The Current State of Research, Challenges, and Future Research Directions of Blockchain Technology in Patient Care: Systematic Review (Preprint)

Abstract

BACKGROUND Blockchain offers a promising new distributed technology to address the challenges of data standardization, system interoperability and accessibility of medical records. OBJECTIVE The purpose of this review is to survey and analyze the current literature regarding the application of Blockchain technology in health care to broadly determine the Blockchain opportunities for patient care that health researchers are pursuing and the associated challenges. METHODS This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. We queried the Cumulative Index of Nursing and Allied Health Literature (CINAHL), PubMed, Embase, and the Web of Science databases for peer-reviewed research articles published up to December 2019 that examined the implementation of Blockchain technology in health care settings. RESULTS Applying a patient care focus, we identified three main categories of Blockchain research in health care: data privacy and security, interoperability and health care outcomes. Blockchain based health care applications include medical information systems, personal health records, mHealth and telemedicine, data preservation systems and social networks, health information exchanges and remote monitoring systems, and medical research systems. These Blockchain based health care applications may improve patient engagement and empowerment, health care provider access to information, and enhance the use of health care information for medical research. CONCLUSIONS Blockchain provides benefits such as ensuring the data privacy and security of health data, facilitating interoperability of heterogeneous HIT systems and improving the quality of health care outcomes. However, barriers for using Blockchain technology to build HIT include security and privacy vulnerabilities, user resistance, high computing power requirements and implementation costs, inefficient consensus algorithms and challenges of integrating Blockchain with existing HIT. Though Blockchain presents significant potential for disrupting health care, most ideas are in their infancy. Therefore, more research is needed to evaluate the impact of Blockchain technology post implementation.

A Systematic Review on the Adoption of Blockchain Technology in the Healthcare Industry

“…Although there have been various reviews of BCT-based healthcare [10], [11], [18]- [26], we argue that little attention has been paid to BCT-based healthcare adoption studies. As seen in Table 1, the primary focus of existing reviews has been on the outline and synthesizing the BCT application trends and areas in healthcare.…”

“…[11] Presented the scope of BCT applications in the healthcare domain [23] Reviewed the role of BCT in the healthcare domain [24] Investigated the possibilities for using BCT solutions in healthcare. [25] Conducted a review to analyze the current and future use of BCT in healthcare applications [10] Presented the obstacles and chances of using BCT in healthcare [26] Presented the benefits and challenges of BCTbased applications in healthcare [18] To evaluate the studies on the use of BCT in patient care, as well as the related obstacles.…”