A FHIR-compliant Application for Multi-Site and Multi-Modality Pediatric Scoliosis Patient Rehabilitation

Scoliosis is a spinal curvature that most frequently affects adolescents. Posterior spinal fusion surgery is required to correct the deformity in patients with severe scoliosis. Surgeons frequently use radiographic measurements and patient reported outcomes to aid in surgical treatment and monitor patient rehabilitation. Shriners Hospitals for Children is a large healthcare system caring for a significant percentage of pediatric patients with scoliosis. Surgeons from SHC-Greenville and SHC-Lexington have recorded data from more than 1,000 individual scoliosis patients. However, these collected data are usually dispersed across individual healthcare sites, necessitating the development of an integrated clinical data repository for data sharing and management. In this paper, we established a standardized research data repository with FHIR resources to harmonize multi-modal patient data from multiple clinical sites. Additionally, a FHIR-compliant application with a web-based user interface was prototyped to enable clinicians and researchers to access scoliosis patient data within our integrated and standardized research repository. Patient cohort definitions can be used to search these records using the same FHIR application. This standardized data-sharing framework and healthcare information system can be applied to multi-site and multimodality studies for clinical and research purposes, with the ultimate goal of improving the quality of patient care.