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

Abstract

Background Blockchain offers a promising new distributed technology to address the challenges of data standardization, system interoperability, security, privacy, and accessibility of medical records. Objective The purpose of this review is to assess the research on the use of blockchain technology for patient care and the associated challenges and to provide a research agenda for future research. Methods This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. We queried the Cumulative Index of Nursing and Allied Health Literature (CINAHL), PubMed, Excerpta Medica dataBASE (EMBASE), and 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. We identified 800 articles from which we selected 70 empirical research articles for a detailed review. Results Blockchain-based patient care applications include medical information systems, personal health records, mobile health 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, improve health care provider access to information, and enhance the use of health care information for medical research. Conclusions Blockchain health information technology (HIT) provides benefits such as ensuring data privacy and security of health data, facilitating interoperability of heterogeneous HIT systems, and improving the quality of health care outcomes. However, barriers to 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. With 51% of the research focused on medical information systems such as electronic health record and electronic medical record, and 53% of the research focused on data security and privacy issues, this review shows that HIT research is primarily focused on the use of blockchain technologies to address the current challenges HIT faces. Although Blockchain presents significant potential for disrupting health care, most ideas are in their infancy.

Blockchain-Based Digital Contact Tracing Apps for COVID-19 Pandemic Management: Issues, Challenges, Solutions, and Future Directions

“…Blockchain technology can play a significant role in contact tracing as it supports the distributed peer-to-peer connectivity of the network nodes that bridges the gap between the users and app managers. The technical features offered by blockchain allow for sharing of information while preserving the privacy of users [ 42 ]. Table 2 provides a brief description of how the default properties provided by blockchain technology can be utilized for contact tracing apps.…”

Barriers to blockchain adoption in health-care industry: an Indian perspective

“…The BC-T has disrupted the business processes by enabling “trust-based” transactions without third-party involvement with high level of success (Firdaus et al , 2019; McKinsey, 2020; Queiroz and Wamba, 2019; Durneva et al , 2020). The intrinsic uniqueness of BC design ensures vital features including transparency, robustness, audit-ability and security (Grover et al , 2019; Dutta et al , 2020).…”

“…Several recent studies have identified BCB in context to different industries (Kouhizadeh et al , 2020; Lohmer and Lasch, 2020; Öztürk and Yildizbaşi, 2020). To device the operational strategies and to unleash the benefits of health-care systems to masses, in developing countries, it has become essential to explore BCBs, which influence the health services (Abu-Elezz et al , 2020; De Aguiar et al , 2020; Durneva et al , 2020; El-Gazzar and Stendal, 2020). The identified BCBs are as follows.…”

Advancing Health Equity for People Experiencing Homelessness Using Blockchain Technology for Identity Management: A Research Agenda

“…While practical examples of blockchain applications in health care are being reported at an increasing rate, according to two recently published systematic reviews, very little empirical research has been conducted so far. 18,40 Much of the published literature consists of opinion pieces discussing the fragmentation of electronic health records systems and the potential applicability of blockchain in solving this problem, drawing from its use in other sectors. Most of the empirical research has focused on the use of blockchain to strengthen health information technology (HIT) security or privacy, or to improve HIT interoperability across different health care systems.…”