Blockchain is a technology that enables the creation and maintenance of a distributed, decentralized, and immutable ledger of transactions and data. Blockchain can offer various benefits and challenges for implementing healthcare records, such as:

- **Benefits**:

- **Data security**: Blockchain can enhance the security and privacy of healthcare data, as it can enable the encryption, decentralization, and immutability of data, as well as the selective disclosure and consent of data owners. This can prevent unauthorized access, leakage, or tampering of data, as well as protect the data from cyberattacks or human errors. For example, Akiri¹ is a network-as-a-service platform that uses blockchain to securely transport and share healthcare data across different stakeholders.

- **Data transparency**: Blockchain can enhance the transparency and accountability of healthcare data, as it can enable the verification, validation, and auditability of data, as well as the traceability and provenance of data sources and transactions. This can improve the trust and reliability of healthcare data, as well as enable the evaluation and improvement of healthcare outcomes and performance. For example, Embleema² is a platform that uses blockchain to create a decentralized network of real-world health data, which can be used for clinical research and drug development.

- **Data interoperability**: Blockchain can enhance the interoperability and accessibility of healthcare data, as it can enable the standardization, integration, and sharing of data across different platforms, systems, and organizations. This can improve the efficiency and quality of healthcare services, as well as empower the patients and providers to access and control their own data. For example, Medicalchain³ is a platform that uses blockchain to create a single, secure, and universal health record for patients, which can be accessed and updated by authorized healthcare providers.

- **Challenges**:

- **Scalability**: Blockchain can suffer from scalability and performance issues, as it has to process and store a large amount of data and transactions, as well as maintain the synchronization and consensus of the network. This can result in high latency, low throughput, and high resource consumption, which can affect the user experience and the quality of the service. For example, the Bitcoin network can only process about 7 transactions per second, while the Visa network can process about 24,000 transactions per second⁴.

- **Security**: Blockchain can be exposed to security and vulnerability risks, as it relies on the security and correctness of the underlying protocols, algorithms, and implementations. This can result in potential flaws, bugs, or exploits, which can compromise the security and functionality of the service. For example, in 2016, a hacker exploited a vulnerability in a smart contract on the Ethereum network and stole about USD 50 million worth of Ether, the native cryptocurrency of Ethereum⁵.

- **Regulation**: Blockchain can operate in a complex and uncertain regulatory and legal environment, as it challenges the existing norms and standards of the traditional systems. This can result in potential conflicts, disputes, or liabilities, which can affect the legitimacy and viability of the service. For example, blockchain can face issues, such as jurisdiction, governance, data protection, or consumer rights, which may vary across different countries and regions⁶.

These are some of the examples of how blockchain can impact healthcare records, but there are many more potential applications and benefits that can be explored and realized. Blockchain can provide a new paradigm for healthcare records, where data, transactions, and value can be more secure, transparent, and interoperable. However, blockchain requires careful and responsible development, adoption, and regulation, as well as continuous research and education.

If you want to learn more about blockchain and healthcare records, you can check out some of the following resources:

- [Electronic health records in a Blockchain: A systematic review](^7^) by André Henrique Mayer et al., a comprehensive and academic overview of blockchain and its applications, opportunities, and challenges in the healthcare sector.

- [Blockchain-Based Electronic Health Records Management: A Comprehensive Review and Future Research Direction](^8^) by Zhen Li et al., a systematic literature review of the current state and future directions of blockchain applications in healthcare records management, using a research framework based on the design science methodology.

- [The Use of Blockchain Technology in Electronic Health Record Management: A Systematic Review and Future Research Direction](^9^) by Zhen Li et al., a systematic review of the literature on blockchain technology and enhanced health record management systems utilizing artificial intelligence technologies.

- [Evaluating the Impact of Blockchain Models for Secure and Trustworthy Electronic Healthcare Records] by M. H. Khan et al., an analysis of the benefits and implications of blockchain technology for information sharing in healthcare.

Source: Conversation with Bing, 1/19/2024

(1) Electronic health records in a Blockchain: A systematic review. https://journals.sagepub.com/doi/pdf/10.1177/1460458219866350.

(2) Blockchain-Based Electronic Health Records Management: A Comprehensive .... https://ieeexplore.ieee.org/document/9673752.

(3) Systematic Review on AI-Blockchain Based E-Healthcare Records .... https://ieeexplore.ieee.org/abstract/document/9868006/.

(4) The Use of Blockchain Technology in Electronic Health Record ... - Springer. https://link.springer.com/chapter/10.1007/978-3-030-97652-1_22.

(5) Evaluating the Impact of Blockchain Models for Secure and Trustworthy .... https://ieeexplore.ieee.org/document/9178798.

(6) undefined. https://doi.org/10.1177/1460458219866350.

(7) undefined. http://www.creativecommons.org/licenses/by-nc/4.0/%29.

(8) undefined. https://us.sagepub.com/en-us/nam/open-access-at-sage%29.

(9) undefined. https://ieeexplore.ieee.org/servlet/opac?punumber=6287639.