet plus nursing" follow-up model on plasma concentration and coagulation function in elderly orthopedic patients taking oral rivaroxaban. Methods Seventy-four elderly orthopedic patients taking oral rivaroxaban were divided into a control group of 30 and an experimental group of 44, according to their admission time. The control group was given conventional follow-up after discharge, while the experimental group was followed up based on "Internet plus nursing". After 3 weeks of follow-up, the trough concentration of rivaroxaban (Ctrough), the degree of dispersion of Ctrough, the achievement rate of target Ctrough and the results of coagulation indexes were evaluated for both groups. Results Twenty-seven patients in both groups completed the study. In the experimental group, the degree of dispersion of Ctrough was significantly smaller than the control group, and the achievement rate of target Ctroughwas significantly higher than the latter (both P<0.05). However, there were no significant differences between the two groups in Ctrough and coagulation indexes (all P>0.05). Conclusion The "Internet plus nursing" follow-up model can improve the compliance of elderly patients taking anticoagulants and maintain the stability of drug plasma concentration.