Baysal Merve Vildan, Özcan-Top Özden, Betin-Can Aysu
Graduate School of Informatics, Middle East Technical University, Ankara, Türkiye.
The Scientific and Technological Research Council of Turkey (TÜBİTAK), Ankara, Türkiye.
J Supercomput. 2023;79(3):3112-3156. doi: 10.1007/s11227-022-04772-1. Epub 2022 Aug 30.
Blockchain technology has been changing the nature of several businesses, from supply chain management to electronic record management systems and copyright management to healthcare applications. It provides a resilient and secure platform for modifications due to its distributed and shared nature and cryptographic functions. Each new technology, however, comes with its challenges alongside its opportunities. Previously, we performed a systematic literature review (SLR) to explore how blockchain technology potentially benefits health domain applications. The previous SLR included 27 formal literature papers from 2016 to 2020. Noticing that blockchain technology is rapidly growing, we extended the previous SLR with a multivocal literature review (MLR) approach to present the state of the art in this study. We focused on understanding to what degree blockchain could answer the challenges inherited in the health domain and whether blockchain technology may bring new challenges to health applications. The MLR consists of 78 sources of formal literature and 23 sources of gray literature from 2016 to 2021. As a result of this study, we specified 17 health domain challenges that can be categorized into four groups: (i) meeting regulatory requirements and public health surveillance, (ii) ensuring security and privacy, (iii) ensuring interoperability, and (iv) preventing waste of resources. The analysis shows that blockchain makes significant contributions to the solutions of these challenges. However, 10 new pitfalls come with adopting the technology in the health domain: the inability to delete sensitive data once it is added to a chain, limited ability to keep large-scale data in a blockchain, and performance issues. The data we extracted during the MLR is available in a publicly accessible online repository.
区块链技术一直在改变着多个行业的性质，从供应链管理到电子记录管理系统，从版权管理到医疗应用。由于其分布式和共享的特性以及加密功能，它为数据修改提供了一个有弹性且安全的平台。然而，每一项新技术在带来机遇的同时也伴随着挑战。此前，我们进行了一项系统文献综述（SLR），以探索区块链技术如何潜在地造福于健康领域的应用。之前的SLR纳入了2016年至2020年的27篇正式文献论文。注意到区块链技术正在迅速发展，我们采用多视角文献综述（MLR）方法扩展了之前的SLR，以呈现本研究的最新进展。我们专注于了解区块链在多大程度上能够应对健康领域固有的挑战，以及区块链技术是否可能给健康应用带来新的挑战。该MLR由2016年至2021年的78篇正式文献来源和23篇灰色文献来源组成。作为本研究的结果，我们明确了17个健康领域的挑战，这些挑战可分为四类：（i）满足监管要求和公共卫生监测，（ii）确保安全和隐私，（iii）确保互操作性，以及（iv）防止资源浪费。分析表明，区块链对这些挑战的解决方案做出了重大贡献。然而，在健康领域采用该技术会带来10个新的陷阱：敏感数据一旦添加到链中就无法删除、在区块链中存储大规模数据的能力有限以及性能问题。我们在MLR过程中提取的数据可在一个公开访问的在线存储库中获取。
