I'm building a nostr based EHR (actually two with different iterations). The ideal is getting other healthcare entities to naturally converge on a format standard without being decreed into one (theres already too little flexibility in most aspects of healthcare) . The format that more easily allows for privacy and portability of patient's own data would win. Seems like there would still need to be a place to see what candidate implementations exist, such as staging relays, or something.

Legend has it that the first set, many millennia ago, freed itself.

What freed the first one?

I made a docviewer cuz I got tired of not being able to open documents on graphene os. doc, ppt, xls, PDF, txt. https://github.com/johnsoc34/docviewer-grapheneos

"I hate AI (I love it)" https://youtu.be/dbMXi9q78Tk?si=d_6PObNHAVXhtoQW

Ugh I hate to say it but the virtual urgent care feature is just too vulnerable. Wide open APIs, risk of spamming the schedule, npub exposed, patient lists visible. Mitigatable but way more of a problem than the features's benefit. Gona have to chop this feature

Working on adding a telehealth service that plugs into the nostr EHR and portal. Think of it like urgent care by video, paid in sats. Also, changing portal to allow parents to choose which child's chart they're in from parents own chart. This creates lots of key management decisions. Decided on a parent grant system so parent can still message doctors office without having to switch in and out of accounts on the portal. Will be doing a big security audit next. APIs in billing and calendar need authentication added. Also it is optional if the practice chooses to store patient nsec. If they do, will plan to encrypt by default.

Nostr based Electronic Health Record https://github.com/johnsoc34/nostr-ehr/blob/main/README.md

Here are some preview photos of NostrEHR, Patient Portal, and Billing system. https://github.com/johnsoc34/nostr-ehr/blob/main/README.md

The Nip17 invoice DMs and the fhir rest api for connecting traditional outside medical facilities require nsec for signing and decrypting respectively. As it stands currently the practice key sits on the server in two different files. This weighs heavy on my mind and needs fixing. My solution is a to create a separate "billing bot" keypair and a "FHIR API" keypair. These are purpose-limited identities: -Billing bot keypair: only used to send NIP-17 invoice DMs. The key only has permission to send messages, not decrypt clinical data. -FHIR API keypair: gets its own ECDH grants (kind 1013) just like a staff member would. It can decrypt patient data through the shared secret, but if compromised, you revoke its grants and rotate — same as firing a staff member. The practice nsec stays offline. The risks after an exposure or server compromise goes from everything to just billing messages or read-only FHIR access depending on which key leaks.

The Nostr-based electronic health record (EHR) has now been open-sourced. It contains multiple systems including EHR, Patient Portal, and Billing/Patient Management capable of invoices paid in bitcoin. The patient portal can be used by anyone to connect your own personal private health relay and then share with the desired doctors relay. My portal can be reached at portal.immutablehealthpediatrics.com. Choose your relay, login with nostr extension, yubikey, passkey, or nsec. This is not currently an open practice but have plans for a small pediatric practice in the works. The EHR itself has a demo mode so anyone can try it out and see it. You can even add mock patients. Just download the NostrEHR-Setup-1.0.0.exe Also ignore the website, its in need of some adjusting. I'd be glad to hear what people think. Let me know if there are some changes that you would recommend (especially critical ones) or features you'd want for building better medical-sovereignty tools. https://github.com/johnsoc34/nostr-ehr