JMIR Publications

ABSTRACT

Background:

Blockchain is an emerging technology that enables secure and decentralized approaches to reduce technical risks and governance challenges associated with sharing sensitive health data. Although blockchain-based solutions have been suggested for sharing health information, it is still unclear if a suitable incentive mechanism (intrinsic or extrinsic) can be identified to encourage individuals to share their sensitive data for research purposes.

Objective:

We aim to investigate how important extrinsic incentives are and what type of incentive is the best option in blockchain-based platforms designed for sharing sensitive health information.

Methods:

In this study, we conducted three experiments with 493 individuals to investigate the role of extrinsic incentives (i.e., cryptocurrency, money, and recognition) in data sharing with research organizations.

Results:

Findings highlight that offering different incentives is insufficient to encourage individuals to use blockchain technology or change their perceptions about the technology's premise for sharing sensitive health data. The results demonstrate that individuals still attribute serious risks to blockchain-based platforms. Privacy and security concerns, trust issues, lack of knowledge about the technology, lack of public acceptance, and lack of regulations are reported as top risks. We exhibit that blockchain-based platforms for data sharing in healthcare are mainly affected by technology usage inhibitors, not extrinsic motivations (crypto-incentives, money, and status) to attract participants.

Conclusions:

We suggest that prior to emphasizing the use of various types of extrinsic incentives, the users need to get educated about the capabilities and benefits that this technology could offer. Thus, an essential first step to shifting from an institution-based to patient-centric data exchange (using blockchain) is addressing technology inhibitors to promote patient-driven interoperability. This study shows that extrinsic incentives by themselves are not adequate to change users' perceptions, increase their trust, or encourage them to use the technology for sharing health data.