BackgroundData security issues still constitute the main reason for the sluggish dissemination of electronic health records (EHRs). Given that blockchain technology offers the possibility to verify transactions through a decentralized network, it may serve as a solution to secure health-related data. Therefore, we have identified stakeholder-specific requirements and propose a blockchain-based architecture for EHRs, while referring to the already existing scientific discussions on the potential of blockchain for use in EHRs.ObjectiveThis study aimed to introduce blockchain technology for EHRs, based on identifying stakeholders and systematically eliciting their requirements, and to discuss the key benefits (KBs) and key challenges (KCs) of blockchain technology in the context of EHRs.MethodsThe blockchain-based architecture was developed in the framework of the design science research paradigm. The requirements were identified using a structured literature review and interviews with nine health care experts. Subsequently, the proposed architecture was evaluated using 4 workshops with 15 participants.ResultsWe identified three major EHR stakeholder groups and 34 respective requirements. On this basis, we developed a five-layer architecture. The subsequent evaluation of the artifact was followed by the discussion of 12 KBs and 12 KCs of a blockchain-based architecture for EHRs. To address the KCs, we derived five recommendations for action for science and practice.ConclusionsOur findings indicate that blockchain technology offers considerable potential to advance EHRs. Improvements to currently available EHR solutions are expected, for instance, in the areas of data security, traceability, and automation by smart contracts. Future research could examine the patient’s acceptance of blockchain-based EHRs and cost-benefit analyses.

In the course of digitization in healthcare, personal health records (PHRs) are handled as a key solution. Despite the indisputable benefits, the adoption of PHRs is hampered by data security and data privacy concerns. Blockchain technology offers promising potential to address these issues by enabling secure transactions of sensitive data. With regards to PHRs, the blockchain can be used to manage the access to health-related data. Besides existing generic PHR architectures, we systematically identified issues for the healthcare sector that need to be considered for the development of a PHR. We subsequently derived eight meta-requirements that were consolidated into three design principles. Within a 1-year design science research project, we developed the blockchain-secured PHR prototype, OSHealthRec, and evaluated the system in four evaluation cycles. The findings of our research are twofold. On the one hand, we contribute to the design knowledge base by presenting three design principles. On the other hand, we present the development of a real, operational blockchain-secured PHR and the findings from its continuous evaluation, which may serve as useful advice for further solutions.

In this study, we examine the configurations of trust-enhancing factors that determine the intention to adopt conversational agents (CAs) for disease diagnosis. After identifying trust factors influencing the behavioral intent to adopt CAs based on the information systems acceptance research field, we assigned 201 participants to use the mobile Ada application and surveyed them about their experience. Ada is a medical diagnostic CA that combines patients' symptoms with their medical history and provides diagnostic suggestions. The collected data was analyzed using a fuzzy set qualitative comparative analysis to capture the causal complexity of trust. We identified several configurations of trust-enhancing factors affecting the intention to adopt the CA. In particular, our results show that the adoption intentions are strongly determined by trust factors associated with the performance dimension. Furthermore, we derived two propositions for the development of CAs for healthcare purposes and elaborated implications for research and practice.

No abstract

No abstract