As a nurse educator, I’ve identified different tools that would streamline and enhance the education of new and existing healthcare professionals… but as a software developer, it can be tricky to determine how to best implement those tools. With that said, Infirmary Integrated has come to a massive fork in the road and this post is to help explain the feature roadmap that I am following in developing Infirmary Integrated.
Infirmary Integrated has always been a toolkit: a collection of tools built into one package. Initially, it was a device simulator, then it was multiple device simulators built into one program… then the device simulator could run step-by-step simulations and a scenario editor was added to the package…
Now, to simulate an often ubiquitous device utilized in healthcare- the Electronic Health Record (EHR)– Infirmary Integrated is expanding again! However, the best way to implement an EHR simulator is actually using a web-based platform, substantially different than the desktop application that Infirmary Integrated is currently!
To accomodate the implementation of the EHR, Infirmary Integrated will be the overarching suite of software that will remain open-source and freely available, and will consist of:
- Infirmary Integrated: Simulator (commonly called “Infirmary Integrated” or II:SIM)
- Runs as a desktop application on Windows, Mac OS, and Linux
- Bundled along with the Scenario Editor (II:SE)
- Infirmary Integrated: Electronic Health Record (II:EHR)
- A web-hosted application that requires the use of a web server
- Can be accessed by many users simultaneously through a web browser
Features Implemented
While the entire EHR is now under development, features currently implemented and in beta testing are:
- User management
- Access via username & password
- Users assigned roles (None, Clinician, Manager, Administrator, etc.)
- Users assigned licenses (MA, CNA, LPN, RN, NP, PA, MD)
- Access to add, edit, and delete chart items based on role and license
- Administrator access required to add, edit, or remove users
- Users can self-register but receive no role at default
- Facility management
- Able to simulate unit census on multiple units (facilities)
- Different units (facilities) can have different amounts of rooms
- Patient management
- Add, edit, and delete simulated patients
- Assign or unassign patients to rooms
- Navigate unit census, list all patients admitted to unit
- Health record (patient chart) functionality including:
- Chart banner: essential information (e.g. name, date of birth, allergies, code status)
- Demographics: view patient’s demographic information (which is added by a manager in the patient management tool)
- Allergies: list, add, view, and remove patient’s allergies
- User access (license & role) required to chart
- Notes (e.g. progress notes, history and physical) and Diagnostic Reports (e.g. x-ray, CT scan)
- List, add, view, and remove notes/reports
- User access (license & role) required to chart
- Only managers/administrators can remove notes/reports
- Add addendums to notes (e.g. to redact or add information)
- Attach files to notes/reports; when viewing notes/reports with attached files, images are displayed directly with the note (e.g. can simulate an x-ray reading alongside the x-ray itself).
- Documents (e.g. .docx or .pdf) can be downloaded for viewing
- Clicking on an attached image opens it enlarged in a new tab
- List, add, view, and remove notes/reports
- Orders: write, pend, complete, or discontinue orders
- User access (license & role) required for actions
- Prescriber licenses (NP, PA, MD, DO) can order
- Registered Nurses can order with cosign
- Administrator or manager can delete orders
- View all written orders- orders are color coded by priority and sorted by order type (medication or general order)
- User access (license & role) required for actions
Under Development
The following features are currently in the alpha stage of development:
- Medication Administration Record
- View all medications and doses due
- Medications and doses are populated from the patient’s orders
- Sign doses as being given, not given, and make notations on doses
Coming Soon…
The following features are planned for development prior to the first production release:
- Flowsheet
- Chart on the patient and view previously charted information, including:
- Vital signs
- Assessments
- Chart on the patient and view previously charted information, including:
- Results: enter and show lab results
Linking the Electronic Health Record and Simulator
While this project is a large undertaking, it is rapidly being developed with a production release estimated to be ready by mid-summer! Following the release of the Electronic Health Record, there are plans to merge functionality between the EHR and Simulator with the ability to:
- Generate an access token from a patient’s chart in the EHR
- Paste the access token into the Scenario Editor for a simulation
- Access the patient’s EHR directly from a scenario in the Simulator
Allowing educators to craft a scenario, create the simulation in the Scenario Editor to simulate healthcare devices such as the cardiac monitor and 12 lead ECG, and also have students be able to open the EHR directly into the scenario’s patient chart, view their health record, lab results, vital sign documentation, notes, and integrated medication administration into scenarios using the medication administration record!
Stay Tuned!
While an initial release is expected in the summer of 2024, you can keep track of the project or try it yourself from the code repository hosted at GitHub! (step-by-step instructions for setting up your own EHR are also planned!)