Canadian Journal of Nursing Informatics

WordPress as a Platform for Nursing Informatics

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By Raymund John Ang, RN, MAN
Open Nursing Information System (Open-NIS) Project Lead


Wordpress for NINursing informatics is a technology-inclined nursing specialty that enables and empowers nurses to utilize advanced technology in the provision of nursing and patient care (McGonigle & Mastrian, 2017). With the transition to electronic medical records and hospital information systems, nurses are expected to expand their toolsets, and become familiar with how to use computers, access computer systems and manipulate peripheral devices, such as printers and scanners. The question now is “Should nurses explore other areas of informatics, aside from being users of technology?”

Organizations and institutions have varying definitions and job descriptions for informatics nurses and nursing informatics specialists. As a nurse with an informatics role, one needs to be familiar with the system being used by nurses organization-wide. This is important since informatics nurses may also deal with educating the nursing workforce on how to use the system or update the nurses on new modules or health informatics workflows. The nursing informatics specialist is also instrumental in introducing modifications to the system, especially those used by nurses. He/she does this by being onsite – on the floor with nurses, talking with the actual users – and gathering their ideas on how to better improve the system.

As an informaticist, a nurse can further expand their toolset by becoming a program developer. It may not be a requirement for nurse informaticists to be software or web developers, but it will surely benefit the organization if the nurse informaticist is familiar with how a program is being created, and is also able to develop programs to some degree. Being skilled in programming does not mean the informatics nurse should be able to create electronic medical records or nursing information systems from scratch. There are tools available that can help in rapid prototyping or development of actual programs themselves.

Many users are familiar with blogs and blogging platforms, most notably, WordPress. WordPress is a free and open source content management system mostly used for blogging. However, it can also be used as an application platform to speed up development, particularly by those who are not trained programmers. With WordPress, nursing informaticists can be empowered to develop programs of their own design, as a prototype for demonstration or as an actual platform for deployment. Of course, any system for production deployment should be examined carefully by an organization’s IT department for performance and security concerns (Messenlehner & Coleman, 2014). 


The concept of using WordPress as an application development platform can be integrated in the academe, empowering educators by providing a flexible web-based tool. It may be more interesting and convenient for students to view a real web application being demonstrated by faculty, or something that they can access themselves, instead of plain lectures and Power Point presentations. Since the content management system is free and open source, educational institutions do not need to purchase a license to show educational versions of electronic medical records. A nurse developer working in collaboration with the IT department can come up with an application to showcase important informatics concepts, such as databases, security with login and data access management, data analytics and simple CRUD (create-read-update-delete) operations to show modifiability of data.

Having a flexible platform to customize also means students can broaden their field of nursing interest. Students who are interested in building nursing applications, but have a difficult time learning programming language, can explore developing their applications using WordPress. They can then use these applications in their course projects or in nursing informatics-related theses or dissertations. Let us say a group of students in the baccalaureate program or a graduate student wanted to explore if a social media platform for smokers can help decrease the number of cigarettes smoked per day as part of a smoking cessation program. A social media platform can easily be developed using WordPress and available plugins. There are other social media platforms to choose from as well, but WordPress offers a configuration where the database and server files can be stored securely on campus or private servers, rather than servers owned by third party entities.

Besides using WordPress as an application development platform for nursing informatics-related topics and demonstrations, educators can use it as a learning management system as well. Plugins are available to extend WordPress functionalities to become an online platform for learning. As a basic setup, a simple blog post may include videos, images/infographics, online lectures and downloadable references, and a user content access plugin to control which users can access which type of content. This shows how flexible WordPress can be for nurse developers who are not skilled at programming.

Clinical Practice

It is not currently common practice for nurse informaticists to develop their own nursing information systems and have them deployed in production servers for mission critical operations. The concept of WordPress being used by a nurse developer to design a prototype of a system that can improve nurses’ efficiency is something new. Many would think it might be out of the nurse’s context or job description. But, there is nothing new with healthcare professionals taking the necessary steps to improve how they provide care for their patients. Management may not need to hire additional or contractual IT developers just to develop a prototype for a particular system. A nurse informaticist, who happens to be a nurse developer as well, would be able to do this. It is then up to management and the IT department to decide whether to deploy a WordPress application in the organizational production server or re-write the application in another platform or framework.

A good example of implementing WordPress in nursing information systems is to develop an electronic form of the nursing kardex. The kardex has been used for decades and has become a very important tool for nurses to have a clinical or holistic glimpse of their patients. Electronic medical records are designed to replace entries in the chart, like doctor’s orders, medication administration sheets, history and progress notes, laboratory and diagnostic results, and nurse’s notes. But with the advent of technological advancement, we can still see nurses giving bedside report using pen and paper. Why is this so? Why is it that even with advanced EMR’s, nurses still take down notes by hand during report?

To answer this, we should first examine the Data-Information-Knowledge-Wisdomcontinuum. What is stored and being manipulated in the electronic medical records are mostly, if not all, data – like patient’s vital signs, doctor’s orders, laboratory and diagnostic, and entries in the nurse’s notes. In order for nurses to make sense of the data stored in the EMR’s, these data need to be processed first by nursesto translate them into information and knowledge that is then relayed to the other nurse during bedside shift report. Nurses do not go about robotically browsing through dataset and mentally storing them. We can consider EMR’s as storage units of healthcare data, while the nursing kardex is a storage space for nursing care-related information and knowledge specifically designed to aid in the nurse’s workflow. Transforming the traditional kardex to an electronic form, either as a module in the EMR or as a separate application (utilizing WordPress), means there would be little information or knowledge lost while communicating from one nurse to another since they are stored electronically.


When designing the user interface, the programmer needs to have sufficient knowledge in HTML, CSS and JavaScript. These three technologies are essential in front-end development. The term “front-end” means the section of the program that deals with user interaction and experience. These technologies display and control how users are viewing different website or web application elements, such as paragraphs, textboxes, links and buttons. Learning these skills from basic to advanced may not be suitable for everyone.

WordPress devised a theming architecture where administrative users are able to choose among free and paid themes, and install them into the application they are working on. Knowledge of HTML, CSS and JavaScript means the nurse developer is able to tweak or modify the theme programmatically. But those who are unfamiliar with these scripts can still customize through the admin appearance settings – a point-and-click interface that does not require altered codes.

There are various themes available in the WordPress themes repository and commercial outlets, and the beginning nurse developer may feel overwhelmed with the options available. One may be tempted to install a fully featured theme, complete with almost all features and customizations. However, the underlying principle when developing a healthcare application is to keep it simple. Start with a theme suitable for a minimum viable product (MVP). The MVP may not be the fully featured web application one is expecting, but it should have the interface and key features required, at a minimum.

As a nurse developer continues their journey, they may decide to acquire coding skills to further enhance the web application being developed. One may decide to develop a unique theme from scratch or improve upon a starter theme. They may learn how to build themes according to set specifications and do custom work at the code level. Whether building upon a starter theme or developing a unique theme from scratch, it is always important to integrate security and user experience when developing themes for WordPress-based healthcare applications. This should be of utmost importance particularly since the application revolves around data privacy and confidentiality.


A web application goes beyond how it is being rendered in the browser. This means technology stack extends to the back-end as well. The term “back-end” means dealing with the business logic or how the application is designed to interact with user input, the database or any other mission critical operations. Since WordPress is based on the PHP programming language, a nurse developer who decides to adopt it as an application platform will ultimately need to learn PHP to further extend application features. But, what if learning how to code using programming language is not something the nurse developer is prepared for, as least not immediately? The answer – plugins.

Plugins are external codes that can be integrated with the WordPress environment to extend its functionalities. By default, WordPress is a very able blogging platform. But with the use of plugins, a WordPress installation can be transformed into a directory listing, a booking platform, a reservation management system, or anything a PHP developer would want it to be. A nurse developer has a plethora of plugins available. He/she should, however, be diligent when choosing which plugins to include in a project. Not every plugin in the WordPress plugins repository is suitable for building healthcare or nursing applications.

Security and privacy are major concerns when it comes to developing nursing web applications. One must choose plugins from reputable maintainers, and must always ensure that the plugins are regularly updated. Any unpatched vulnerability could mean a hacker may gain access to sensitive information. One should, therefore, test plugins (and themes) in a development environment before using in a production server.

Once the nurse developer becomes familiar with front-end and back-end technologies, they can learn how to customize plugins at the code level or develop plugins from scratch. With additional tools in their toolkit, they are able to take full advantage of the WordPress Codex (containing list of functions) and WordPress API (application programming interface), enabling him/her to further extend the functionalities of the application. The nurse developer is no longer reliant on available plugins since they are become able to transform the business logic into actual codes. This gives him/her the flexibility to improve performance and security.


With a lot of information about WordPress development on the internet, a nurse developer needs a guide on how to go through development with WordPress as an application platform. Some questions that could come to mind would be: Should I use default WordPress user management, or use a separate plugin? Should I use default Posts or create Custom Post Types to define and store data in my application? Do I allow users to have access to the administrative dashboard, or only allow users with specific roles?

These are, in fact, valid questions that need to be addressed before one can start building nursing web applications using WordPress. Despite the flexibility and customization that the content management system offers, there are still aspects of web development that need to be designed based on default WordPress configuration.

To address these questions and to streamline the process of nursing web application development, the Open Nursing Information Systemor Open-NIS (2018) project came up with a set of open standards for WordPress development, with specific emphasis to healthcare or nursing applications. These are open standards that can be adopted or modified accordingly based on the type of healthcare application being built.

The Open Standards for WordPress in Healthcarecan be accessed at

These open standards revolve around defining data, displaying and manipulating data in the front-end, administrative dashboard and user management. These may not cover the entirety of WordPress development, but are a good starting point for nurse developers.


Even though a software program is released as free and open source software, it is still important to know what type of open source license the program uses (McLean, 2015). In the case of WordPress, it is distributed under GNU General Public License (GNU GPL)version 2 or later (, n.d.). This means that when the nurse developer distributes – either freely or sells it – a derivative of WordPress (which may include plugins or themes), the one who receives the source code has the freedom to examine and make changes to the source code. While images, CSS and JavaScript may be copyrighted, the PHP section of the plugin or theme, especially those that use WordPress functions and API’s, are automatically released under the GNU GPL license. There may be different licensing interpretations to codes integrated with WordPress. Nonetheless, it is expected that the nurse developer should know the possibility of his own codes being subjected to the GPL license while distributing them within the WordPress ecosystem.

To read more about licensing in WordPress, please access the License About page located at


Messenlehner, B., & Coleman, J. (2014). Building Web Apps with WordPress: WordPress as an Application Framework. Sebastopol, CA: O’Reilly Media Inc.

McGonigle, D., & Mastrian, K. G. (2017). Nursing Informatics and the Foundation of Knowledge(4th ed.). Burlington, MA: Jones & Bartlett Learning.

McLean, A. (2015). Open-source software. Canadian Journal of Nursing Informatics, 10(3).

Open Nursing Information System Project (2018). Open Standards for WordPress in Healthcare. Retrieved from (n.d.). GNU Public License.Retrieved from


Raymund is a medical-surgical RN with an interest in health informatics. He graduated with a BSN degree from the University of St. La Salle, and earned his Master of Arts in Nursing degree from the University of the Philippines Open University. He is currently the project lead of the Open Nursing Information System (Open-NIS) Project – with the aim of democratizing web application development for health professionals, especially nurses, using open source platforms, like WordPress

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