I don't think patient demand would actually be a large driving force in the adoption of something like this. At least in the US, the hospital's customer is actually the insurance company. The patients are the product. The most effective avenue for adoption would be to appeal to insurance companies. Increase their ability to quickly and effectively audit/investigate a claim.

Focus on UI around provenance, audit trail, chain of permission (who knew what, when), signatures, and permissions etc.

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It's up to us to change that.

I am willing to bet Nostr's network effects will be quite convincing in the future.

I am with you on this, although I would like to see more of a DID approach that could facilitate a different identity for each relationship. Incremental steps is the right approach.

The DID integration in my mind is orthogonal to this proposal. It will be done at the protocol level and all event kinds will benefit from it.

Nice, I would have thought DID would have come first, but I can see the orthogonal approach. Encryption and sovereignty makes sense but privacy could become a concern.

DID is just another NIP-05 field, linking to a DID and not a website.

Yes, but then you can facilitate different identity with different medical providers and your medical data. Nostr clients have a difficult time facilitating the use of multiple accounts let alone a master controlling many identities :)

I agree, patients have the least amount of control in the US for our current system. The only problem is Insurance companies want to maintain full control. This proposal puts patients in more control. Therefore insurance companies I fear will fight this.