# Open-source healthcare AI projects worth knowing in 2026

> Ten open projects for clinical NLP, de-identification, medical imaging, synthetic data, FHIR and medical language models, and what each one is good for.

Open source · Regions: Global · By Harsh Vitra (BrandLabs) · Published 2026-11-14 · Reviewed 2026-11-14 · Source: https://www.brandlabs.app/learn/open-source-healthcare-ai-projects

**TL;DR:** You can build most of a private health AI stack from open projects: OpenMed or Presidio for de-identification, medspaCy or MedCAT for clinical NLP, MONAI for imaging, Synthea for synthetic patients, HAPI FHIR for interoperability, and open-weight medical models such as MedGemma for generation. Check each licence: open weights are not always open source.

## Key takeaways

- De-identification: OpenMed (Apache-2.0, 35 PII languages) and Microsoft Presidio (MIT) both run on your own hardware.
- Synthea generates realistic synthetic patient records, so you can build and test without touching real data.
- HAPI FHIR is the most widely used open-source FHIR server and library for Java.
- Open-weight medical models such as MedGemma ship under their own terms. Read them before you build a product on top.

## Which open-source projects matter for health AI?

| Project | What it does | Licence | Good for |
| --- | --- | --- | --- |
| **OpenMed** | Clinical NER and de-identification, 2,200+ models | Apache-2.0 | Removing identifiers on-device, in 35 languages |
| **Microsoft Presidio** | PII detection and anonymisation framework | MIT | Pipelines that mix rules, regex and models |
| **medspaCy** | Clinical NLP on top of spaCy | MIT | Rule-based clinical text processing, negation and context |
| **MedCAT** | Concept extraction and linking to SNOMED CT and UMLS | Check current terms | Turning notes into coded concepts |
| **Apache cTAKES** | Clinical text analysis from Mayo Clinic, on the JVM | Apache-2.0 | Legacy hospital NLP pipelines |
| **Project MONAI** | Deep learning framework for medical imaging | Apache-2.0 | Training and deploying imaging models |
| **Synthea** | Synthetic patient generator | Apache-2.0 | Test data with no privacy risk |
| **HAPI FHIR** | FHIR server and Java library | Apache-2.0 | Interoperability with EHRs |
| **MedGemma** | Open-weight medical text and image models from Google | Health AI Developer Foundations terms | Medical text and image understanding |

## Where should a new health AI team start?

Start with data safety, not models. Put **de-identification** (OpenMed or Presidio) between your users and anything that stores or learns from their messages. Use **Synthea** to build and test flows without real patients. Add **HAPI FHIR** when you need to talk to clinical systems. Only then pick a model, and pick it with an evaluation set, not a leaderboard.

## What should you check before adopting a project?

1. **Licence**: Apache-2.0 and MIT are permissive. Some projects have moved to source-available licences, and many models ship under custom terms.
2. **Release cadence**: a project that has not shipped in a year will not fix the bug you find.
3. **Languages**: most clinical NLP is English-first. Test every language your users write in.
4. **Evaluation**: can you reproduce the published numbers? Projects that publish weights, recipes and evaluation scripts let you check.

## Frequently asked questions

### Is it safe to use open-source models for patient-facing health AI?

The licence and the code are only the start. Safety depends on how you test the model on your users, languages and risky scenarios, and on the guardrails around it. Evaluate before launch and on every update.

### What is the difference between open source and open weights?

Open source means the code is under a licence such as Apache-2.0 or MIT that allows use, change and redistribution. Open weights means you can download the model parameters, but the terms may restrict uses. Many medical models are open weights, not open source.

## Where BrandLabs fits

We build private health AI on open-source foundations like these, add our own components, and test every model on the client's own data before launch. https://www.brandlabs.app/private-ai

## Sources

- OpenMed, OpenMed, 2026-11: https://openmed.life
- Presidio, Microsoft on GitHub: https://github.com/microsoft/presidio
- medspaCy, GitHub: https://github.com/medspacy/medspacy
- MedCAT, CogStack on GitHub: https://github.com/CogStack/MedCAT
- Apache cTAKES, Apache Software Foundation: https://ctakes.apache.org
- Project MONAI, MONAI Consortium: https://monai.io
- Synthea, The MITRE Corporation: https://synthetichealth.github.io/synthea/
- HAPI FHIR, Smile Digital Health: https://hapifhir.io
- MedGemma, Google Health AI Developer Foundations, 2025-05: https://developers.google.com/health-ai-developer-foundations/medgemma