۱٫ Introduction and rationale

۲٫ Background

۳٫ Method

۴٫ Results

۵٫ Discussion

۶٫ Conclusion

Appendix A. Supplementary data

References

Abstract

Background: Blockchain can be described as an immutable ledger, logging data entries in a decentralized manner. This new technology has been suggested to disrupt a wide range of data-driven domains, including the health domain.

Objective: The purpose of this study was to systematically review, assess and synthesize peer-reviewed publications utilizing/proposing to utilize blockchain to improve processes and services in healthcare, health sciences and health education.

Method: A structured literature search on the topic was conducted in October 2018 relevant bibliographic databases. Result: 39 publications fulfilled the inclusion criteria. The result indicates that Electronic Health Records and Personal Health Records are the most targeted areas using blockchain technology. Access control, interoperability, provenance and data integrity are all issues that are meant to be improved by blockchain technology in this field. Ethereum and Hyperledger fabric seem to be the most used platforms/frameworks in this domain.

Conclusion: This study shows that the endeavors of using blockchain technology in the health domain are increasing exponentially. There are areas within the health domain that potentially could be highly impacted by blockchain technology.

Introduction and rationale

The technology of blockchain, with inherited characteristics such as decentralization, transparency and anonymization, was introduced in the cryptocurrency Bitcoin in 2008 [1]. Bitcoin, with close to 400 million completed transactions (March 19, 2019) [2], represents a solid use-case that blockchain technology works. This has led to discussions and proposals that blockchain technology could be useful in a range of other data-driven domains, including healthcare [3].

According to IBM, 70 % of healthcare leaders predict that the greatest impact of blockchain within the health domain will be improvement of clinical trial management, regulatory compliance and providing a decentralized framework for sharing electronic health records (EHR) [4]. Moreover, the global blockchain technology market in the healthcare industry is expected to cross $500 million by 2022 [61]. Although blockchain technology is considered to have potential for real improvement of health information systems [3], the recent hype surrounding this technology similarly entails unrealistic proposals and ideas and current literature provides little overview of applications that have been developed, tested and/or deployed.

It is valuable to investigate if the current research meets the expectations to blockchain technology within healthcare, health sciences and health education (from hereinafter, referred to as “the health domain”). This study aims to systematically review, assess and synthesize published peer-reviewed studies where blockchain has been utilized (or proposed to be utilized) to improve processes and services within the health domain. In addition to examining the evidence, we also aim to provide an overview of what has been done, what is known, and the potential directions forward on this topic.