Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: May 22, 2025
Date Accepted: Jan 20, 2026
Resistance to blockchain adoption in healthcare organizations: Evidence from a cross-sectional study
ABSTRACT
Background:
Traditional healthcare systems face security challenges that prevent them from ensuring medical data security. To overcome these challenges, healthcare organizations are turning to blockchain-based systems. Thanks to blockchain's characteristics, these applications provide high security in managing medical data and transactions. However, despite this advantage, healthcare organizations remain reluctant to adopt blockchain-based applications. This reluctance could be explained by the risks that healthcare organizations perceive regarding these applications.
Objective:
Our research aims to study the adoption of blockchain-based healthcare applications in healthcare organizations by adopting a risk-based approach. Through perceived risk theory (PRT), we built a research model that relates certain perceived risks of blockchain-based healthcare applications to the intention to adopt these applications.
Methods:
The research model was tested by collecting data from 194 IT professionals from 46 healthcare organizations in Canada and Africa. We used partial least squares structural equation modeling (PLS-SEM) to evaluate the hypothesized relationships of the research model.
Results:
Our study identified six dimensions of risk that are likely to influence the overall perceived risk regarding blockchain-based healthcare applications and, therefore, their adoption in healthcare organizations. Our study also showed that the association between the general perception of risks regarding blockchain-based healthcare applications and the intention to adopt them is significant in healthcare organizations in Canada but not in healthcare organizations in Africa. Moreover, our results indicate that the availability of cloud-based blockchain solutions reduces healthcare organizations’ risk perception regarding the lack of resources needed to adopt and use blockchain-based healthcare applications.
Conclusions:
Our findings contribute to the literature by extending perceived risk theory (PRT), originally developed in marketing, through the integration of risks likely to prevent the adoption of blockchain in healthcare sector. This makes PRT more suitable for examining factors that may hinder the adoption of blockchain-based healthcare applications. Future research that focuses on analyzing the barriers to blockchain adoption in the healthcare sector will be able to use the extended PRT as a theoretical lens to develop its theoretical research model.
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Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.