I like IMCN, but it never was balanced for my Realism Tweaks. But the bigger problem has always been the sheer amount of mods/patches necessary. When I used RI/PN + RiPnO +BLTC + IMCN, it required 2 esms, plus 12 esps, plus my own patch. My module will NEVER be that complex, but it will be balanced for my Tweaks and it will be one or two esps (and probably a GOTY patch), which a user can select (or not) when they install my Realism Tweaks. My new module will likely remain totally optional. That way everyone who uses my Tweaks can use whatever Injuries and/or Needs mods they want. I'm making this module for myself, because I wanted to see if I could come up with a better Injury mod ("better", as in closer to my own vision of what one should be), that would be totally balanced for my Tweaks.
My needs system will likely be closer to Primary Needs. You'll need to sleep a certain amount of hours, and consume a certain amount of food, and drink a certain amount of water. At this point I don't know how complex I'm going to be making the Needs part . . . my focus at this point has been almost entirely on the Injury part.