Leonardo Pegollo doctor, data and clinical work today.

I work as a district doctor. I work with complex patients, home care and community healthcare; when a problem keeps coming back, I try to put it back in order: data, code when it helps, a more repeatable way to reach an answer. That is where MediFlow comes from: a local-first medical record that keeps the authoritative record on the computer of the person providing care. The work on the Intelligence Fabric starts from the same idea: not deciding in the abstract that everything must be local or cloud-based, but choosing each time according to the work, the data and the risk.

In today's clinical work, tools matter: prevention, proactive care and AI-assisted code. They can shorten the distance between data, people and decisions, but they ask for humility and review. If they only serve to produce content, they have already missed the point.

MediFlow

MediFlow is the open-source practice-management system for outpatient patients. It organises records, therapies, documents, measurements and follow-up activities, with or without artificial intelligence. Version 0.8.6 source is published: it covers the local/Headless runtime and localhost UI on Mac; source availability does not establish clinical qualification. AI is optional and external providers are off by default; native apps remain follow-up work. Get MediFlow presents the product, shows how it works and leads from the first reading to the details of coding, interoperability and the Intelligence Fabric.

Explore 0.8.6 →

0.8.6 · One node, more ways in.

For 0.8.6, the local runtime runs on Mac. The localhost browser and authorised Headless paths use named MediFlow services without opening the database. Native apps remain follow-up work.

EntryRouteMediFlow node · data authority

Local browserFolders, agenda, documents and settings

HTTP loopback

macOS app · follow-upOnline access through an explicit paired path

HTTPS · explicit pairing

Headless MCP paths on MacNamed commands · authorisation · currentness · receipts

Local Supervisor · IPC

Web API/api/*Web session · version checks

Associated-client APIs/api/v1/network/*Pairing + native operator session + authorised capabilities

AIP application servicesAuthenticated RPC over IPCLimits, revocation and audit · no authority supplied by caller

Inside the local node

Authoritative SQLiteSensitive clinical fields encrypted · versioned writes

Administrative backupContent verification and controlled restore

Optional servicesOllama · ATHENA/MLX on a compatible MacWHO: code search and verification through a local service to configure

Distinct access pathsThe paired device does not replace the operator login

Operational boundary: the local network is optional; external OpenAI and AI generation are disabled by default. No offline writes or multi-master synchronisation. Windows, Linux, Mini, iOS and iPadOS remain outside this delivery. Native app qualification and signed distribution remain separate follow-up work. Version 0.8.6 source is published; source availability does not establish clinical qualification.

General project outline. Version 0.8.6 covers the local/Headless runtime and localhost UI on Mac. Native apps and Mini remain outside this delivery.

Notes

All →

9 September 2026

Who owns the tools of healthcare?

MediFlow, everyday operations, and the possibility of building public infrastructure in code as well.

7 September 2026

Towards MediFlow 0.8.6: making room for clinical work

Records, documents, local models and the Mac: what changes in the version in preparation and what we have tried so far.

11 August 2026

SISS part 2: inside PRREG, the new regional prescribing system

A second observational reconstruction of the Lombardy SISS: what changes with PRREG, how the browser moves, where errors emerge and why it remains a handoff.