College of Science and Engineering, Hamad Bin Khalifa University, Qatar.
College of Science and Engineering, Hamad Bin Khalifa University, Qatar.
Int J Med Inform. 2020 Oct;142:104246. doi: 10.1016/j.ijmedinf.2020.104246. Epub 2020 Aug 14.
The application of blockchain technology is being explored to improve the interoperability of patient health information between healthcare organisations while maintaining the privacy and security of data.
The objective of this scoping review is to explore and categorise the benefits and threats of blockchain technology application in a healthcare system.
Databases such as PubMed, CINAHL, IEEE, Springer, and ScienceDirect were searched using a combination of terms related to blockchain, healthcare, benefits and threats. Backward-reference list checking was conducted to identify other relevant references. Study selection process was performed in three steps based on PRISMA flow diagram. Extracted data were synthesised and presented narratively using tables and figures.
The search resulted in 84 relevant studies that have been conducted of which only 37 unique studies were included in this review. Eight benefits of blockchain were categorised in either patient related-benefits (security and authorisation, personalised healthcare, patients' health data tracking, and patient's health status monitoring) or organisational-related benefits (health information exchange, pharmaceutical supply chain, clinical trials, and medical insurance management). Meanwhile, eight threats of blockchain were categorised into three groups: organisational threats (installation and transaction costs, interoperability issues, and lack of technical skills), social threats (social acceptance and regulations issues), and technological threats (scalability issues, authorisation and security issues, high energy consumption, and slow processing speeds).
Blockchain is a viable technology that can improve the healthcare data sharing and storing system owing to its decentralisation, immutability, transparency and traceability features. However, many healthcare organisations remain hesitant to adopt blockchain technology due to threats such as security and authorisation issues, interoperability issues and lack of technical skills related to blockchain technology.
区块链技术的应用正在被探索，以提高医疗机构之间患者健康信息的互操作性，同时保护数据的隐私和安全。
本综述旨在探索和分类区块链技术在医疗系统中的应用的益处和威胁。
使用与区块链、医疗保健、益处和威胁相关的术语组合，在 PubMed、CINAHL、IEEE、Springer 和 ScienceDirect 等数据库中进行搜索。通过回溯参考文献列表来识别其他相关参考文献。根据 PRISMA 流程图，研究选择过程分三个步骤进行。提取的数据使用表格和图形以叙述方式进行综合和呈现。
搜索结果产生了 84 项相关研究，其中只有 37 项独特的研究被纳入本综述。区块链的 8 项益处被归类为患者相关益处（安全性和授权、个性化医疗、患者健康数据跟踪和患者健康状况监测）或组织相关益处（健康信息交换、药品供应链、临床试验和医疗保险管理）。同时，区块链的 8 项威胁被分为三组：组织威胁（安装和交易成本、互操作性问题和缺乏技术技能）、社会威胁（社会接受度和法规问题）和技术威胁（可扩展性问题、授权和安全问题、高能耗和处理速度慢）。
区块链是一种可行的技术，由于其去中心化、不可变、透明和可追溯的特点，可以改善医疗保健数据共享和存储系统。然而，由于与区块链技术相关的安全性和授权问题、互操作性问题以及缺乏技术技能等威胁，许多医疗保健组织仍然对采用区块链技术犹豫不决。
