Large-scale chain of trust

Dutch share decentralised data exchange as open source

Published on: 26/03/2020

Nuts, an open source, decentralised data exchange solution offering a large-scale trusted chain of custody, is inviting healthcare organisations to join. The project is being tested by hospitals, general practitioners and companies involved in healthcare, and hopes to launch the first version this summer.

The primary focus of Nuts - short for ‘nutsvoorzieningen’, or public utilities - is on healthcare. Nuts aims to reduce administrative paperwork and phone calls, stop the use of faxes, and end the practice of ordering a taxi to send a DVD with medical images. The peer-to-peer exchange of nothing but metadata links healthcare organisations without forcing a costly rebuild of ICT systems.

“Our goal is to create a national and international network of nodes – a frictionless patient healthcare data exchange that puts the patient in control,” says Steven van der Vegt, Nuts board member and one of the project’s core developers.

Image from Youtube video, a drawing showing two healthcare workers behind computer screens, with lines depicting the exchange of medical data, using a key to symbolise security.
A smart idea.

“A good healthcare data exchange is difficult to do correctly”, says Van der Vegt. “It involves multiple IT systems, with fixed internal processes that make data exchange a hassle.” The developer presented the project at Fosdem, Europe’s biggest open source conference, in Brussels on 2 February.


To encourage others to join the project, and to prevent IT vendor lock-in, the project publishes all of its software as open source. Nuts components include Corda, a blockchain ledger used by banks, and IRMA, a privacy-focused smartphone eID application developed by the University of Nijmegen. The software is available as a Docker container.

Nuts was created in 2018 by ten Dutch healthcare ICT specialists. The consortium says privacy-by-design and decentralisation are key to any electronic health record. The Dutch government in 2011 stopped its attempt to create a national health record system, following concerns about privacy and security. In 2014, the government set up 44 healthcare regions, within which medical data can be exchanged more easily.

In January, Nuts was one of the winners of the annual Dutch Privacy Awards.

More information:

Presentation at Fosdem
Presentation at Fosdem (PDF)
Nuts software
Nuts technical documentation