#[1] The gap in BC, Canada is not physician patient communication. It is physician to physician cimmunication. Sending a referral to another physician is done by fax. Yes, fax. Nostr can be the physician exchange for referrals and receiving report. Thus killing the fax forever. The problem would be to get the support from various EMR vendors to intergate nostr backend into their EMR. If the exchange is a standalone it will fail. Most docs want the functionality build into their EMR. Hope this makes sense.