JMIR Publications

ABSTRACT

Background:

Nowadays, a number of mechanisms and tools are being used by healthcare organizations and physicians to electronically exchange personal health information of patients. The main objectives of different methods of Health Information Exchange (HIE) are to reduce healthcare costs, minimize medical errors, and improve the coordination of inter-organizational information exchange transactions across healthcare entities. The main challenges associated with the common HIE systems is the privacy concerns, security risks, low visibility of system transparency, and lack of patient control. Blockchain technology, based on its special characteristics, is likely to disrupt the current information exchange models utilized in the healthcare industry.

Objective:

Little is also known about patients’ attitudes and perceptions toward the implementation of Blockchain-enabled HIE networks and it is still not clear if patients (as one of the main HIE stakeholders) are likely to opt-in to the applications of this technology in HIE initiatives. Thus, this study is aimed at exploring the core value of Blockchain technology in the healthcare industry from healthcare consumers.

Methods:

To recognize the potential applications of Blockchain technology in healthcare practices, we designed sixteen information exchange scenarios for controlled online experiments. Totally, 2013 respondents participated in the online experiments that described information exchange conditions characterized by four exchange mechanisms (i.e., direct, look-up, patient-centered, and Blockchain), two types of health information (i.e., sensitive vs. non-sensitive), and privacy policy transparency (weak vs. strong).

Results:

The findings show that there are significant differences in patients’ perceptions of various exchange mechanisms with regards to patient privacy concern, trust in competency and integrity, opt-in intention, and willingness to share information. Interestingly, participants hold favorable attitude toward Blockchain-based exchange mechanisms for privacy protection, coordination, and information exchange purposes. This study proposes the potentials and limitations of a Blockchain-based attempt in the HIE context.

Conclusions:

The results of this research should be of interest to both academics and practitioners. The findings propose potential limitations of a Blochchain-based HIE that should be addressed by healthcare organizations to exchange personal health information in a secure and private manner. This work can contribute to the research in the Blochchain area and enrich the literature on the use of Blockchain in HIE efforts. Practitioners can also identify how to leverage the benefit of Blochchain to promote HIE initiatives nationwide.