Challenge Mission

At its core, the mission of this challenge is to bootstrap an ecosystem of interoperable tools that allow individuals to take full control of their health data. By building apps on the Nostr protocol and integrating bitcoin, the challenge hopes to address key issues in traditional healthcare, including access to services, privacy, and fragmented health data systems. All participating apps will be required to be compatible with the SALUD protocol, or Sistema de Administración de Libertad Único y Decentralizado, which is an open-source framework for utilizing health data over Nostr.

Challenge Structure

The challenge is structured to span five months, from January through May. Throughout this period, participants will meet weekly to discuss their progress, share insights, and collaborate with others. These sessions will be instrumental in connecting developers, designers, and healthcare professionals, fostering a community focused on building the future of decentralized healthcare.

The challenge will include weekly office hours for participants, held every Thursday at 11 AM Eastern Time (4 PM UTC), starting on January 16th. These open office hours will provide opportunities to connect with doctors, developers, entrepreneurs, and health-minded bitcoiners to ensure that the apps being developed address real-world healthcare needs.

Evaluation Criteria

All submissions to the challenge will be evaluated based on four key metrics:

1. App Production Readiness: Is the app functional and polished enough for real-world use?
2. Solution Depth and Creativity: How innovative and impactful is the solution in addressing healthcare challenges?
3. Interoperability: How well does the app integrate with the SALUD protocol and other healthcare tools, ensuring it can work seamlessly within the decentralized ecosystem?
4. Overall Contribution to the Ecosystem: Does the app contribute to the broader vision of decentralized healthcare and enhance individual control over health data?

Prize Pool

The challenge features a prize pool starting at 10 million satoshis (0.1 BTC). Winning participants will not only receive financial rewards but also have the opportunity to collaborate with NosFabrica, a leading force in decentralized technology development, and Illuminodes, piloting the SALUD protocol in El Salvador. This container provides an exciting pathway for long-term collaboration and innovation in the global and decentralized health space.

Who Should Participate?

This challenge is open to a wide range of participants, each contributing unique expertise and perspectives:

• Developers and Designers: Those skilled in app development, UX/UI design, bitcoin and the Lightning Network.
• Healthcare Providers (Doctors/Nurses/Alternative Health): Professionals who can offer insights into real-world healthcare needs and help design solutions that truly benefit patients.
• Health-Conscious Individuals: People passionate about taking control of their own health data and empowering others to do the same.
• Bitcoiners and Nostriches: Enthusiasts of Bitcoin and Nostr who are excited to apply these censorship resistant technologies to solve pressing issues in healthcare.
• Investors: Individuals or firms interested in supporting innovative projects and startups that have the potential to shape future of healthcare.

How to Participate

To get involved in the challenge and receive important updates and event invitations, participants can sign up through either of the provided forms:

• Formstr
• Google Form

The main categories we'll encourage individuals to develop solutions for are personal health apps, healthcare provider tooling, and SALUD protocol infrastructure. So far, the SALUD protocol includes NIP-82, a way to store FHIR healthcare records on Nostr, developed by NosFabrica co-founder, Vitor Pamplona. We see more Nostr improvement proposals being made as healthcare data use cases develop.

Conclusion

The SALUD Decentralized Health App Development Challenge is a groundbreaking opportunity for anyone passionate about using Nostr and Bitcoin to reshape the healthcare landscape. By building apps that empower individuals to control their own health data, participants will play a pivotal role in addressing some of the most pressing challenges in modern healthcare, from data privacy to accessibility and portability. We're xcited about this challenge and to continue building the future of decentralized healthcare!

Happy new year!

PS. Feel free to reach out with any questions to jon@nosfabrica.com or go to https://nosfabrica.com/challenge/ to learn more.

The Problem:

The fiat healthcare system has led to a dangerous centralization of healthcare records in the US and globally, where companies ultimately own health data, not individuals. Current protocols of oAuths and APIs have led to bloated and expensive walled gardens (eg, Epic, Cerner) and a honeypot for healthcare hackers, most notably the recent Change Healthcare hack, owned by United Healthcare - affecting Avi's work. In 2023, more than 115 million health records were compromised across 655 data breaches.

High cost and poor outcomes are the current product of fiat healthcare. Of the $4.5 trillion annual US healthcare spend, 25% is administrative cost, and half of that is waste. 6-10% of every healthcare transaction goes to a medical billing middleman. Meanwhile, 6 in 10 Americans has a chronic health condition.

A decentralized healthcare application ecosystem would give the healthy sovereign individual the opportunity to take back ownership of their healthcare data, and their health, too.

The Solution:

NosFabrica means "our factory" in Latin, with of course the nod to Nostr. We aim to build a new, parallel health system on top of open source protocols Nostr and bitcoin. This decentralized healthcare ecosystem will be driven by peer-to-peer interactions between patients and providers. We will move healthcare onto a bitcoin and Nostr standard, giving independent healthcare providers the tools to integrate bitcoin deeper into their practice while maintaining practice sovereignty.

By establishing an open-source protocol for the private exchange of health data on Nostr, NosFabrica will set a foundation for a decentralized healthcare system and enable bitcoin-native electronic medical record (EMR) software clients to be built on top of Nostr.

We will cut out middlemen in healthcare and build tools that put the individual at the center of the solution. The benefits to patients include owning their own medical data, care discovery at competitive prices, portability of health data, and ultimately improve health outcomes. Doctors will also have the ability to reach a much broader population, reduce their administrative cost, and own their key demographic data such as licenses, credentials, and board certifications. Ultimately, we envision a more robust ecosystem of independent providers, combatting the trend of M&A and centralization we see under the current fiat healthcare regime.

There are several impacts for the broader free and open-source community, as it gives tools for individuals with different healthcare use cases to bring solutions to sorely needed applications such as medical consent, data sharing, clinical trials, and public health.

Nostr enables the NosFabrica future in three primary ways.

Identity and Access:

• User identity exists at the protocol layer via your npub/nsec, instead of the application layer.
• Users can sign into any application connected to the protocol
• Users can sign and certify events with their key pair, verifiably demonstrating ownership

Data Standardization

• We can develop specific Nostr event "kinds" created for medical data. Vitor has already started by building NIP-82 for medical data.
• Existing international data standards and formats such as FHIR/HL7 can be "wrapped" within Nostr events"
• This structure provides seamless data portability and interoperability across applications.

Persistence and Availability:

• HIPAA compliant, encrypted healthcare data is stored on relays
• Only the owner of the data and those authorized by the owner can decrypt or view the data - in other words, selective disclosure, which is a cornerstone of privacy.

Boosting the Nostr network effect and flywheel will continue, as there are already 40,000 weekly active users. By building healthcare applications on Nostr, we can onboard more people to the ecosystem, who may not be interested in social media.

Call to Action:

Of course, Nostr and Bitcoin are global protocols and networks that anyone can opt into. While the US gets a lot of the focus due to its expensive and complex healthcare system, there are many challenges globally including healthcare access, affordability, and timely care that we can address with open source tools and permissionless, sound money. We'd love to hear from you if you're interested in joining our mission.

About the team:

Avi Burra is an experienced healthcare veteran, working as senior director of product management at Optum. He is also the host of PlebChain Radio, a leading bitcoin and nostr podcast. With masters in electrical engineering and financial engineering, Avi brings a wealth of healthcare software product experience to NosFabrica.

Jon Gordon has worked across the healthcare industry, including in provider strategy, payers and suppliers. Jon has been helping healthcare providers integrate a bitcoin strategy with his consulting business, Satoshi Health Advisors. He also has a double masters in health economics and policy.

Vitor Pamplona is the creator of Amethyst, the top Android client for Nostr. Vitor previously led a company spun out of the MIT lab utilizing VR for eye exams at EyeNetra. Vitor has a PhD in computer science from MIT.

Go to nosfabrica.com to learn more and follow us along on Nostr!