Smart Contracts and Shared Platforms in Sustainable Healthcare: Systematic Review (Preprint)

Abstract

BACKGROUND The benefits of SC (smart contracts) for sustainable healthcare are a relatively recent topic that has gathered attention given its relationship with trust and the advantages of decentralization, immutability, and traceability that could be introduced in healthcare. Nevertheless, there is a lack of studies exploring the role of SC in this sector based on the frameworks propounded by the literature that reflect the business logic -that has been customized, automatized, and prioritized- and the system trust. This study will address this lacuna OBJECTIVE This study aims to provide a comprehensive understanding of SC in healthcare based on reviewing the frameworks propounded by the literature. METHODS A structured literature review based on PRISMA principles was performed. A quantitative assessment of the studies, based on machine learning and data reduction methodologies, is complemented by a qualitative, in-depth, detailed review of the frameworks propounded by the literature. RESULTS A total of 70 studies, which depicted 19% of studies about this subject, met the selection criteria and were analyzed. Three factors depicted the advances in the topic. Two of them were referred to the leading roles of SC: (a) healthcare process enhancement and (b) assurance of patients’ privacy protection. The first role included six themes, and the second one three themes. The third factor encompassed the technical features that improve systems’ efficiency. The in-depth review of these three factors and the identification of stakeholders allowed us to characterize the system trust in healthcare SC. CONCLUSIONS This comprehensive review allows us to understand the relevance of SC and the potentiality of their use in patient-centric healthcare that considers more than technical aspects. It also provides insights for further research based on specific stakeholders, locations, and behaviors.