I am across the pond from you and as far as my knowledge goes laws are even more strict here.
I am not a medical professional, but I did accounting for a lot of them and from what I have seen them pay for the relevant authentication hardware and software it seems to be nightmarish to navigate.
While I am very pro data security and people being the owners of their own data, this goes the other way for me too. I own the data about my health, so I should be able to decide that I am fine with having it on my phone.
The medication rollback I mentioned would have been completely unnecessary if that option existed. It was Ibuprofen, which my SO shouldn’t due to an already stressed kidney. Now that I know that I can look out for it too, provided I am allowed to go with.
Yes, if the other option is for you to play whack a mole, just defederate. People that follow that ideology can always go somewhere else, if they dislike you keeping this instance from being subjected to trolls and the like.