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In my country (france), such a service is currently deployed by the public healthcare organization. After the digitization of public administrative services by every state (which is mandatory in the european union), the EU will surely make it mandatory to have interoperability between the different health systems.
What is nice with this approach is that each state keeps control over their citizen’s data, but the mandatory interoperability (for administrative documents, and hopefully healthcare later) will make it easy for every citizen to move from one country to another.
It will be federated rather than decentralized, though, and I think that it should become way more decentralized so that every citizen really have a control over their data. I don’t think we can trust governments of nations. I agree that a reliable decentralized database approach doesn’t exist yet.
For the issue of “records that is not meant to be seen” I don’t think that it should exist. I think everybody have the right to be informed about their health¹. You can forbid modifications of the medical record by using merkle trees and signature, but I don’t see any reason to hide this information from the patient. For the example, if the person is told that they have the same comportment as an addict, don’t you think they will be more inclined to seek for help if they really have an addiction issue ? (provided this help is free and accessible, of course)
¹ if the person is recognized as responsible of themself