HealthNet: Rebuilding Trust in Open Medical Innovation

The Vision: An Ecosystem for Open Healthcare Some of the world's most urgent health needs go unmet, not because solutions are impossible, but because they are unprofitable. Rare diseases, affordable therapies, and do-it-yourself (DIY) medical devices rarely attract the investment of large manufacturers. HealthNet is a project designed to change that.

Young cystic fibrosis patient at Sainte Justine Hospital using the PEP Master device.

HealthNet is a new model for creating, verifying, and sharing open source medical devices and software. It brings together developers, researchers, medical professionals, and patients into a single collaborative ecosystem, one where high-quality, life-improving solutions can be built in the open and trusted by everyone who depends on them. Our goal is to prove that healthcare innovation can be transparent, collaborative, and accessible to all, without sacrificing safety or quality.

The Core Concept: Trust Without Gatekeepers

Traditional medicine builds trust through a closed, accredited supply chain: a small number of certified companies design, manufacture, and distribute devices under strict regulatory oversight. This system works, but it leaves out the many valuable solutions that emerge from open communities and local makers.

HealthNet asks a simple question: How do we rebuild trust in a distributed system of production, as a genuine alternative to the traditional supply chain? The answer is a chain of trust that follows an open source design from its first sketch to certified clinical use. Every contribution, every improvement, and every validation is recorded transparently, so that a device designed by a global network of volunteers and fabricated by local makers can earn the same confidence as one produced by a traditional manufacturer.

The First Use Case: PEP Master

HealthNet grows out of a real-world initiative called PEP Master, an open venture nurtured within the Sensorica network, in collaboration with the Breathing Games network. PEP Master develops an affordable, DIY therapy instrument, a computer game paired with a hardware controller, that helps children living with cystic fibrosis practice positive expiratory pressure (PEP) physiotherapy.

Because cystic fibrosis affects a relatively small number of people worldwide, the private sector has little incentive to invest in dedicated tools. PEP Master, developed with partners including Sainte-Justine Hospital in Montreal and Breathing Games, shows how an open, community-driven approach can serve patients that the market overlooks. It is HealthNet's first proof that decentralized innovation can deliver tangible, trustworthy healthcare solutions.

The Participants: A Collaborative Community

HealthNet brings together everyone who plays a role in the life of an open medical solution:

• Developers & Designers: The open source software and hardware creators who bring new devices to life. HealthNet lets them catalog their creations, collaborate across organizational boundaries, and be recognized and rewarded for their contributions.

• Researchers & Academic Institutions: University labs and clinical teams (such as Sainte-Justine Hospital and Western University) who scientifically evaluate designs, validate safety and efficacy, and mature solutions to the standards patients deserve.

• Medical Professionals: Doctors and healthcare workers who can confidently recommend open source solutions, backed by peer-reviewed evidence and a transparent record of provenance.

• Patients: The people at the heart of it all, who gain access to affordable, effective therapies and can trust the devices they rely on every day.

• Partners & Stewards: The wider network of collaborators, non-profits, technology-transfer intermediaries, and regulators (like Health Canada) that help open solutions cross the bridge from community project to certified care.

The Journey of a Medical Innovation

HealthNet provides the tools to guide an open medical solution through its entire life, without a central authority owning the process:

1. Creating an Open Design: A developer registers a device or software design, defining how it may be used, shared, and improved. This "digital twin" becomes the permanent anchor for the solution's identity and history.

2. Cataloging and Discovery: Contributors and communities can find existing designs, understand their provenance, and build on proven work, reducing wasteful duplication and competition.

3. Fork, Remix, and Improve: Like collaborative software tools, HealthNet lets developers safely fork and remix existing creations while preserving a clear lineage. Every improvement is traceable back to what came before, so credit and provenance are never lost.

4. Scientific Validation: A feedback loop connects designers with academic labs, maturing each solution to the required level of safety. When a design meets the standard, its validation is published in peer-reviewed journals, anchoring trust in independent evidence.

5. A Path to Certification: With a transparent record of quality, safety, and provenance in hand, HealthNet supports the journey toward regulatory approval, offering institutions like Health Canada a new, credible pathway for solutions built outside the traditional supply chain.

6. Fair Rewards and Sustainability: Every meaningful contribution, design, validation, or refinement, is recognized. HealthNet's Trust Economy ensures developers can earn a fair return for their work, sustaining the ecosystem over the long term.

Why HealthNet Matters

For developers, it means recognition, protection for their open work, and a sustainable way to be rewarded for building solutions that matter.

For patients and communities, it means access to affordable, trustworthy medical devices, especially for conditions the market ignores.

For the healthcare system, it means a proven, replicable model for trusting distributed innovation, opening the door to solutions that would otherwise never reach the people who need them.

HealthNet is more than a platform; it is a new way to build, verify, and share the medical innovations that improve and save lives.

Powered by Nondominium: The Foundation of Trust

HealthNet is built on the Nondominium protocol, a specialized infrastructure designed for sharing and governing resources without centralized ownership. Nondominium provides the underlying building blocks that make HealthNet's chain of trust possible:

• Nondominium Objects (NDOs): Every device design and piece of software is represented as an NDO, a permanent "digital twin" that lives on a distributed network. Its identity and full history cannot be deleted or quietly rewritten by any single operator, ensuring provenance is preserved from first draft to certified use.

• Embedded Governance: The rules that keep a design safe and open, quality standards, licensing that prevents it from being privately enclosed, and conditions for who may modify it, are baked directly into the NDO. This is what guarantees an open source solution stays open and trustworthy as it travels through the network.

• Version Tracking with Provenance: Nondominium links related designs together (as components, derivations, or successors), so that forking and remixing never severs the trail of authorship. This gives HealthNet the "Git-like" collaboration it needs while maintaining a rigorous record of lineage.

• Private Participation Receipts (PPRs): Every contribution, whether writing code, validating a device, or refining a design, generates a bilateral receipt of that "act of contribution." Stored privately by each participant, these receipts build a verifiable reputation and form the basis of HealthNet's Trust Economy, ensuring recognition and fair rewards.

• Agent-Centric Infrastructure: Every participant, developer, researcher, clinician, or patient, is a first-class "agent" who owns their own data, with no central server in the middle. This makes the HealthNet community sovereign, resilient, and private by design, well-suited to the sensitivity of the medical field.

Related past post: Sensorica and health care

Attribution

• Currently, Nondominium is developed mainly by Sacha and Tibi at the Sensorica lab, taking into consideration the synthesis of 15 years of OVN development and practice within the Sensorica network, encapsulated in the OVN wiki. 
• This post was drafted using previous publications and polished with the help of AI. 

         You can monitor development of Nondominium and HealthNet closely and even influence it by investing in this endeavor. Find the Finance button here.

Complexity Driven Development

We are living through a strange historical moment. Everywhere we look, institutions appear increasingly incapable of governing the systems they created. Governments struggle to respond to cascading crises. Corporations drown in their own internal coordination overhead. Supply chains fracture unpredictably. Digital transformation programs stall despite massive investments. Entire industries experience accelerating instability despite unprecedented technological sophistication.

Yet technology itself is not slowing down. AI, automation, distributed systems, digital platforms, global logistics, climate feedback loops, geopolitical interdependence and planetary-scale information networks are dramatically increasing the complexity of civilization itself.

The contradiction is becoming difficult to ignore: our systems are becoming more interconnected, dynamic, and interdependent than ever before, while the organizational models we use to manage them remain fundamentally industrial-age.

This is not merely a management problem. It is a computational problem, and increasingly, it is becoming a civilizational problem. (ref. Sensorica)

The Grammar That Never Outgrows Itself

On fractal composability, and why the best systems have very small hearts

Consider two systems that seem to have nothing in common. The first is a music composition language written in Rust. You describe a melody the way you might describe a sentence: pitch and duration, sequences of notes, simultaneous voices, modifiers that wrap a phrase and give it context. You write music like you write code, and then you render it to audio. The second is a protocol for governing shared resources across a peer-to-peer network. A makerspace in Montreal has a 3D printer sitting idle. A cooperative across town needs one. The protocol lets them find each other, negotiate terms, transfer custodianship, and record the whole interaction without any platform taking a cut or any central authority imposing the rules. Governance travels with the resource itself.

Different domains. Different problems. And yet, when you look at their internal structure, you find the same pattern at work.

The Distinction That Matters

Most systems are built by accumulation. You start with a core and keep adding parts. You add a module for this, a layer for that, a plugin for the other thing. Over time the system becomes capable, and also becomes impossible to hold in your head. The complexity compounds because each new part adds surface area.

A small class of systems works differently. They are built from a single primitive that can contain itself. You don’t add parts: you compose the primitive with itself, recursively, at any depth. The system grows not by accumulating components but by elaborating its own grammar.

The technical name for this property is fractal composability. A system is fractally composable when its combination operation is closed: any composition of parts produces something that can in turn be composed, without ever leaving the grammar. A modular system has parts you can swap. A fractal system has a primitive whose recursive self-application generates the whole space.

The difference matters because closed systems don’t develop seams. There is no boundary where “inside the grammar” ends and “outside the grammar” begins. You can always go deeper, wrap more context, compose at a higher level, and the system stays coherent throughout.  Read more... 

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Sensorica is implementing its OVN model for material peer production. You can donate to support the amazing people who have sacrificed for the past 15 years to refine peer production.

Our feedback on --> Cautious hope: Prospects and perils of communitarian governance in a Web3 environment

The goal of this post is to provide feedback on the Cautious hope: Prospects and perils of communitarian governance in a Web3 environment paper written by Nancy Ettlinger (Professor of Geography at The Ohio State University), in 2024. More importantly, I will nuance some statements about Sensorica and address some factually false ones. 

Before we begin, it is probably important to mention that, to my recollection, the author has never contacted any Sensorica affiliate before publishing this paper. I also don't know what sources of information Nancy used to learn about Sensorica, apart from one paper written by Pazaitis, A. (2020), provided as reference (Breaking the chains of open innovation: Post-blockchain and the case of Sensorica) and a link to a P2PFoundation wiki page on Sensorica. 
I discover the paper in 2026 and I sent my feedback to Nancy, which is the first version of this document. She got back to me the next day with her feedback to my feedback, which I integrated into this final version. 

Nondominium - A Coordination Layer for Parallel Infrastructure

Executive Summary

Critical infrastructure no longer behaves like a set of separate sectors. Energy, communications, finance, transport, manufacturing, supply chains, water, and public governance now operate as a tightly coupled system of systems. Failures in one layer increasingly propagate into the others, turning local disturbances into systemic shocks (Buldyrev et al., 2010; Helbing, 2013; CISA, 2025; DOE, 2023).

This is not a small market problem. Global supply chains alone account for over $10 trillion in annual intermediate goods trade, while infrastructure investment requirements exceed $3.3 trillion annually and rise toward $7 trillion when climate-adjusted needs are included (McKinsey, 2020; Woetzel et al., 2016; OECD, 2017). Yet recent evidence suggests that the binding constraint is often not capital itself, but coordination: the ability to govern interdependent assets, actors, and processes across fragmented institutional boundaries (World Bank, 2020).

From Digital Commons to Coordinated Commons: How Web3 Solves Open Source Fragmentation

The open-source movement is founded on the principle of sharing. Developers are granted the freedom to view, use, modify, and distribute code, a pool of shared knowledge known as digital commons. This freedom, however, carries an inherent paradox: the ease of copying code often leads to unwanted proliferation or project fragmentation, draining resources and creating chaos for users.

This post explores the governance, social, and economic failures inherent in traditional open-source development and presents a new paradigm: using Web3 primitives like blockchain, NFTs, and DAOs to enforce coordination, accountability, and sustainable development.

Complexity Rising: Are We Living Through the Collapse of Hierarchy?

In our previous post Are We Living Through Collapse? Complexity, Digital Technology, and the Future Beyond Capitalism we proposed complexity as the main cause of the socioeconomic turbulence that we experience today. Here we double down on this proposition by addressing Yaneer Bar-Yam’s paper Complexity Rising.

Collapse rarely looks like fire and ruins. Most often, it feels like drift, a slow unraveling of institutions, the loss of confidence in systems that once seemed unshakable, a spreading sense that no one is in control anymore. The question that haunts our time is not whether society will collapse, but whether it already is.

Over the last few decades, researchers across economics, ecology, and complexity science have been circling around the same idea: our world is entering a transition phase. The mechanisms that once allowed civilization to grow and adapt are breaking down. And yet, from the midst of that breakdown, a new kind of order is trying to emerge.