Table 6.

Perceived risks of a blockchain-based hospital information exchange (HIE) system.

Group	Quotes
Patients	“I’m not too concerned about the security. I don’t think it would be a huge risk for me even if my health information is leaked. An old saying goes, ‘the more serious the illness, the more you should tell people’.” “Because of my age, I’m not too interested in looking for new ways to do things and learn new things. But I’m not incapable of doing all that. If it’s something that must be done, I’d go through it, even if it’s a little burdensome.”
Physicians	“Considering the situation in Korea, doctor shopping [the practice of visiting different hospitals to get a diagnosis because they don’t trust a doctor’s diagnosis for their pathological symptoms] would happen more commonly because of the convenient HIE system.” “Being unable to revise the data would be a problem. We are human, and everyone makes mistakes when generating data. But there’s no opportunity to fix errors. If the transaction is made again to fix the error, patients would know that their records contain errors, which would cause conflicts between the patient and the hospital. In ophthalmology, the records of left and right eyes are switched from time to time.” “If anybody can see the treatment history, even small details would be available for lawyers to see and there’s a possibility of being dragged into conflict for everything. The ideal case would be when data are used for positive purposes such as research or health management, but health care professionals would actually become very defensive when diagnosing patients and making care plans.” “Some patients might refuse to provide data that are absolutely necessary, and it might become even harder when the physicians exchange patient information.”
Developers	“If consent is given through apps, there is a risk of health data being leaked when a mobile phone is lost or an app is hacked. In cryptocurrency systems, people cannot withdraw their money if their personal key or mobile phone is lost. The fact that the patient cannot find their own health information should be taken very seriously.” “Blockchain technology has not been around for long and is still being researched, there are still questions about the reliability of blockchain technology. In order to gain reliability of this technology, small-scale projects for building clinical study platforms should be conducted more and carried out up to actual demonstration.” “If data are lost due to carelessness or inexperience, restoring the lost data would be difficult. Health data can be disclosed if a mobile phone is lost or an app is hacked.”