JMIR Publications

ABSTRACT

Background:

Academic literature highlights the potential benefits of blockchain to transform healthcare, focusing on its potential seamlessly and securely to integrate existing ‘data silos’ while enabling patients to exercise automated, fine-grained control over access to their Electronic Health Records (EHRs). Yet no serious scholarly attempt has been made to assess the extent to which these technologies have in fact been applied to real-world healthcare contexts.

Objective:

The primary aim of this paper is to report on the results of an inquiry into the healthcare sector’s actual engagement and experience of blockchain technologies to date in order to assess the extent to which the potential for blockchain technologies to transform healthcare highlighted in academic literature is likely to be realised in healthcare practice.

Methods:

We conducted a mixed-methods investigation, comprised of academic literature reviews and web-based investigations of primary sources including industry publications, government reports, mainstream media and supplemented by focus group discussions concerning the early experiences of healthcare actors engaging with blockchain technology. We drew on insights from academic literature concerned with the configuration, design and functionality of blockchain technologies to identify recurring difficulties encountered in developing viable healthcare applications. We consider how early experiences of blockchain technologies in healthcare may be understood in light of academic literature concerned with technological innovation generally, and in relation to health IT in particular.

Results:

Healthcare organisations have actively experimented with blockchain technologies since 2016, and have demonstrated proof of concept for several applications (‘use cases’) primarily concerned with administrative data and to facilitate medical research by enabling algorithmic models to be trained on multiple disparately located sets of patient data in a secure, privacy-preserving manner. Yet blockchain technology is yet to be implemented at scale in healthcare, remaining largely in its infancy. These early experiences of blockchain technologies have demonstrated blockchain’s potential to generate meaningful value to healthcare by facilitating data sharing between organisations in circumstances where computational trust can overcome a lack of social trust that might otherwise prevent valuable cooperation. Although there are genuine prospects of utilising blockchain to bring about positive transformation in healthcare, the successful development of blockchain for healthcare applications face a number of very significant, multi-dimensional and highly complex challenges. Early experience suggests that blockchain is unlikely to rapidly and radically revolutionise healthcare.

Conclusions:

The successful development of blockchain for healthcare applications face a number of very significant, multi-dimensional and complex challenges which will not be easily overcome, suggesting that blockchain technologies are unlikely to revolutionise healthcare in the near future.