femr / femr

A simple and fast EMR system used in low resource settings.

FEMR - Fast Electronic Medical Records

Description

fEMR is a fast EMR solution for remote clinics who depend on speed and ease of use rather than complex features. Check out Team fEMR's website for more information and a live demo.

Community

1. Slack
2. JIRA
3. Team FEMR

tEMR Community

1. JIRA

Dependencies

• Play Framework

Contributing

For more information on contributing, please see the CONTRIBUTING.md file. For details regarding installation and deployment, continue reading.

CI

This repo uses Github Actions workflows for continuous integration, which can be found under the Actions tab in Github (https://github.com/CPSECapstone/zzs-femr/actions?query=workflow%3A%22Scala+CI%22). The Scala CI workflow runs 'sbt test' whenever code is pushed or a pull request is made to the main branch.

Setting up weekly backup reminder

• It is very important for the administrator to backup local data to the remote database.
• A cronjob can be set up before a kit is deployed to automatically display a message once a week.

1. In the command line, type crontab -e
2. A text editor should appear.
3. Add the following line to this file: 0 11 * * 5 /util/WeeklyReminder.sh
4. This will display a reminder pop up at 11:00AM every Friday.

Warnings

• fEMR is not HIPAA compliant (... yet).
• fEMR is not meant to diagnose, treat, cure or prevent disease.
• fEMR may attempt to establish a secure remote connection when internet access becomes available. This behavior is configurable and turned off by default.

Questions?

Email: [email protected]

Running the application using Docker

1. Make sure you have Docker installed and running on your machine.
2. Clone the FEMR/femr repo: git clone https://github.com/FEMR/femr.git
3. Checkout the super-femr branch: git checkout super-femr.
4. Cd into the femr directory: cd femr
5. Run docker-compose up to start the app.
6. If step 5 successfully finishes, then the app will be available at http://localhost:9000/

Setting up the project with IntelliJ on macOS

Step 1: Download and Install the following Software and Dependencies

• IntelliJ IDEA Ultimate
• MySQL Server
• MySQL Workbench
• Java JDK 1.8
• Git

Step 2: Clone the repo and checkout super-femr branch

• git clone https://github.com/FEMR/femr.git
• git checkout super-femr

Step 3: Setting up the DB

1. Make sure your MySQL server is running on your machine.
2. Open the MySQL Workbench.
3. Select the db icon to create a new schema and call it femr_db.

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4. Under the Administration tab, select User and Priviliges. Then Add account and add Login name and Password of your preference. Save the login and password because you will need it in the later steps.
   • For this example, the username is testing and password is password.

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5. Then go to the Schema Privileges tab, select Add Entry... for the user you created in the previous step, and select the femr_db schema.

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6. Give all of the rights, except the GRANT OPTION.

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Step 4: Configuring IntelliJ

1. Open IntelliJ IDEA Ultimate. Then open the femr project with super-femr branch checked out.

2. In IntelliJ IDEA Ultimate and go to Preferences -> Plugins -> click Marketplace -> Then download Scala and Play Framework. Then restart the IDE.

3. Inside femr/conf folder, create a new file named application.dev.conf.

4. Copy the following settings inside and save it. Note that db.default.username and db.default.password values must match the account and password from the Step 3.3. For this example, my username is testing and password is password.

include "application.conf"
settings.researchOnly=0
db.default.url="jdbc:mysql://127.0.0.1:3306/femr_db?characterEncoding=UTF-8&useSSL=false"
db.default.username="testing"
db.default.password="password"
photos.defaultProfilePhoto="./public/img/defaultProfile.png"
csv.path="./Upload/CSV"

5. Go to Run -> Edit Configurations -> click on the + sign -> Play 2 App.
   • If Play 2 App doesn't appear, try restarting the IDE.

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6. Then, click on Edit Environment Variables -> add the following two environment variables: user.dir and config.file (make sure to change the value based on where the two are stored on your local machine). Then click apply and ok.
   • config.file is the path for application.dev.conf.
   • user.dir is the path for the project.

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7. Go to File -> Project structure -> Under the Project tab -> Select Project SDK and set it to 1.8.
   • You can download 1.8 directly from IntelliJ. If so, choose 1.8 Amazon Correto.

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8. Change the language level to 8.

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9. On the rightmost side of IntelliJ, if there is a vertical line containing sbt. Click on the sbt tab and then click the refresh symbol.
   • If there isn’t sbt on the right, remove the .idea folder from the root directory of the project. In the command line, traverse to the root directory and do: rm -r .idea. Then redo step 2 and then continue. If still does not work try removing the project and recloning it again.

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10. After that runs, click on the Play button to run the configuration. If everything was set up correctly, the website should open up on another window. Select “Apply this script now”.

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Troubleshooting

1. Try deleting the .idea folder and rerunning sbt
2. Confirm you have the absolute path in your environment variables
3. Try to re-apply the plugins Scala and Play Framework
4. Otherwise, try cloning the femr github and going through the steps once more.
5. Try invalidating Intellij IDEA cache.

EULA and Privacy Policy

femr's Issues

Ability to upload photo of patient

A photo should be able to be uploaded to the patient profile

Implement automatic logoff after X amount of inactivity

HIPAA requirement - 15 minute sessions would be great.

Ability to edit vitals

A physician should be able to edit the vitals on the Medical page. Both the old vitals (taken by the nurse in Triage) and the new replacements should be recorded.

Feature testing

Create a test document

Dependency Injection

Enable dependency injection into the application.

More information:
http://www.playframework.com/documentation/2.1.3/JavaInjection

Update User

Users should be able to update their profile

Make the admin page pretty

Try adding a user, it's ugly.

Create a friendly 500 error page

When a user gets a 404 error they should see a friendly error page.

User Creation

Add ability for administrators to add users to the system

User Roles

Add ability for administrators to assign roles to users.

Test UserService object

Triage height submission shouldn't be above 11 inches or below 0

I entered height as 20 inches and it should max out at 11.

Submitting patient age as a decimal causes an error

When submitting a new patient if a decimal is entered in the age field an Execution exception error occurs. Also entering 0 or negative numbers are acceptable values, they probably shouldn't be. Age should probably have a maximum limit of 123 years (the oldest recorded human was 122 years old.)

Patient pregnancy submission accepts negative weeks value

I created a pregnant female patient who was -3 weeks pregnant and the submission was accepted.

Triage Page - Firefox vs. Chrome

Can someone confirm whether or not the difference in the page layout is a result of my browser settings. I've tried disabling all Firefox add-ons but it doesn't resolve the issue.

tabbed viewing for HPI and Treatment

Allow a physician to "tab" between HPI and Treatment while always leaving Patient Overview and Vitals visible.

Populate a detailed encounter search

When a user clicks an encounter on the search page it will bring the user to a detailed encounter page.

There is no information about the encounter here yet.

A physician should also have quick access to this information about a patient from the medical page.

prereq: #236

Recognizable Errors

After validation, errors should be red or have some kind of indicator rather than just a placeholder on the input element.

Pregnancy Input

Right now pregnancy is stored as an integer value representing the number of weeks. A nurse should be able to say that a patient is pregnant and optionally enter the number of weeks.

Post replacement medications

prereq: issue #60

Error - Searching a non-integer in the patient ID field causes an execution exception

When searching for a string, decimal, or any non-integer value in the patient id field for the triage, medical, or pharmacy page an executing exception occurs.

Create new patient triage record

Triage should be able to enter vitals and statistics for the patient

• Respiratory/Breathing Rate
• Blood Pressure
• Temperature (F)
• Height (inches)
• Weight (lbs)

Retrieve medications and diagnosis (auto populate)

prereq: issue #57

Create deliverable for class

We will be presenting 11/5

Eliminate duplicate code in view

Right now each view has an index and a populated version of the index. Each of which are two different files with the same HTML markup. One file (populated) accepts a viewModel then populates relevant fields, the other file (not populated) leaves relevant fields empty.

This is bad.

Create Evolutions for medical data

A doctor cannot submit HPI and Treatment information yet because a table does not exist for the data. Update the database model to reflect the changes.

Add validation to user authentication

• Validate presence of email field
• Validate presence of password field
• Display kind error to user if validation fails
• Repopulate email field

Medical page height displays feet and inches symbols mixed up

Height has the symbols for feet (') and inches(") mixed up. The numbers are also displayed as decimals.

Test SessionService object

Consider patients with the same name

When searching for a patient that has the same name as another patient, errors happen.

The error page should display the different patients and let a user pick which one.

Patient Informational PDF

Be able to create a PDF with patient history information so the patient can bring this with them in the next visit.

Finalize a working Ad-Hoc network on the clients laptop

Add validation to user creation

Validate input on form in business layer.

• First name is not blank
• Last name is not blank
• Email is not blank and is a proper format
• Password has a min length of 8 characters
• Display friendly errors next to field
• Repopulate fields

Add create new encounter

From the search page, a user should be able to create a new encounter for the patient they are viewing.

User Authentication

Users should be able to log into the EMR system

Make the encounter list user friendly

The search page lists encounters on the right hand side, but they are not user friendly. (The date isn't clear and it is very small etc).

Create application set up page

When run for the first time, the application should bring the user to a screen to create a new admin account.

Calculate BMI

BMI should be calculated when a patient has their height/weight recorded.

HIPAA Compliance

Figure out a way for software to be HIPAA compliant in remote clients for research in the US.

• Automatic logoff (Issue #21)
• Removal of patient identifiers (Issue #31)

Fix roles

Right now we have Admin, Physician, Pharmacist, and Researcher. We need to add a Nurse.

Test SessionsController

Post HPI and Treament data from medical page

prereq: issue #56

Client side validation is necessary.

Test a landing page for Medical and Pharmacy

Unlike the Triage page, the Medical and Pharmacy pages serve no purpose when they aren't populated. It might be better to have a "Search for a patient now!" type landing page for both pages.

Remove patient identifiers in research tab

Remove the 18 specific identifiers listed in the Privacy Rule and determine there is no other information that may identify the individual. The identifiers are:

• names
• geographic subdivisions smaller than a state
• all elements of dates (except year) related to an individual (including dates of admission, discharge, birth, death and, for individuals over 89 years old, the year of birth must not be used)
• telephone numbers
• FAX numbers
• electronic mail addresses
• Social Security numbers
• medical record numbers
• health plan beneficiary numbers
• account numbers
• certificate/license numbers
• vehical identifiers and serial numbers including license plates
• device identifiers and serial numbers
• web URLs
• internet protocol addresses
• biometric identifiers (including finger and voice prints)
• full face photos and comparable images
• any unique identifying number, characteristic or code

Relates to issue #4

Create current user object

Keep from exposing the data layer object above the Business layer.

Create new patient record

Users can create a new patient record in the system.

For age, two fields should be present. Age and birthdate. If user enters year, system will default to Jan 1, (current year - age)

• First name
• Last name
• Age
• Sex
• Street address
• City
• State
• Zip

Test UserController

Admin update User

Admins should be able to update a user profile

Medical page height displays values as decimals

When looking up a patient height the values are displayed as decimals when feet and inches should be treated as integers.

Age Input

Age is currently being input as an integer by default. It should be input as a date with the option of using an integer for age.

The patient table should store the date so we can always calculate the current age.