Table 4.

Health care service pain points and the potential effects of blockchain in the health care ecosystem.

Issue	Health care service pain points	Potential effects of blockchain leverage
Medical data storage	Highly disparate data sources across individual clinics or health care–related institutions	Decentralized data storage allows duplicate and immutable health records in the health network
Fraud and authenticity	Malicious attempts or human processing errors may cause fraud, alterations, or medical disputes Authorities are required for trust building among stakeholders Major issues include drug counterfeiting and provenance	Keeping critical items (ie, medical transactions or records) on blocks and permanently recording operations on-chain Mitigating the tampering issue via the verification and consensus architecture
Document type	Paper-based and manual processing causes difficulties in data aggregation	Supporting digitalized health documents deployed on secured shared ledger
Interoperability	Siloed data structures hinder interoperations across different databases	Blockchain-based networks enable interactions among health care stakeholders
Health claims and transactions	Inefficiencies that exist in clinical and administrative procedures and frictions among respective health systems have caused poor operations	Process automation facilitated by blockchain-based smart contracts enables streamlined claims and transaction procedures
Research data access and monetization	Challenges in aggregating, recruiting, and retaining data among medical parties and difficulties in monetization	Enabling of clinical trial data sharing and value-added analysis to create data use and monetization
Information sharing and transmission	Manual processing increases operational costs and expenditures Vulnerability and uncertainties from cyberattacks or system malfunction	Blockchain’s distributed attributes allow shared information in the health care network Consensus mechanism with tamper-proof features could reduce security and privacy concerns
Medical supply chain traceability	Uncertainties during handovers among participating parties Poor control in tracking user identities, ownership, and delivery status	Common shared ledger system allows for better transparency and monitoring on supply chain traceability Smart contracts can facilitate notifications of state changes