Viewing the world from the bottom up, local-first cooperation points out ways in which we can make our software more resilient, give prompt responses to the end users, and at the same time run it on existing resources — leading to less infrastructure cost and waste. We get these benefits by recognizing that inherently localized processes are best dealt with in a purely local manner, without involving centralized services or long-range communication paths. All we need to do is to make full use of the edge devices that people already hold in their hands, utilizing the compute and storage available.
In its simplest form, decentralisation means that no single power has exclusive control over the data or its processing. In the context of blockchain, this is achieved because the data is also distributed, ie, it is stored at each individual node in the network and not a single location. In terms of clinical trials, decentralisation means that it is not happening at a single central site; instead, it may be a multi-centre trial or be using connected technologies to enable participants and investigators to report remotely – while remaining within the overall structure of scientific and regulatory controls.