Abstract
BackgroundHealth care systems are currently undergoing a digital transformation that has been primarily triggered by emerging technologies, such as artificial intelligence, the Internet of Things, 5G, blockchain, and the digital representation of patients using (mobile) sensor devices. One of the results of this transformation is the gradual virtualization of care. Irrespective of the care environment, trust between caregivers and patients is essential for achieving favorable health outcomes. Given the many breaches of information security and patient safety, today’s health information system portfolios do not suffice as infrastructure for establishing and maintaining trust in virtual care environments.ObjectiveThis study aims to establish a theoretical foundation for a complex health care system intervention that aims to exploit a cryptographically secured infrastructure for establishing and maintaining trust in virtualized care environments and, based on this theoretical foundation, present a proof of concept that fulfills the necessary requirements.MethodsThis work applies the following framework for the design and evaluation of complex intervention research within health care: a review of the literature and expert consultation for technology forecasting. A proof of concept was developed by following the principles of design science and requirements engineering.ResultsThis study determined and defined the crucial functional and nonfunctional requirements and principles for enhancing trust between caregivers and patients within a virtualized health care environment. The cornerstone of our architecture is an approach that uses blockchain technology. The proposed decentralized system offers an innovative governance structure for a novel trust model. The presented theoretical design principles are supported by a concrete implementation of an Ethereum-based platform called VerifyMed.ConclusionsA service for enhancing trust in a virtualized health care environment that is built on a public blockchain has a high fit for purpose in Healthcare 4.0.
Highlights
Overview As a result of health care development, societies are undergoing a current demographic shift—people live longer, and fewer are born
The presented theoretical design principles are supported by a concrete implementation of an Ethereum-based platform called VerifyMed
We first describe a technology forecast of health care and demonstrate how trust will emerge in this transformed health care system as a component of an intervention
Summary
Overview As a result of health care development, societies are undergoing a current demographic shift—people live longer, and fewer are born. 1 (page number not for citation purposes) caregivers need to support an ever–increasing number of retirees with a rising number of chronic diseases. This unsustainable scenario is the strongest motivation behind many different ongoing proposals for transformations in the health care industry. Delivering health care, as we know it today, will most likely be unaffordable for any health system in 15 years and many health services will have to be delivered by nonprofessionals and machines This includes artificial intelligence health workers and devices connected via machine-to-machine protocols and automated, computerized services, which will be accessible via fast connections from anywhere, anyhow, and at any time (5G). Given the many breaches of information security and patient safety, today’s health information system portfolios do not suffice as infrastructure for establishing and maintaining trust in virtual care environments
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