The taxonomy of blockchain applications in healthcare
Category
Description
Blockchain properties supporting the applications
Healthcare data management
Management, storage, and sharing of electronic health records (EHRs) and electronic medical records (EMRs). Enhancing patient data control and interoperability
TransparencyImmutabilityDecentralization
Pharmaceutical supply chain and healthcare logistics
Ensuring authenticity, traceability, and safety of pharmaceutical products, organ transplants, and blood donations
TransparencyImmutability
Interoperability and consolidated healthcare systems
Creating a unified view of patient data across healthcare providers to improve care coordination and outcomes
TransparencyDecentralization
Clinical trials and medical research
Securing data collection, patient recruitment, and results sharing for clinical trials. Supporting reliability and verifiability of medical research
ImmutabilityTransparency
Remote care and Internet of Things (IoT) architectures
Real-time patient monitoring, secure data collection, and remote healthcare delivery through integration with IoT devices
Enforceable agreementsDecentralization
Health insurance and claims processing
Automating and securing health insurance claims processing via smart contracts. Reducing fraud and streamlining the claims lifecycle
Enforceable agreementsTransparency
Governance
Ensuring health data security and privacy across applications through cryptographic methods. Providing audit trails, access control, and data aggregation for governance
KL: Conceptualization, Investigation, Writing—original draft, Writing—review & editing. ARS: Conceptualization, Writing—original draft, Writing—review & editing. VU: Conceptualization, Writing—review & editing, Supervision. All authors read and approved the submitted version.
Conflicts of interest
The authors declare that they have no conflicts of interest.
Ethical approval
Not applicable.
Consent to participate
Not applicable.
Consent to publication
Not applicable.
Availability of data and materials
The datasets that support the findings of this study are available from the corresponding author upon reasonable request.
Funding
This work was partially funded by the following grants: the China Scholarship Council [202109650003]. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Cong LW, He Z. Blockchain Disruption and Smart Contracts.Rev Financ Stud. 2019;32:1754–97. [DOI]
Zīle K, Strazdiņa R. Blockchain Use Cases and Their Feasibility.Appl Comput Syst. 2018;23:12–20. [DOI]
Attaran M. Blockchain technology in healthcare: Challenges and opportunities.Int J Healthc Manag. 2022;15:70–83. [DOI]
AbuHalimeh A, Ali O. Comprehensive review for healthcare data quality challenges in blockchain technology.Front Big Data. 2023;6:1173620. [DOI] [PubMed] [PMC]
O’Donoghue O, Vazirani AA, Brindley D, Meinert E. Design Choices and Trade-Offs in Health Care Blockchain Implementations: Systematic Review.J Med Internet Res. 2019;21:e12426. [DOI] [PubMed] [PMC]
Hoffman MR, Ibáñez L-D, Simperl E. Toward a Formal Scholarly Understanding of Blockchain-Mediated Decentralization: A Systematic Review and a Framework.Front Blockchain. 2020;3:35. [DOI]
Yaqoob I, Salah K, Jayaraman R, Al-Hammadi Y. Blockchain for healthcare data management: opportunities, challenges, and future recommendations.Neural Comput Applic. 2022;34:11475–90. [DOI]
Wüst K, Gervais A. Do you Need a Blockchain?In: 2018 Crypto Valley Conference on Blockchain Technology (CVCBT). Crypto Valley Conference on Blockchain Technology (CVCBT); 2018 Jun 20-22; Zug, Switzerland. IEEE; 2018. pp. 45–54. [DOI]
Casino F, Dasaklis TK, Patsakis C. A systematic literature review of blockchain-based applications: Current status, classification and open issues.Telemat Inform. 2019;36:55–81. [DOI]
Levis D, Fontana F, Ughetto E. A look into the future of blockchain technology.Plos One. 2021;16:e0258995. [DOI] [PubMed] [PMC]
Yaga D, Mell P, Roby N, Scarfone K. Blockchain Technology Overview.arXiv: 1906.11078v1 [Preprint]. 2019 [cited 2023 Nov 1]: [68 p.]. Available from: https://arxiv.org/pdf/1906.11078
Khan MA, Salah K. IoT security: Review, blockchain solutions, and open challenges.Future Gener Comput Syst. 2018;82:395–411. [DOI]
Fernández-Caramés TM, Fraga-Lamas P. A Review on the Use of Blockchain for the Internet of Things.IEEE Access. 2018;6:32979–3001. [DOI]
Taherdoost H. Smart Contracts in Blockchain Technology: A Critical Review.Information. 2023;14:117. [DOI]
Naaz R, Saxena AK, Shah PK. Blockchain technology’s overview: Consensus, architecture and future trends.AIP Conf Proc. 2023;2427:020018. [DOI]
Hawlitschek F, Notheisen B, Teubner T. The limits of trust-free systems: A literature review on blockchain technology and trust in the sharing economy.Electron Commer Res Appl. 2018;29:50–63. [DOI]
Belchior R, Vasconcelos A, Guerreiro S, Correia M. A Survey on Blockchain Interoperability: Past, Present, and Future Trends.ACM Comput Surv. 2021;54:1–41. [DOI]
Mackey TK, Kuo TT, Gummadi B, Clauson KA, Church G, Grishin D, et al. ‘Fit-for-purpose?’ – challenges and opportunities for applications of blockchain technology in the future of healthcare.BMC Med. 2019;17:68. [DOI] [PubMed] [PMC]
Haleem A, Javaid M, Singh RP, Suman R, Rab S. Blockchain technology applications in healthcare: An overview.Int J Intell Networks. 2021;2:130–9. [DOI]
Soltanisehat L, Alizadeh R, Hao H, Choo K-KR. Technical, Temporal, and Spatial Research Challenges and Opportunities in Blockchain-Based Healthcare: A Systematic Literature Review.IEEE Trans Eng Manage. 2020;70:353–68. [DOI]
Elangovan D, Long CS, Bakrin FS, Tan CS, Goh KW, Yeoh SF, et al. The Use of Blockchain Technology in the Health Care Sector: Systematic Review.JMIR Med Inf. 2022;10:e17278. [DOI] [PubMed] [PMC]
Merlo V, Pio G, Giusto F, Bilancia M. On the exploitation of the blockchain technology in the healthcare sector: A systematic review.Expert Syst Appl. 2023;213:118897. [DOI]
Saeed H, Malik H, Bashir U, Ahmad A, Riaz S, Ilyas M, et al. Blockchain technology in healthcare: A systematic review.Plos One. 2022;17:e0266462. [DOI] [PubMed] [PMC]
Agbo CC, Mahmoud QH, Eklund JM. Blockchain Technology in Healthcare: A Systematic Review.Healthcare. 2019;7:56. [DOI] [PubMed] [PMC]
Chukwu E, Garg L. A Systematic Review of Blockchain in Healthcare: Frameworks, Prototypes, and Implementations.IEEE Access. 2020;8:21196–214. [DOI]
Azaria A, Ekblaw A, Vieira T, Lippman A. MedRec: Using Blockchain for Medical Data Access and Permission Management.In: 2016 2nd International Conference on Open and Big Data (OBD). International Conference on Open and Big Data (OBD); 2016 Aug 22-24; Vienna, Austria. IEEE; 2016. pp. 25–30. [DOI]
Huang Y, Wu J, Long C. Drugledger: A Practical Blockchain System for Drug Traceability and Regulation.In: 2018 IEEE international conference on internet of things (iThings) and IEEE green computing and communications (GreenCom) and IEEE cyber, physical and social computing (CPSCom) and IEEE smart data (SmartData). IEEE/ACM Int’l Conference on & Int’l Conference on Cyber, Physical and Social Computing (CPSCom) Green Computing and Communications (GreenCom); 2018 Aug 03-2018 Jul 30; Halifax, NS, Canada. IEEE; 2018. pp. 1137–44. [DOI]
Yue X, Wang H, Jin D, Li M, Jiang W. Healthcare Data Gateways: Found Healthcare Intelligence on Blockchain with Novel Privacy Risk Control.J Med Syst. 2016;40:218. [DOI] [PubMed]
Zhang P, White J, Schmidt DC, Lenz G, Rosenbloom ST. FHIRChain: Applying Blockchain to Securely and Scalably Share Clinical Data.Comput Struct Biotechnol J. 2018;16:267–78. [DOI] [PubMed] [PMC]
Azbeg K, Ouchetto O, Andaloussi SJ. BlockMedCare: A healthcare system based on IoT, Blockchain and IPFS for data management security.Egypt Inf J. 2022;23:329–43. [DOI]
Karmakar A, Ghosh P, Banerjee PS, De D. ChainSure: Agent free insurance system using blockchain for healthcare 4.0.Intell Syst Appl. 2023;17:200177. [DOI]
Hölbl M, Kompara M, Kamišalić A, Nemec Zlatolas L. A Systematic Review of the Use of Blockchain in Healthcare.Symmetry. 2018;10:470. [DOI]
Urovi V, Jaiman V, Angerer A, Dumontier M. LUCE: A blockchain-based data sharing platform for monitoring data License accoUntability and CompliancE.Blockchain Res Appl. 2022;3:100102. [DOI]
Jaiman V, Urovi V. A Consent Model for Blockchain-Based Health Data Sharing Platforms.IEEE Access. 2020;8:143734–45. [DOI]
Khezr S, Moniruzzaman M, Yassine A, Benlamri R. Blockchain Technology in Healthcare: A Comprehensive Review and Directions for Future Research.Appl Sci. 2019;9:1736. [DOI]
Peng Z, Xu C, Wang H, Huang J, Xu J, Chu X. P2B-Trace: Privacy-Preserving Blockchain-based Contact Tracing to Combat Pandemics.In: 2021 International Conference on Management of Data. International Conference on Management of Data; 2021 Jun 20-25; China. MOD; 2021. pp. 2389–93. [DOI]
Adere EM. Blockchain in healthcare and IoT: A systematic literature review.Array. 2022;14:100139. [DOI]
Pandey AK, Khan AI, Abushark YB, Alam MM, Agrawal A, Kumar R, et al. Key Issues in Healthcare Data Integrity: Analysis and Recommendations.IEEE Access. 2020;8:40612–28. [DOI]
Chandol MK, Kameswara Rao M. Blockchain-based cryptographic approach for privacy enabled data integrity model for IoT healthcare.J Exp Theor Artif Intell. 2023:1–22. [DOI]
Jiang R, Chen X, Yu Y, Zhang Y, Ding W. Risk and UCON-based access control model for healthcare big data.J Big Data. 2023;10:104. [DOI]
Ali A, Al-Rimy BAS, Alsubaei FS, Almazroi AA, Almazroi AA. HealthLock: Blockchain-Based Privacy Preservation Using Homomorphic Encryption in Internet of Things Healthcare Applications.Sensors (Basel). 2023;23:6762. [DOI] [PubMed] [PMC]
Moosa H, Ali M, Alaswad H, Elmedany W, Balakrishna C. A combined Blockchain and zero-knowledge model for healthcare B2B and B2C data sharing.Arab J Basic Appl Sci. 2023;30:179–96. [DOI]
Mittal S, Ghosh M. A three-phase framework for secure storage and sharing of healthcare data based on blockchain, IPFS, proxy re-encryption and group communication.J Supercomput. 2024;80:7955–92. [DOI]
Liu G, Xie H, Wang W, Huang H. A secure and efficient electronic medical record data sharing scheme based on blockchain and proxy re-encryption.J Cloud Comput. 2024;13:44. [DOI]
Zhou L, Diro A, Saini A, Kaisar S, Hiep PC. Leveraging zero knowledge proofs for blockchain-based identity sharing: A survey of advancements, challenges and opportunities.J Inf Secur Appl. 2024;80:103678. [DOI]
Ramzan S, Aqdus A, Ravi V, Koundal D, Amin R, Al Ghamdi MA. Healthcare Applications Using Blockchain Technology: Motivations and Challenges.In: IEEE Transactions on Engineering Management. IEEE Transactions on Engineering Management; 2022 Jul 25; 2022. pp. 2874–90. [DOI]
Minssen T, Rajam N, Bogers M. Clinical trial data transparency and GDPR compliance: Implications for data sharing and open innovation.Sci Public Policy. 2020;47:616–26. [DOI]
Haddad A, Habaebi MH, Islam MR, Hasbullah NF, Zabidi SA. Systematic Review on AI-Blockchain Based E-Healthcare Records Management Systems.IEEE Access. 2022;10:94583–615. [DOI]
Javed W, Aabid F, Danish M, Tahir H, Zainab R. Role of Blockchain Technology in Healthcare: A Systematic Review.In: 2021 International Conference on Innovative Computing (ICIC). International Conference on Innovative Computing (ICIC); 2021 Nov 9-10; Lahore, Pakistan. IEEE; 2021. pp. 1–8. [DOI]
Fang HSA, Tan TH, Tan YFC, Tan CJM. Blockchain Personal Health Records: Systematic Review.J Med Internet Res. 2021;23:e25094. [DOI] [PubMed] [PMC]
Tandon A, Dhir A, Islam AN, Mäntymäki M. Blockchain in healthcare: A systematic literature review, synthesizing framework and future research agenda.Comput Ind. 2020;122:103290. [DOI]
Yaqoob S, Khan MM, Talib R, Butt AD, Saleem S, Arif F, et al. Use of Blockchain in Healthcare: A Systematic Literature Review.Int J Adv Comput Sci Appl. 2019;10;644–53. [DOI]
Kiania K, Jameii SM, Rahmani AM. Blockchain-based privacy and security preserving in electronic health: a systematic review.Multimed Tools Appl. 2023:1–27. [DOI] [PubMed] [PMC]
Kamangar ZU, Memon RA, Murtaza Memon G, Kamangar UA. Integration of Internet of Things and blockchain technology in healthcare domain: A systematic literature review.Int J Commun Syst. 2023;36:e5582. [DOI]
Hussien HM, Yasin SM, Udzir S, Zaidan AA, Zaidan BB. A Systematic Review for Enabling of Develop a Blockchain Technology in Healthcare Application: Taxonomy, Substantially Analysis, Motivations, Challenges, Recommendations and Future Direction.J Med Syst. 2019;43:320. [DOI] [PubMed]
Saranya R, Murugan A. A systematic review of enabling blockchain in healthcare system: Analysis, current status, challenges and future direction.Mater Today Proc. 2023;80:3010–5. [DOI]
Alghazwi M, Turkmen F, Van Der Velde J, Karastoyanova D. Blockchain for Genomics: A Systematic Literature Review.Distrib Ledger Technol Res Pract. 2022;1:1–28. [DOI]
Thomson C, Beale R. Is blockchain ready for orthopaedics? A systematic review.J Clin Orthop Trauma. 2021;23:101615. [DOI] [PubMed] [PMC]
Mayer AH, da Costa CA, Righi RdR. Electronic health records in a Blockchain: A systematic review.Health Informatics J. 2020;26:1273–88. [DOI] [PubMed]
Fatoum H, Hanna S, Halamka JD, Sicker DC, Spangenberg P, Hashmi SK. Blockchain Integration With Digital Technology and the Future of Health Care Ecosystems: Systematic Review.J Med Internet Res. 2021;23:e19846. [DOI] [PubMed] [PMC]
Lopez-Barreiro J, Alvarez-Sabucedo L, Garcia-Soidan JL, Santos-Gago JM. Use of Blockchain Technology in the Domain of Physical Exercise, Physical Activity, Sport, and Active Ageing: A Systematic Review.Int J Environ Res Public Health. 2022;19:8129. [DOI] [PubMed] [PMC]
Dubovitskaya A, Novotny P, Xu Z, Wang F. Applications of blockchain technology for data-sharing in oncology: Results from a systematic literature review.Oncology. 2020;98:403–11. [DOI] [PubMed]
Zukaib U, Cui X, Hassan M, Harris S, Hadi HJ, Zheng C. Blockchain and Machine Learning in EHR Security: A Systematic Review.IEEE Access. 2023;11:130230–56. [DOI]
Vazirani AA, O’Donoghue O, Brindley D, Meinert E. Implementing Blockchains for Efficient Health Care: Systematic Review.J Med Internet Res. 2019;21:e12439. [DOI] [PubMed] [PMC]
Hulsen T. Sharing Is Caring-Data Sharing Initiatives in Healthcare.Int J Environ Res Public Health. 2020;17:3046. [DOI] [PubMed] [PMC]
Hutchings E, Loomes M, Butow P, Boyle FM. A systematic literature review of health consumer attitudes towards secondary use and sharing of health administrative and clinical trial data: a focus on privacy, trust, and transparency.Syst Rev. 2020;9:235. [DOI] [PubMed] [PMC]
Boué S, Byrne M, Hayes AW, Hoeng J, Peitsch MC. Embracing Transparency Through Data Sharing.Int J Toxicol. 2018;37:466–71. [DOI] [PubMed] [PMC]
Kerasidou A, Kerasidou CX. Data-driven research and healthcare: public trust, data governance and the NHS.BMC Med Ethics. 2023;24:51. [DOI] [PubMed] [PMC]
Kalkman S, Mostert M, Gerlinger C, van Delden JJM, van Thiel GJMW. Responsible data sharing in international health research: a systematic review of principles and norms.BMC Med Ethics. 2019;20:21. [DOI] [PubMed] [PMC]
Reegu F, Daud SM, Alam S. Interoperability Challenges in Healthcare Blockchain System - A Systematic Review.Ann Rom Soc Cell Biol. 2021:15487–99.
Mulaji SS, Roodt SS. The Practicality of Adopting Blockchain-Based Distributed Identity Management in Organisations: A Meta-Synthesis.Secur Commun Networks. 2021;2021:9910078. [DOI]
Zhang R, Xue R, Liu L. Security and Privacy for Healthcare Blockchains.IEEE Trans Serv Comput. 2021;15:3668–86. [DOI]
Schädler L, Lustenberger M, Spychiger F. Analyzing decision-making in blockchain governance.Front Blockchain. 2023;23. [DOI]
Hylock RH, Zeng X. A Blockchain Framework for Patient-Centered Health Records and Exchange (HealthChain): Evaluation and Proof-of-Concept Study.J Med Internet Res. 2019;21:e13592. [DOI] [PubMed] [PMC]
de Freitas C, Amorim M, Machado H, Leão Teles E, Baptista MJ, Renedo A, et al. Public and patient involvement in health data governance (DATAGov): protocol of a people-centred, mixed-methods study on data use and sharing for rare diseases care and research.BMJ Open. 2021;11:e044289. [DOI] [PubMed] [PMC]
Arnstein L, Wadsworth AC, Yamamoto BA, Stephens R, Sehmi K, Jones R, et al. Patient involvement in preparing health research peer-reviewed publications or results summaries: a systematic review and evidence-based recommendations.Res Involv Engagem. 2020;6:34. [DOI] [PMC]
Westphal E, Seitz H. Digital and Decentralized Management of Patient Data in Healthcare Using Blockchain Implementations.Front Blockchain. 2021;4:732112. [DOI]
McCarron TL, Moffat K, Wilkinson G, Zelinsky S, Boyd JM, White D, et al. Understanding patient engagement in health system decision-making: a co-designed scoping review.Syst Rev. 2019;8:97. [DOI] [PubMed] [PMC]
Lo YS, Yang CY, Chien HF, Chang SS, Lu CY, Chen RJ. Blockchain-Enabled iWellChain Framework Integration With the National Medical Referral System: Development and Usability Study.J Med Internet Res. 2019;21:e13563. [DOI] [PubMed] [PMC]
Real-world-data enabled assessment for health regulatory decision-making [Internet].[cited 2024 Apr 16]. Available from: https://realm-ai.eu/
Havelange A, Dumontier M, Wouters B, Linde J, Townend D, Riedl A, et al. LUCE: A Blockchain Solution for monitoring data License accoUntability and CompliancE.arXiv:190802287v1. [Preprint]. 2019 [cited 2023 Nov 1]: [14 p.]. Available from: https://arxiv.org/abs/1908.02287
Bayle A, Koscina M, Manset D, Perez-Kempner O. When Blockchain Meets the Right to Be Forgotten: Technology versus Law in the Healthcare Industry.In: 2018 IEEE/WIC/ACM International Conference on Web Intelligence (WI). IEEE WIC ACM International Conference on Web Intelligence (WI); 2018 Dec 3-6; Santiago, Chile; 2018. pp. 788–92. [DOI]