A Systematic Review on the Adoption of Blockchain Technology in the Healthcare Industry
DOI:
https://doi.org/10.4108/eetpht.v9i.2844Keywords:
Blockchain technology, Adoption, Healthcare, Systematic reviewAbstract
INTRODUCTION: Blockchain technology is a distributed ledger, decentralized, and cryptographically secure technology which has garnered considerable interest in different sectors including healthcare. It can enable better trust, security, management, and transparency of healthcare data, processes, and transactions resulting improving quality of care. Despite the fact of the increasing number of research investigating the applications/potentials of blockchain in healthcare, there is a scarcity of comprehensive reviews that focuses on the factors that influence its adoption in the healthcare industry.
OBJECTIVES: This review aims to summarise existing studies regarding the adoption of blockchain technology in the healthcare industry. This review presents a detailed review of existing empirical studies investigating the factors influencing blockchain adoption in healthcare by highlighting the research methodologies, targeted stakeholders, adoption theories/models used, and the influential factors explored in each of these studies. Careful syntheses of these studies would enable researchers and partitioners to acquire a wide knowledge and understand various opportunities and challenges of blockchain implementation in healthcare.
METHODS: Inspired on “Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)” guidelines, the study's scope and research questions are established, Scopus database is selected as an information resource, search strategy, and inclusion and exclusion criteria for document selection is developed. This review was conducted in August 2022. From 223 articles found in the search, 12 met the eligibility criteria and were selected to be extensively analyzed in this review.
RESULTS: This review reveals that very few empirical studies exist that sought to explore the significant factors influencing blockchain adoption in healthcare. The qualitative method was the most method employed, healthcare providers were the most targeted stakeholders, and most of the studies were not based on adoption theories/models. Privacy, government regulation, and trust were the most influential factors investigated in the studies.
CONCLUSION: The utilization of blockchain can help handle many issues in healthcare systems and bring improved healthcare delivery. Little attention has been paid to highlight internal and external factors that would impact successful blockchain adoption in healthcare. Additionally, the evaluated research placed little attention on understanding how underlying factors interact, social structures and institutional mechanisms affect the adoption of blockchain in healthcare. The reasons why healthcare organizations are hesitant to implement blockchain are still not clear. There is a need to conduct more research to examine the factors influencing the decision of healthcare stakeholders to adopt blockchain by using adoption theories/models. The proposed framework of the factors in this study may contribute as a starting point for future blockchain adoption studies in the healthcare industry.
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References
S. Nakamoto, “Bitcoin: A peer-to-peer electronic cash system,” Decentralized Bus. Rev., p. 21260, 2008.
F. Casino, T. K. Dasaklis, and C. Patsakis, “A systematic literature review of blockchain-based applications: Current status, classification and open issues,” Telematics and Informatics, vol. 36. Elsevier Ltd, pp. 55–81, Mar. 01, 2019, doi: 10.1016/j.tele.2018.11.006. DOI: https://doi.org/10.1016/j.tele.2018.11.006
C. C. Agbo and Q. H. Mahmoud, “Blockchain in healthcare opportunities, challenges, and possible solutions,” Int. J. Healthc. Inf. Syst. Informatics, vol. 15, no. 3, pp. 82–97, 2020, doi: 10.4018/IJHISI.2020070105. DOI: https://doi.org/10.4018/IJHISI.2020070105
M. A. Bazel, F. Mohammed, M. Alsabaiy, and H. M. Abualrejal, “The role of Internet of Things, Blockchain, Artificial Intelligence, and Big Data Technologies in Healthcare to Prevent the Spread of the COVID-19,” in 2021 International Conference on Innovation and Intelligence for Informatics, Computing, and Technologies (3ICT), 2021, pp. 455–462. DOI: https://doi.org/10.1109/3ICT53449.2021.9581469
N. Ullah, W. M. Al-Rahmi, A. I. Alzahrani, O. Alfarraj, and F. M. Alblehai, “Blockchain technology adoption in smart learning environments,” Sustain., vol. 13, no. 4, pp. 1–18, 2021, doi: 10.3390/su13041801. DOI: https://doi.org/10.3390/su13041801
A. Farouk, A. Alahmadi, S. Ghose, and A. Mashatan, “Blockchain platform for industrial healthcare: Vision and future opportunities,” Comput. Commun., vol. 154, no. December 2019, pp. 223–235, 2020, doi: 10.1016/j.comcom.2020.02.058. DOI: https://doi.org/10.1016/j.comcom.2020.02.058
H. M. Altab et al., “Personal and organisational resources on electronic health usage intentions in an emerging economy,” Telemat. Informatics, vol. 71, p. 101832, 2022. DOI: https://doi.org/10.1016/j.tele.2022.101832
A. Dubovitskaya, P. Novotny, Z. Xu, and F. Wang, “Applications of Blockchain Technology for Data-Sharing in Oncology: Results from a Systematic Literature Review,” Oncol., vol. 98, no. 6, pp. 403–411, 2020, doi: 10.1159/000504325. DOI: https://doi.org/10.1159/000504325
S. Balasubramanian, V. Shukla, J. S. Sethi, N. Islam, and R. Saloum, “A readiness assessment framework for Blockchain adoption: A healthcare case study,” Technol. Forecast. Soc. Change, vol. 165, p. 120536, Apr. 2021, doi: 10.1016/J.TECHFORE.2020.120536.
T. McGhin, K.-K. R. Choo, C. Z. Liu, and D. He, “Blockchain in healthcare applications: Research challenges and opportunities,” J. Netw. Comput. Appl., vol. 135, pp. 62–75, 2019. DOI: https://doi.org/10.1016/j.jnca.2019.02.027
A. Tandon, A. Dhir, A. K. M. N. Islam, and M. Mäntymäki, “Computers in Industry Blockchain in healthcare : A systematic literature review , synthesizing framework and future research agenda,” vol. 122, 2020, doi: 10.1016/j.compind.2020.103290. DOI: https://doi.org/10.1016/j.compind.2020.103290
S. Mehta, K. Grant, and A. Ackery, “Future of blockchain in healthcare: potential to improve the accessibility, security and interoperability of electronic health records,” BMJ Heal. Care Informatics, vol. 27, no. 3, 2020. DOI: https://doi.org/10.1136/bmjhci-2020-100217
L. Hughes, Y. K. Dwivedi, S. K. Misra, N. P. Rana, V. Raghavan, and V. Akella, “Blockchain research, practice and policy: Applications, benefits, limitations, emerging research themes and research agenda,” Int. J. Inf. Manage., vol. 49, pp. 114–129, 2019, doi: 10.1016/j.ijinfomgt.2019.02.005. DOI: https://doi.org/10.1016/j.ijinfomgt.2019.02.005
M. Sharma and S. Joshi, “Barriers to blockchain adoption in health-care industry: an Indian perspective,” J. Glob. Oper. Strateg. Sourc., vol. 14, no. 1, pp. 134–169, 2021, doi: 10.1108/JGOSS-06-2020-0026. DOI: https://doi.org/10.1108/JGOSS-06-2020-0026
H. F. Anjum, S. Zaleha, A. Rasid, S. M. Sam, and M. F. Yusof, “Mapping Research Trends of Blockchain Technology in Healthcare,” vol. 8, 2020, doi: 10.1109/ACCESS.2020.3025011. DOI: https://doi.org/10.1109/ACCESS.2020.3025011
A. A. Vazirani, O. O’Donoghue, D. Brindley, and E. Meinert, “Blockchain vehicles for efficient medical record management,” NPJ Digit. Med., vol. 3, no. 1, pp. 1–5, 2020. DOI: https://doi.org/10.1038/s41746-019-0211-0
T. Kumar, V. Ramani, I. Ahmad, A. Braeken, E. Harjula, and M. Ylianttila, “Blockchain utilization in healthcare: Key requirements and challenges,” 2018, doi: 10.1109/HealthCom.2018.8531136. DOI: https://doi.org/10.1109/HealthCom.2018.8531136
P. Durneva, K. Cousins, and M. Chen, “Directions of Blockchain Technology in Patient Care : Systematic Review Corresponding Author :,” vol. 22, pp. 1–16, doi: 10.2196/18619. DOI: https://doi.org/10.2196/18619
C. C. Agbo, Q. H. Mahmoud, and J. M. Eklund, “Blockchain technology in healthcare: a systematic review,” in Healthcare, 2019, vol. 7, no. 2, p. 56.
S. Angraal, H. M. Krumholz, and W. L. Schulz, “Blockchain technology: applications in health care,” Circ. Cardiovasc. Qual. outcomes, vol. 10, no. 9, p. e003800, 2017. DOI: https://doi.org/10.1161/CIRCOUTCOMES.117.003800
A. Hasselgren, K. Kralevska, D. Gligoroski, S. A. Pedersen, and A. Faxvaag, “International Journal of Medical Informatics Blockchain in healthcare and health sciences — A scoping review,” Int. J. Med. Inform., vol. 134, no. November 2019, p. 104040, 2020, doi: 10.1016/j.ijmedinf.2019.104040. DOI: https://doi.org/10.1016/j.ijmedinf.2019.104040
M. Hölbl, M. Kompara, and A. Kamišali, “A Systematic Review of the Use of Blockchain in Healthcare,” 2018, doi: 10.3390/sym10100470. DOI: https://doi.org/10.20944/preprints201809.0136.v1
H. D. Zubaydi, Y. Chong, K. Ko, and S. M. Hanshi, “A Review on the Role of Blockchain Technology in the Healthcare Domain,” pp. 1–29, 2019, doi: 10.3390/electronics8060679. DOI: https://doi.org/10.3390/electronics8060679
N. A. Ali Abdu and Z. Wang, “Blockchain for Healthcare Sector-Analytical Review,” IOP Conf. Ser. Mater. Sci. Eng., vol. 1110, no. 1, p. 012001, 2021, doi: 10.1088/1757-899x/1110/1/012001. DOI: https://doi.org/10.1088/1757-899X/1110/1/012001
H. M. Hussien, S. M. Yasin, S. N. I. Udzir, A. A. Zaidan, and B. B. Zaidan, “A Systematic Review for Enabling of Develop a Blockchain Technology in Healthcare Application: Taxonomy, Substantially Analysis, Motivations, Challenges, Recommendations and Future Direction,” J. Med. Syst., vol. 43, no. 10, 2019, doi: 10.1007/s10916-019-1445-8. DOI: https://doi.org/10.1007/s10916-019-1445-8
I. Abu-elezz, A. Hassan, A. Nazeemudeen, M. Househ, and A. Abd-alrazaq, “The benefits and threats of blockchain technology in healthcare: A scoping review,” Int. J. Med. Inform., vol. 142, p. 104246, Oct. 2020, doi: 10.1016/J.IJMEDINF.2020.104246. DOI: https://doi.org/10.1016/j.ijmedinf.2020.104246
Y. Xiao and M. Watson, “Guidance on conducting a systematic literature review,” J. Plan. Educ. Res., vol. 39, no. 1, pp. 93–112, 2019. DOI: https://doi.org/10.1177/0739456X17723971
V. M. Kiberu, R. E. Scott, and M. Mars, “Assessing core, e-learning, clinical and technology readiness to integrate telemedicine at public health facilities in Uganda: A health facility - Based survey,” BMC Health Serv. Res., vol. 19, no. 1, Apr. 2019, doi: 10.1186/S12913-019-4057-6. DOI: https://doi.org/10.1186/s12913-019-4057-6
S. Balasubramanian, V. Shukla, J. S. Sethi, N. Islam, and R. Saloum, “A readiness assessment framework for Blockchain adoption: A healthcare case study,” Technol. Forecast. Soc. Change, vol. 165, 2021, doi: 10.1016/j.techfore.2020.120536. DOI: https://doi.org/10.1016/j.techfore.2020.120536
A. Pólvora, S. Nascimento, J. S. Lourenço, and F. Scapolo, “Blockchain for industrial transformations: A forward-looking approach with multi-stakeholder engagement for policy advice,” Technol. Forecast. Soc. Change, vol. 157, p. 120091, 2020. DOI: https://doi.org/10.1016/j.techfore.2020.120091
J. M. Eklund, C. C. Agbo, Q. H. Mahmoud, and J. M. Eklund, “Blockchain technology in healthcare: a systematic review,” in Healthcare, 2019, vol. 7, no. 2, p. 56, doi: 10.3390/healthcare7020056. DOI: https://doi.org/10.3390/healthcare7020056
F. Aznoli and N. J. Navimipour, “Deployment strategies in the wireless sensor networks: systematic literature review, classification, and current trends,” Wirel. Pers. Commun., vol. 95, no. 2, pp. 819–846, 2017. DOI: https://doi.org/10.1007/s11277-016-3800-0
S. Gopalakrishnan and P. Ganeshkumar, “Systematic reviews and meta-analysis: understanding the best evidence in primary healthcare,” J. Fam. Med. Prim. care, vol. 2, no. 1, p. 9, 2013. DOI: https://doi.org/10.4103/2249-4863.109934
A. Liberati et al., “The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration,” J. Clin. Epidemiol., vol. 62, no. 10, pp. e1–e34, 2009. DOI: https://doi.org/10.1016/j.jclinepi.2009.06.006
D. Moher, D. G. Altman, A. Liberati, and J. Tetzlaff, “PRISMA statement,” Epidemiology, vol. 22, no. 1, p. 128, 2011. DOI: https://doi.org/10.1097/EDE.0b013e3181fe7825
A. A. Chadegani et al., “A comparison between two main academic literature collections: Web of Science and Scopus databases,” arXiv Prepr. arXiv1305.0377, 2013. DOI: https://doi.org/10.5539/ass.v9n5p18
A. O. Baarimah et al., “A bibliometric analysis and review of building information modelling for post-disaster reconstruction,” Sustainability, vol. 14, no. 1, p. 393, 2021. DOI: https://doi.org/10.3390/su14010393
S. Aich, S. Tripathy, M. Il Joo, and H. C. Kim, “Critical dimensions of blockchain technology implementation in the healthcare industry: An integrated systems management approach,” Sustain., vol. 13, no. 9, 2021, doi: 10.3390/su13095269. DOI: https://doi.org/10.3390/su13095269
C. Lu, D. Batista, H. Hamouda, and V. Lemieux, “Consumers’ intentions to adopt blockchain-based personal health records and data sharing: Focus group study,” JMIR Form. Res., vol. 4, no. 11, 2020, doi: 10.2196/21995. DOI: https://doi.org/10.2196/21995
K. Lee et al., “Perspectives of patients, health care professionals, and developers toward blockchain-based health information exchange: qualitative study,” J. Med. Internet Res., vol. 22, no. 11, 2020, doi: 10.2196/18582. DOI: https://doi.org/10.2196/18582
Y. S. Hau, J. M. Lee, J. Park, and M. C. Chang, “Attitudes toward blockchain technology in managing medical information: Survey study,” J. Med. Internet Res., vol. 21, no. 12, pp. 1–7, 2019, doi: 10.2196/15870. DOI: https://doi.org/10.2196/15870
L. Wanitcharakkhakul and S. Rotchanakitumnuai, “Blockchain technology acceptance in electronic medical record system,” in Proceedings of the International Conference on Electronic Business (ICEB), 2017, vol. 2017-Decem, pp. 53–58, [Online]. Available: https://www.scopus.com/inward/record.uri?eid=2-s2.0-85057753091&partnerID=40&md5=ce47128cdf34f6c268656ea80e6d4277.
L. Lu, C. Liang, D. Gu, Y. Ma, Y. Xie, and S. Zhao, “What advantages of blockchain affect its adoption in the elderly care industry? A study based on the technology–organisation–environment framework,” Technol. Soc., vol. 67, p. 101786, 2021. DOI: https://doi.org/10.1016/j.techsoc.2021.101786
P. Esmaeilzadeh and T. Mirzaei, “The potential of blockchain technology for health information exchange: Experimental study from patients’ perspectives,” J. Med. Internet Res., vol. 21, no. 6, 2019, doi: 10.2196/14184. DOI: https://doi.org/10.2196/14184
P. Esmaeilzadeh, “Benefits and concerns associated with blockchain-based health information exchange (HIE): a qualitative study from physicians’ perspectives,” BMC Med. Inform. Decis. Mak., vol. 22, no. 1, pp. 1–18, 2022. DOI: https://doi.org/10.1186/s12911-022-01815-8
S. Murphy, P. Reilly, and T. Murphy, “Assessing the potential use of blockchain technology to improve the sharing of public health data in a western Canadian province,” Health Technol. (Berl)., vol. 11, no. 3, pp. 547–556, 2021. DOI: https://doi.org/10.1007/s12553-021-00539-5
A. G. Alzahrani, A. Alhomoud, and G. Wills, “A Framework of the Critical Factors for Healthcare Providers to Share Data Securely Using Blockchain,” IEEE Access, vol. 10, pp. 41064–41077, 2022, doi: 10.1109/access.2022.3162218. DOI: https://doi.org/10.1109/ACCESS.2022.3162218
M. A. Bazel, F. Mohammed, and M. Ahmed, “BLOCKCHAIN TECHNOLOGY IN HEALTHCARE BIG DATA MANAGEMENT : Benefits , Applications and Challenges,” 2021. DOI: https://doi.org/10.1109/eSmarTA52612.2021.9515747
M. Alshamsi, M. Al-Emran, and K. Shaalan, “A Systematic Review on Blockchain Adoption,” Appl. Sci., vol. 12, no. 9, pp. 1–18, 2022, doi: 10.3390/app12094245. DOI: https://doi.org/10.3390/app12094245
J. Frizzo-Barker, P. A. Chow-White, P. R. Adams, J. Mentanko, D. Ha, and S. Green, “Blockchain as a disruptive technology for business: A systematic review,” Int. J. Inf. Manage., vol. 51, 2020, doi: 10.1016/j.ijinfomgt.2019.10.014. DOI: https://doi.org/10.1016/j.ijinfomgt.2019.10.014
A. Bhattacherjee, “Social science research: Principles, methods, and practices,” 2012.
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