Benefits and concerns associated with blockchain-based health information exchange (HIE): a qualitative study from physicians' perspectives

Identifying the Barriers to Acceptance of Blockchain-Based Patient-Centric Data Management Systems in Healthcare

A number of recent studies have shown that wastage and inefficiency are a significant problem in all global healthcare systems. One initiative that could radically improve the operational efficiency of health systems is to make a paradigm shift in data ownership-that is, to transition such systems to a patient-centric model of data management by deploying blockchain technology. Such a development would not only make an economic impact, by radically cutting wastage, but would deliver significant social benefits by improving patient outcomes and satisfaction. However, a blockchain-based solution presents considerable challenges. This research seeks to understand the principal factors, which act as barriers to the acceptance of a blockchain-based patient-centric data management infrastructure, in the healthcare systems of the GCC (Gulf Cooperation Council) countries. The study represents an addition to the current literature by examining the perspectives and views of healthcare professionals and users. This approach is rare within this subject area, and is identified in existing systematic reviews as a research gap: a qualitative investigation of motivations and attitudes among these groups is a critical need. The results of the study identified 12 key barriers to the acceptance of blockchain infrastructures, thereby adding to our understanding of the challenges that need to be overcome in order to benefit from this relatively recent technology. The research is expected to be of use to healthcare authorities in planning a way forward for system improvement, particularly in terms of successfully introducing patient-centric systems.

Self-sovereign identity empowered non-fungible patient tokenization for health information exchange using blockchain technology

BACKGROUND

Patient tokenization is a novel approach that allows anonymous patient-level linkage across healthcare facilities, minimizing the risk of breaching protected health information in health information exchange (HIE). Most patient tokenization is the centralized approach that is unable to address data security concerns fundamentally. Non-Fungible Tokens (NFT), which are non-transferable cryptographic assets on the blockchain, have the potential to provide secure, decentralized, and trustworthy patient tokenization. Self-Sovereign Identity (SSI) is a user-centric approach to verify the ownership of NFTs in a decentralized manner.

METHODS

We have developed a blockchain architecture that contains four modules: (1) Creation module for NFTs creation, (2) Linkage module to link the local patients' accounts to their NFTs, (3) Authentication module that allows patients to permit healthcare providers to access their token, and (4) Exchange module, which involves the HIE process and the validation of the legitimacy of the token through SSI.

RESULTS

A case study has been conducted on the proposed architecture. Over 3 million transactions have been completed successfully with a blockchain validation and written time of 1.17 s on average. A stability test has also been conducted with a higher throughput of 200 transactions per second running for an hour with an average transaction processing time of 1.42 s.

CONCLUSIONS

This study proposed a blockchain architecture that achieves SSI-enabled NFT-based patient tokenization. Our architecture design, implementation, and case studies have demonstrated the feasibility and potential of NFT with SSI to establish a secure, transparent, and patient-centric identity management and HIE.

Clinical Pharmacy Services Enhanced by Electronic Health Record (EHR) Access: An Innovation Narrative

BACKGROUND

Patient care in the community pharmacy setting is often hindered due to limited access to adequate patient health information (PHI). Various studies suggest that lack of access to PHI is a main reason for delay in pharmaceutical care, medication dispensing errors, and lacking interprofessional relationships between prescribers and pharmacists. Literature has shown that interprofessional collaboration and improved access to PHI can improve transitions of care and communication for pharmacists, but literature is sparse on implementation of electronic health record (HER) access within independent community pharmacies.

METHODS

This observational study follows implementation of HER access into a rural community pharmacy to enhance common clinical services carried out by pharmacy staff. Metrics include number of enhanced consultations by pharmacy staff, type of consultations provided, potential reimbursement, decreased need to follow up with other providers, potential for decreased time to treatment or refills, and aspects of EHR most utilized during search.

RESULTS

Two-hundred sixty three patients' profiles were assessed, with 164 (62.4%) deemed appropriate for EHR access and searching. Most interventions made were related to cardiovascular, endocrinologic, neuropsychiatric, and COVID-19 therapy medications.

CONCLUSION

EHR access in community pharmacy has the potential to improve both the quality and availability of clinical patient interventions through enhanced knowledge of PHI.

New technological trajectories to reduce fossil-fuel pollution and support sustainable socioeconomic systems.. [DOI: 10.21203/rs.3.rs-2323975/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0]

One of the fundamental problems in modern economies is high carbon emissions and diffusion of pollutants from industrial activities focused on fossil-based energy that generate detrimental effects on climate, environment and human population. The goal of this study is to analyze new trajectories of technologies that can reduce, whenever possible, environmental degradation and support a sustainable growth. A model of technological evolution is proposed to detect new technological trajectories directed to sustainability. Results reveal that technologies with a high sustainability perspective for reducing environmental pollution and climate change are: offshore wind turbines, carbon capture storage technology associated with renewable energy, cellular agriculture and blockchain technology directed positive environmental impact. Findings here can sustain decision making of policymakers towards investment in promising technological directions that reduce environmental pollution and sustain ecological transition and sustainable development in human society.

Bibliometric Analysis of Health Technology Research: 1990~2020

This paper aims to summarize the publishing trends, current status, research topics, and frontier evolution trends of health technology between 1990 and 2020 through various bibliometric analysis methods. In total, 6663 articles retrieved from the Web of Science core database were analyzed by Vosviewer and CiteSpace software. This paper found that: (1) The number of publications in the field of health technology increased exponentially; (2) there is no stable core group of authors in this research field, and the influence of the publishing institutions and journals in China is insufficient compared with those in Europe and the United States; (3) there are 21 core research topics in the field of health technology research, and these research topics can be divided into four classes: hot spots, potential hot spots, margin topics, and mature topics. C21 (COVID-19 prevention) and C10 (digital health technology) are currently two emerging research topics. (4) The number of research frontiers has increased in the past five years (2016-2020), and the research directions have become more diverse; rehabilitation, pregnancy, e-health, m-health, machine learning, and patient engagement are the six latest research frontiers.