Singapore National Eye Centre, Singapore Eye Research Institute, Singapore; Duke-NUS Medical School, National University of Singapore, Singapore.
Certis Commercial and Industrial Security Corporation Security, Singapore.
Lancet Digit Health. 2021 Dec;3(12):e819-e829. doi: 10.1016/S2589-7500(21)00210-7. Epub 2021 Oct 13.
The COVID-19 pandemic has had a substantial and global impact on health care, and has greatly accelerated the adoption of digital technology. One of these emerging digital technologies, blockchain, has unique characteristics (eg, immutability, decentralisation, and transparency) that can be useful in multiple domains (eg, management of electronic medical records and access rights, and mobile health). We conducted a systematic review of COVID-19-related and non-COVID-19-related applications of blockchain in health care. We identified relevant reports published in MEDLINE, SpringerLink, Institute of Electrical and Electronics Engineers Xplore, ScienceDirect, arXiv, and Google Scholar up to July 29, 2021. Articles that included both clinical and technical designs, with or without prototype development, were included. A total of 85 375 articles were evaluated, with 415 full length reports (37 related to COVID-19 and 378 not related to COVID-19) eventually included in the final analysis. The main COVID-19-related applications reported were pandemic control and surveillance, immunity or vaccine passport monitoring, and contact tracing. The top three non-COVID-19-related applications were management of electronic medical records, internet of things (eg, remote monitoring or mobile health), and supply chain monitoring. Most reports detailed technical performance of the blockchain prototype platforms (277 [66·7%] of 415), whereas nine (2·2%) studies showed real-world clinical application and adoption. The remaining studies (129 [31·1%] of 415) were themselves of a technical design only. The most common platforms used were Ethereum and Hyperledger. Blockchain technology has numerous potential COVID-19-related and non-COVID-19-related applications in health care. However, much of the current research remains at the technical stage, with few providing actual clinical applications, highlighting the need to translate foundational blockchain technology into clinical use.
新冠疫情对医疗保健产生了重大且全球性的影响，并极大地加速了数字技术的采用。其中一种新兴的数字技术区块链具有独特的特性（例如，不可变、去中心化和透明性），可在多个领域（例如，电子病历和访问权限管理以及移动医疗）中发挥作用。我们对与新冠疫情相关和非新冠疫情相关的区块链在医疗保健中的应用进行了系统评价。我们在 MEDLINE、SpringerLink、电气和电子工程师协会 Xplore、ScienceDirect、arXiv 和 Google Scholar 中检索了截至 2021 年 7 月 29 日的相关报告。纳入的文章包括具有或不具有原型开发的临床和技术设计。共评估了 85375 篇文章，最终纳入了 415 篇全文报告（37 篇与新冠疫情相关，378 篇与新冠疫情不相关）。报道的主要新冠疫情相关应用包括大流行控制和监测、免疫或疫苗护照监测以及接触者追踪。排名前三的非新冠疫情相关应用是电子病历管理、物联网（例如，远程监测或移动医疗）和供应链监测。大多数报告详细介绍了区块链原型平台的技术性能（415 篇中的 277 篇[66.7%]），而 9 篇（2.2%）研究显示了真实世界的临床应用和采用。其余的研究（415 篇中的 129 篇[31.1%]）本身就是技术设计。使用最广泛的平台是以太坊和 Hyperledger。区块链技术在医疗保健领域有许多潜在的与新冠疫情相关和非新冠疫情相关的应用。然而，目前的大部分研究仍处于技术阶段，很少有提供实际的临床应用，这突显了将基础区块链技术转化为临床应用的必要性。
