Table of Contents
One of the challenges encountered by the healthcare industry is the inability to safely manage and retrieve personal health information (PHI) in a timely manner. Effective management and retrieval of patient data would enable healthcare providers to capture a holistic picture of a patient’s health, improve patient-physician interaction, and achieve better use of healthcare-related data1. Interoperability has enormous potential to transform the health sector through the development of affordable cures and cutting-edge treatments for numerous diseases but depends upon smooth, effective data exchange, and distribution across all the well-known network participants and health professionals2. Privacy and security threats are common challenges faced by the healthcare industry. The rise in cybersecurity attacks and security breaches of healthcare records has stimulated the pressing need of healthcare organizations to invest in advancing security technologies3. As a disruptive innovation, blockchain technology is paving the way for new potential of solving serious data privacy, security, and integrity issues in healthcare and facilitating the paradigm shift of patient-centric interoperability, while enabling decentralization and transparency of stored information4. The global pandemic has revealed a lack of interoperability in the current healthcare system and the need for accurate clinical data that can be widely distributed to healthcare providers in an efficient and secure manner5.
Blockchain is seen as a key breakthrough that will likely have a considerable influence on a myriad of different industries such as healthcare, supply chain management, and business. A peer-to-peer network called blockchain was initially proposed by Satoshi in 2008 and then commercialized in 2009 when Bitcoin emerged as its first use case 46. Kassab et al reported that in 2016, “healthcoin” was developed by Diego Espinosa and Nick Gogerty as the first platform based on blockchain to manage and reward Type-2 diabetes prevention39. Users submit their biomarkers into the blockchain. If the biomarker is an improvement, the system rewards the patient with digital tokens: healthcoin that can be applied toward government tax breaks and/or discounts on multiple fitness brands6. Future technology may open the door to significant opportunities, ranging from research and economics to interactions between patients and physicians 7. Blockchain technology conflates complexity, novelty, and diversity, which has posed challenges in gauging the value proposition of incorporating the technology47. Due to its complexity, blockchain may be used for managing business processes or as a workflow system8.
Several research studies have been conducted on the benefits and challenges of blockchain technology in the healthcare industry. However, some of the potential applications have not yet deployed9. The objective of this literature review is to explore the research studies that have been conducted on applications of blockchain technology as a disruptive innovation in healthcare industry10, addressing current and potential uses, benefits, and threats of the technology based on the historical research studies. Several researchers suggested studying the outcomes of leveraging blockchain technology in the context of improving security of health records, meeting social determinant of health needs, and improving health outcomes11,12, 3, 4. Based on this context, the previously available scholarship on blockchain were analyzed through a systematic review as an assessment tool. The findings convey key insights on the current state of research investigation on blockchain, including benefits and implications as a disruptive innovation in healthcare industry 13. The study also highlights the gaps in research and the need for further blockchain research in healthcare domain.
This paper was framed to guide future researchers and decision-makers on the current knowledge of benefits, drawbacks, and gaps in blockchain research landscape. The findings were conveyed to proactively identify key challenges pertaining to blockchain adoption and application in the healthcare domain to support improvement opportunities and tackle challenges at their initial stages. This paper was framed to explore the theoretical lens of disruptive innovation theory and innovation diffusion theory. The study was organized to begin with a background of blockchain technology, then explore its key uses and potential benefits within a healthcare context based on the research studies and addressing possible threats discussed by literature from an organizational, social, and technological level. Finally, this review provides recommendations to guide future research, bridge the gaps identified in literature, and further examine the prototypes implemented in the healthcare sector.