SingHealth Polyclinics, Singapore, Singapore.
National University Health System, Singapore, Singapore.
J Med Internet Res. 2021 Apr 13;23(4):e25094. doi: 10.2196/25094.
Blockchain technology has the potential to enable more secure, transparent, and equitable data management. In the health care domain, it has been applied most frequently to electronic health records. In addition to securely managing data, blockchain has significant advantages in distributing data access, control, and ownership to end users. Due to this attribute, among others, the use of blockchain to power personal health records (PHRs) is especially appealing.
This review aims to examine the current landscape, design choices, limitations, and future directions of blockchain-based PHRs.
Adopting the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines, a cross-disciplinary systematic review was performed in July 2020 on all eligible articles, including gray literature, from the following 8 databases: ACM, IEEE Xplore, MEDLINE, ScienceDirect, Scopus, SpringerLink, Web of Science, and Google Scholar. Three reviewers independently performed a full-text review and data abstraction using a standardized data collection form.
A total of 58 articles met the inclusion criteria. In the review, we found that the blockchain PHR space has matured over the past 5 years, from purely conceptual ideas initially to an increasing trend of publications describing prototypes and even implementations. Although the eventual application of blockchain in PHRs is intended for the health care industry, the majority of the articles were found in engineering or computer science publications. Among the blockchain PHRs described, permissioned blockchains and off-chain storage were the most common design choices. Although 18 articles described a tethered blockchain PHR, all of them were at the conceptual stage.
This review revealed that although research interest in blockchain PHRs is increasing and that the space is maturing, this technology is still largely in the conceptual stage. Being the first systematic review on blockchain PHRs, this review should serve as a basis for future reviews to track the development of the space.
区块链技术具有实现更安全、透明和公平的数据管理的潜力。在医疗保健领域，它最常用于电子健康记录。除了安全地管理数据外，区块链在向最终用户分发数据访问、控制和所有权方面具有显著优势。由于其他一些原因，使用区块链来支持个人健康记录 (PHR) 特别有吸引力。
本综述旨在检查基于区块链的 PHR 的当前现状、设计选择、局限性和未来方向。
采用 PRISMA（系统评价和荟萃分析的首选报告项目）指南，于 2020 年 7 月对来自以下 8 个数据库的所有符合条件的文章（包括灰色文献）进行了跨学科系统综述：ACM、IEEE Xplore、MEDLINE、ScienceDirect、Scopus、SpringerLink、Web of Science 和 Google Scholar。三名审查员使用标准化的数据收集表独立进行全文审查和数据提取。
共有 58 篇文章符合纳入标准。在综述中，我们发现过去 5 年来，区块链 PHR 空间已经成熟，从最初的纯概念性想法到越来越多的描述原型甚至实现的出版物趋势。尽管区块链最终在 PHR 中的应用是针对医疗保健行业的，但大多数文章都发表在工程或计算机科学出版物中。在所描述的区块链 PHR 中，许可区块链和链下存储是最常见的设计选择。尽管有 18 篇文章描述了连接的区块链 PHR，但它们都处于概念阶段。
本综述表明，尽管对区块链 PHR 的研究兴趣正在增加并且该领域正在成熟，但这项技术仍在很大程度上处于概念阶段。作为第一个关于区块链 PHR 的系统综述，本综述应作为未来跟踪该领域发展的综述的基础。
