Shaikh Mutiullah, Memon Shafique Ahmed, Ebrahimi Ali, Wiil Uffe Kock
SDU Health Informatics and Technology, The Maersk Mc-Kinney Moller Institute, University of Southern Denmark, 5230 Odense, Denmark.
Healthcare (Basel). 2025 May 7;13(9):1087. doi: 10.3390/healthcare13091087.
Healthcare information systems are hindered by delayed data sharing, privacy breaches, and lack of patient control over data. The growing need for secure, privacy-preserved access control interoperable in health informatics technology (HIT) systems appeals to solutions such as Blockchain (BC), which offers a decentralized, transparent, and immutable ledger architecture. However, its current adoption remains limited to conceptual or proofs-of-concept (PoCs), often relying on simulated datasets rather than validated real-world data or scenarios, necessitating further research into its pragmatic applications and their benchmarking.
This systematic literature review (SLR) aims to analyze BC-based healthcare implementations by benchmarking peer-reviewed studies and turning PoCs or production insights into real-world applications and their evaluation metrics. Unlike prior SLRs focusing on proposed or conceptual models, simulations, or limited-scale deployments, this review focuses on validating practical BC real-world applications in healthcare settings beyond conceptual studies and PoCs.
Adhering to PRISMA-2020 guidelines, we systematically searched five major databases (Scopus, Web of Science, PubMed, IEEE Xplore, and ScienceDirect) for high-precision relevant studies using MeSH terms related to BC in healthcare. The designed review protocol was registered with OSF, ensuring transparency in the review process, including study screening by independent reviewers, eligibility, quality assessment, and data extraction and synthesis.
In total, 82 original studies fully met the eligibility criteria and narratively reported BC-based healthcare implementations with validated evaluation outcomes. These studies highlight the current challenges addressed by BC in healthcare settings, providing both qualitative and quantitative data synthesis on its effectiveness.
BC-based healthcare implementations show both qualitative and quantitative effectiveness, with advancements in areas such as drug traceability (up to 100%) and fraud prevention (95% reduction). We also discussed the recent challenges of focusing more attention in this area, along with a discussion on the mythological consideration of our own work. Our future research should focus on addressing scalability, privacy-preservation, security, integration, and ethical frameworks for widespread BC adoption for data-driven healthcare.
医疗保健信息系统受到数据共享延迟、隐私泄露以及患者对数据缺乏控制权的阻碍。在健康信息技术（HIT）系统中，对安全、隐私保护的访问控制互操作性的需求日益增长，这促使人们寻求诸如区块链（BC）之类的解决方案，区块链提供了一种去中心化、透明且不可变的账本架构。然而，其目前的应用仍局限于概念或概念验证（PoC），通常依赖模拟数据集而非经过验证的真实世界数据或场景，因此有必要进一步研究其实际应用及其基准测试。
本系统文献综述（SLR）旨在通过对同行评审研究进行基准测试，并将概念验证或生产见解转化为实际应用及其评估指标，来分析基于区块链的医疗保健实施情况。与以往侧重于提议的或概念模型、模拟或有限规模部署的系统文献综述不同，本综述侧重于验证区块链在医疗保健环境中的实际应用，而不仅仅是概念研究和概念验证。
遵循PRISMA - 2020指南，我们使用与医疗保健领域区块链相关的医学主题词（MeSH），在五个主要数据库（Scopus、科学网、PubMed、IEEE Xplore和ScienceDirect）中系统搜索高精度的相关研究。设计的综述方案已在开放科学框架（OSF）上注册，确保了综述过程的透明度，包括由独立评审员进行研究筛选、资格审查、质量评估以及数据提取和综合。
总共有82项原始研究完全符合资格标准，并以叙述方式报告了基于区块链的医疗保健实施情况以及经过验证的评估结果。这些研究突出了区块链在医疗保健环境中所应对的当前挑战，提供了关于其有效性的定性和定量数据综合。
基于区块链的医疗保健实施在定性和定量方面均显示出有效性，在药物可追溯性（高达100%）和欺诈预防（减少95%）等领域取得了进展。我们还讨论了近期在该领域需要更多关注的挑战，以及对我们自身工作的神话学考量。我们未来的研究应专注于解决可扩展性、隐私保护、安全性、集成以及广泛采用区块链以实现数据驱动型医疗保健的伦理框架等问题。
