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

Min Chen,Karlene Cousins,Polina Durneva

doi:10.2196/18619

Abstract

BackgroundBlockchain offers a promising new distributed technology to address the challenges of data standardization, system interoperability, security, privacy, and accessibility of medical records.ObjectiveThe 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.MethodsThis 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.ResultsBlockchain-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.ConclusionsBlockchain 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.

Highlights

BackgroundThere is a growing need to integrate health care information across a range of uses and stakeholders and to secure such data from unauthorized breaches, while making it easier for patients to access patient data
We identify the different types of blockchain health information technology (HIT) and discuss their implications for patient engagement and empowerment, provider access to personal health information (PHI), and medical or clinical research
We evaluated each paper to determine the following: (1) the types of blockchain-based HIT applications that researchers focused on including electronic health records (EHRs), personal health records (PHR), health information exchange (HIE), and telemedicine; (2) benefits of using blockchain for HIT; (3) health care activities that would benefit from their use, including patient engagement and empowerment, medical/clinical research, and provider access and use; and (4) the barriers and challenges associated with the implementation and maintenance of blockchain-based HIT

Summary

Introduction

BackgroundThere is a growing need to integrate health care information across a range of uses and stakeholders and to secure such data from unauthorized breaches, while making it easier for patients to access patient data. Blockchain is a distributed technology that has the potential to address data standardization challenges, system interoperability, and accessibility of medical records to support a more secure, patient-centric approach to health care information systems. Blockchain offers a promising new distributed technology to address the challenges of data standardization, system interoperability, security, privacy, and accessibility of medical records. 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. 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. Blockchain presents significant potential for disrupting health care, most ideas are in their infancy

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