Encrypted off-chain storage (Iagon) + on-chain integrity anchors (Cardano / CIP-83).
Key rule: No PHI (personally identifiable health data) ever goes on-chain.
This project integrates with the Midnight Network.
This repository is not yet running against Midnight Preprod.
Current status:
- Midnight integration is planned but not yet implemented in the current public MVP.
- The present repository remains Cardano + Iagon based.
- No
testnet-02configuration is used in this repository.
Blocker:
- Preprod migration depends on required technical support/guidance for Midnight integration.
Next step:
- Once Preprod integration is available, this README will be updated with exact Preprod configuration and usage steps.
Haiti continues to face some of the most severe health disparities in the Western Hemisphere. Rural communities are especially affected due to a combination of systemic challenges: a critical shortage of healthcare professionals (with more than 85% of Haitian medical graduates emigrating), fragile infrastructure, and limited access to consistent medical services.
The problem is not only medical—it is also infrastructural and social. Persistent poverty, low health literacy, and a deep digital divide constrain access to innovation and care. Current conditions include:
- 60% of Haitians live below $3.65/day (World Bank, 2023)
- >40% of youth (15–24) are neither in school, training, nor employment (UNDP)
- <2% of schools have functional computer labs and rural internet access is <10% (IHSI)
In response, the Haitian Resource Development Foundation (HRDF)—a 501(c)(3) nonprofit established in 1987—launched a telemedicine initiative in Aquin, a rural commune in Haiti’s southern peninsula. The pilot began on May 19, 2025, and operates across five healthcare sites: the Aquin Community Hospital (hub) and four rural satellite clinics. Phase I includes deployment of Starlink internet, solar energy, and computers, alongside training for frontline staff.
A key differentiator of the initiative is that it is people-first, not technology-first. Telemedicine is treated as a tool for dignity and equitable care, and is paired with an intentional sociological research-action approach that studies trust, cultural adaptation, and adoption dynamics.
At the center of the initiative is a guiding research question:
How do rural populations transition from traditional and empirical medicine to trusting and adopting modern telehealth technologies?
The project follows an action research approach inspired by Kurt Lewin’s iterative cycle (observe → plan → act → evaluate), ensuring the model stays responsive to real community perceptions and barriers as adoption evolves.
Florida International University (FIU)—the fifth-largest university in the United States—is collaborating on the academic and research components, including support from the Robert Stempel College of Public Health & Social Work. The collaboration focuses on sociological research design, ethical alignment (including IRB pathways where applicable), and co-authoring a scientific publication documenting rural health transitions and outcomes. The State University of Haiti contributes local academic support in survey design, cultural alignment, and field methodology.
In low-connectivity environments, maintaining privacy, data integrity, and trust across clinics, institutions, and donors is difficult. This repository focuses on a practical building block: a privacy-preserving pipeline that keeps health data off-chain while still providing tamper-evident verification for audits, research traceability, and institutional accountability.
In clinics with spotty internet, staff still need to collect visit data, keep it private, and prove later that nothing was altered.
This MVP lets teams:
- Work offline on tablets/phones.
- Encrypt and store visit bundles safely in Iagon’s decentralized network.
- Stamp a tiny, private receipt on the Cardano blockchain (an “anchor”) so anyone can verify the data wasn’t tampered with—without seeing private details.
Why it matters: Patients keep their privacy. Clinics get an audit trail. Donors and institutions get verifiable integrity.
- Clinicians & coordinators – a simple, step-by-step routine (capture → encrypt → upload → anchor).
- IT/engineers – scripts, APIs, and wallet tooling to automate the pipeline.
- Partners & sponsors – privacy-first architecture with verifiable integrity.
- Privacy first: PHI stays off-chain. Only anonymous IDs, hashes, sizes, timestamps are anchored.
- Offline-first: everything works without internet; syncs when possible.
- Tamper-evident: each record’s cryptographic hash is anchored on Cardano.
- Simplicity: small scripts + a one-page SOP for field use.
flowchart LR
A["Tablet capture: JSON, images, audio"] --> B["Encrypt & bundle: ZIP + manifest.json (SHA-256)"]
B --> C{"Connectivity available?"}
C -->|No| B
C -->|Yes| D["Iagon upload: sharded & encrypted"]
D -->|file_id| E["Cardano anchor: CIP-83 encrypted metadata"]
E --> F["Audit & verify: hash match + restore drill"]
As the Haiti Telemedicine architecture evolves, the broader stack is shaping up around several complementary components:
- iTERVE – intended support for palm-based capture of patient vital signs in rural care settings
- OnDoctor365 – telemedicine interface and clinical workflow expertise layer
- GameChanger Wallet – exploratory Cardano-side interaction path for hashing, transaction orchestration, and verifiable integrity workflows
- Iagon – decentralized encrypted off-chain storage for medical records and associated files
- Midnight – privacy, identity, consent, and access-control layer for sensitive patient data
This reflects the proposed target architecture, not a fully implemented production stack. Some integration details are still being defined, including:
- how iTERVE fits into the broader patient-data workflow
- how records move across capture, hashing, storage, and access-control layers
- how Iagon and Midnight will interoperate within the final privacy-preserving architecture
- how OnDoctor365 interfaces operationally with field and clinical processes
A cross-team technical alignment meeting is being organized with the following participants and technical roles:
- OnDoctor365 — telemedicine platform and clinical workflow integration
- GameChanger — Cardano-side transaction orchestration, hashing flows, and integrity workflow design
- Haiti CS data collection and integration team — field data collection, systems integration, and implementation coordination
- iTERVE — palm-based vital-sign capture and device/data integration
- Iagon — decentralized encrypted storage architecture, retrieval flows, and data persistence design
- Midnight — privacy, identity, consent, and access-control architecture
The goal of this session is to define:
- capture and intake responsibilities
- data handoff points between tools and teams
- integrity and verification workflow requirements
- storage and retrieval responsibilities
- privacy, identity, consent, and access-control requirements
This meeting is intended to inform the next architecture phase, including how the privacy-preserving identity, consent, access-control, and decentralized storage layers should be mapped into the broader system design.
The intended system direction is:
- Perform patient triage and assess the immediate care context.
- Capture patient vitals and field data through appropriate care interfaces and devices.
- Generate verifiable integrity artifacts for auditability and record validation.
- Store encrypted records off-chain using decentralized infrastructure.
- Apply privacy, identity, consent, and access control around sensitive medical information.
- Enable telemedicine workflows that remain practical in low-connectivity environments.
This direction remains aligned with the project’s core rule: no PHI goes on-chain.
Status: Exploratory / under evaluation
In addition to the current Cardano + Iagon architecture, this project is evaluating GameChanger Wallet as a possible Cardano-side interaction layer for QR-driven workflows, transaction orchestration, and hash-anchored record verification.
This does not change the project’s core privacy model:
- No PHI goes on-chain
- Medical records remain off-chain
- Cardano is used only for integrity anchors, verification, and auditability
- Any QR-based interaction is intended for workflow access, portability, or verification, not for exposing private medical data
GameChanger’s public architecture and educational materials suggest a possible fit for this MVP because they emphasize:
- URL/JSON-based dApp and wallet interaction patterns
- QR-mediated user and device flows
- scripting and transaction orchestration
- hash-aware and file-related Cardano workflows
For this repository, that makes GameChanger relevant as a potential operational layer for initiating or simplifying Cardano-side integrity actions in low-connectivity healthcare environments.
At this stage, this repository does not claim:
- a production GameChanger integration
- a turnkey healthcare deployment
- a one-step “medical data hash from just a QR code” implementation
The current position is more conservative: GameChanger appears to be a feasible component for future Cardano-side workflow design, pending technical validation, compliance review, and implementation support.
- GameChanger education brief: https://gc-education-one-pager.netlify.app/
