Table 2.
Information extracted and collected from the selected papers.
| Study first author, year | Location | Use cases and fields | Usability and reasons for using blockchain | Technology | ||
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|
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Application area | Description | Simplified classification | Description |
|
| Maslove, 2018 [14] | Kingston, Canada | Biomedical research and education (ie, clinical trials) | Development of a system that uses a web-based interface to allow users to run trial-related smart contracts on an Ethereum network | Data integrity | Enabling of clinical trials data management; functions allow patients to grant researchers access to their data and allow researchers to submit queries for data that are stored off-chain | Ethereum |
| Cunningham, 2017 [18] | The Netherlands | Electronic medical record (EMR) | A system that uses smart contract–based Ethereum blockchain technology to operate in a verifiably secure, trustless, and openly auditable environment | Access control | Improvement of the uptake and acceptance of medical informatics platforms where patients directly control medical data in an open and secure manner | Ethereum |
| Nugent, 2016 [29] | London, the United Kingdom | Biomedical research and education (ie, clinical trials) | A system that uses smart contracts, which enhance the trust in the data and clinical trials; this reduces patient risk and financial strain in health care by allowing better-informed decisions to be made by medical professionals | Data integrity and logging | Improvement of data transparency in clinical trials and immutable records of trial history, which act as trusted administrators; tamper-resistant characteristics of blockchain prevent all forms of manipulation; mainly used for complex clinical trial management | Ethereum |
| Benchoufi, 2017 [15] | Paris, France | Biomedical research and education (ie, clinical trials) | A system with time-stamping of each patient’s consent using blockchain technology in a securely unfalsifiable and transparent way | Nonrepudiation, logging, and data versioning | All consent-related data on the blockchain enhance security, reliability, and transparency and could be a consistent step toward reproducibility | N/Aa |
| Ichikawa, 2017 [16] | Tokyo, Japan | Remote patient monitoring (ie, mobile health [mHealth]) | Development of a smartphone app with blockchain technology to provide an mHealth system for cognitive behavioral therapy for insomnia | Data integrity | Establishment of accessibility and transparency of data without the third party by incorporating blockchain technology into mHealth; blockchain also serves as a tamperproof system for mHealth | Hyperledger Fabric |
| Cichosz, 2018 [25] | Aalborg, Denmark | EMR (ie, health care data) | Development of a platform using the New Economy Movement (NEM) multi-signature blockchain contracts to access data management, sharing, and encryption | Access control and data integrity | Improvement in privacy and diabetes data management, where patients have access to control and share their own data | NEM |
| Omar, 2019 [26] | The United States | EMR | Development of a patient-centric health care data management system using blockchain technology as storage, which enhances privacy | Data integrity | Patients will have overall control over their data; MediBchain increases patients’ interest in EMRs or electronic health records and enhances accountability, integrity, pseudonymity, security, and privacy | N/A |
| Liang, 2017 [30] | Norfolk, England | Remote patient monitoring | Development of an mHealth care system for personal health data collection, sharing, and collaboration between individuals, health care providers, and insurance companies, and its implementation in a distributed and trustless way | Data integrity, access control, and logging | Improvement of personal health data collection, sharing, validation, protection, and integrity and health care collaboration; this system ensures the scalability and efficiency of the data process by handling a large data set at low latency | Hyperledger Fabric |
| Kleinaki, 2018 [28] | The Netherlands | Biomedical research and education (ie, database queries) | Presentation and testing of the use of smart digital contracts by a blockchain-based notarization service to seal a biomedical database query using a real blockchain infrastructure | Data integrity and data versioning | Improvement of retrieved data integrity, nonrepudiation, and biomedical evidence data versioning | Ethereum |
| Bocek, 2017 [32] | Zurich, Switzerland | Pharmaceutical supply chain (ie, ambient temperature) | Implementation of sensor devices using blockchain technology to enhance data immutability and public accessibility of temperature records | Logging | This system can be evaluated automatically, and the stored data are tamperproof with Ethereum, which can be used at a low cost | Ethereum |
| Mendes, 2018 [22] | Évora, Portugal | EMR | Development of a system with raw blockchain with Hyperledger Fabric by DLA | Data integrity | While consuming low computational power, it enhances tamperproof, fair, and democratic maintenance of the ledger | Hyperledger Fabric |
| Li, 2018 [20] | Beijing, China | EMR (ie, health record) | Development of a novel blockchain-based data preservation system based on the real-world blockchain-based platform, and its implementation for medical data | Data integrity | Preservation of important data in perpetuity and verification of data originality; illegal operation of the data is detected, and the user is notified on time | Ethereum |
| Azaria, 2016 [17] | The United States | EMR (ie, health record) | Development of a decentralized record management system using blockchain technology to handle EMRs | Logging and access control | The system becomes more convenient and adaptable in its management of authentication, confidentiality, accountability, and data sharing | Ethereum |
| Zhou, 2018 [33] | Beijing, China | Health insurance claims | Development of a blockchain-based medical insurance storage system, MIStore; this helps insurance companies obtain patients’ medical spending records, which are always confidential | Data integrity and logging | The system provides decentralization and tamper resistance; this gives users high credibility and record-nodes, which help users verify publicly verifiable data | Ethereum |
| Angeletti, 2017 [27] | Rome, Italy | Biomedical research and education (ie, clinical trials) | Presentation of a digital health application enabling clinical trials recruitment using Internet of Things data; using Ethereum, a proof of concept was implemented, and the application’s performance was studied in a real-world evaluation | Data integrity and access control | The clinical research institute can be guaranteed that it is acquiring useful and original data; until an agreement is reached, the individual can keep personal data private | Ethereum |
| Saravanan, 2017 [31] | Chennai, India | Remote patient monitoring | Implementation of a new health care paradigm (SMEADb) to aid diabetic patients via development of an end-to-end secured system; implementation of a blockchain-based disruptive technology to facilitate cryptographic security and formalized data access through smart contracts | Access control | The system aids in data storage for millions of patients, and analysis was performed in real time, which promotes an evidence-based medicine system with privacy and security concerns | Ethereum |
| Zhang, 2018 [24] | The United States | EMR (ie, health record) | Development of a system to support collaborative clinical decision-making via a remote tumor board case study | Access control and data integrity | Improvement of security, trust, and scalable data sharing, which is important for collaborative clinical decision-making; also results in greater data readability | Ethereum |
| Fan, 2018 [19] | China | EMR (ie, health record) | Development of a blockchain-based information management system, MedBlock, to handle patients’ information; this allows for efficient EMR access and retrieval, exhibiting high information security | Access control | Patients can easily access the EMRs of different hospitals; data sharing via blockchain helps the hospital get a full history of patients’ medical history before consultations are carried out | N/A |
| Liu, 2018 [21] | China | EMR | Implementation of blockchain-based privacy-preserving data sharing for EMRs | Access control | The EMRs cannot be modified arbitrarily, which leads to reduced medical data leakage; security analysis shows that this system is a secure and effective way to realize data sharing for EMRs | N/A |
| Nagasubramanian, 2018 [23] | London, the United Kingdom | EMR | Ensuring secrecy of digital signatures and authentication by using keyless signature infrastructure in the system | Access control | The system ensures data transparency, privacy, confidentiality, and verification of data | N/A |
| Kotsiuba, 2018 [34] | Ukraine | Health care data analytics | Implementation of a decentralized system with blockchain technology that protects the confidentiality of medical data; patients receive a personal data monitoring tool, allowing them to participate in accelerating medical analytics | Data integrity | Enhancement of medical data safety, extension of the base of clinical data collection, and creation of an effective shared health infrastructure | N/A |
| Talukder, 2018 [35] | The United States | Others | Implementation of an Ethereum-based Proof of Disease consensus protocol to enhance the accuracy of transactions and eliminate medical errors | Access control and data integrity | Aids in achieving all the complex needs of P6 (participatory, personalized, proactive, preventive, predictive, and precision) medicine and decreases disease burden | Ethereum |
aN/A: not applicable: the technology was not reported in this paper.
bSMEAD: Secured Mobile-Enabled Assisting Device for Diabetics.