Document Type : Original Article

Author

Assistant Professor, Industrial Engineering, Department of Industrial Engineering, Faculty of Engineering, Garmsar University, Garmsar, Iran; E-mail: sm.hosseini@fmgarmsar.ac.ir

Abstract

Introduction: Blockchain technology has emerged as the fourth industrial revolution in recent years, which can facilitate the management and exchange of patient records by developing a new infrastructure. A review of the literature indicates the lack of studies and the need for further study of the factors affecting the adoption of this technology in the healthcare industry. Therefore, the aim of the present study is to prioritize the factors related to the adoption of blockchain technology in the Electronic Health Record (EHR) systems.

Methods: In this descriptive study, 15 factors related to blockchain adoption in EHR systems were identified by reviewing the scientific literature. Then, these factors were validated by 17 experts who were selected by targeted sampling method and divided into five categories: technological, legal, financial, environmental and organizational. Finally, the weight of each criterion was determined by the fuzzy best-worst method and the consistency of experts’ opinions was evaluated.

Results: According to the judgments of experts, the legal criterion with 32 percent was identified as the most important factor in the adoption of blockchain technology in EHR systems. In addition, security and privacy (16.66 percent), compliance with legal requirements (13.10 percent), compliance with changes in laws (12.22 percent), incentives and rewards (7.01 percent) and standardization (6.87 percent) were identified as five most important sub-criteria in the adoption of the technology, respectively.

Conclusion: With the help of the factors identified in this study and the weights determined for each of them, a method can be developed to assess the level of readiness of healthcare providers in adopting blockchain technology in EHR systems.

Keywords

Main Subjects

1. Wong MC, Yee KC, Nøhr C. Socio-technical considerations for the use of blockchain technology in healthcare. In: Building Continents of Knowledge
in Oceans of Data: The Future of Co-Created eHealth. IOS Press; 2018. p. 636–40.
2. Seh AH, Zarour M, Alenezi M, Sarkar AK, Agrawal A, Kumar R, et al. Healthcare data breaches: insights and implications. In: Healthcare.
Multidisciplinary Digital Publishing Institute; 2020. p. 133.
3. Siyal AA, Junejo AZ, Zawish M, Ahmed K, Khalil A, Soursou G. Applications of blockchain technology in medicine and healthcare: Challenges
and future perspectives. Cryptography. 2019;3(1):3.
4. Reisman M. EHRs: the challenge of making electronic data usable and interoperable. Pharm Ther. 2017;42(9):572.
5. Lyu H, Xu T, Brotman D, Mayer-Blackwell B, Cooper M, Daniel M, et al. Overtreatment in the united states. PLoS One. 2017;12(9):e0181970.
6. Skinner J, Chandra A. Health care employment growth and the future of US cost containment. Jama. 2018;319(18):1861–2.
7. McGhin T, Choo K-KR, Liu CZ, He D. Blockchain in healthcare applications: Research challenges and opportunities. J Netw Comput Appl.
2019;135:62–75.
8. Vlachos A, Christodoulou K, Iosif E. An algorithmic blockchain readiness index. In: Multidisciplinary Digital Publishing Institute Proceedings. 2019. p. 4.
9. Katuwal GJ, Pandey S, Hennessey M, Lamichhane B. Applications of blockchain in healthcare: current landscape & challenges. arXiv Prepr
arXiv181202776. 2018;
10. Clohessy T, Acton T, Rogers N. Blockchain adoption: Technological, organisational and environmental considerations. In: Business
transformation through blockchain. Springer; 2019. p. 47–76.
11. Sadhya V, Sadhya H. Barriers to adoption of blockchain technology. 2018;
12. Kumar T, Ramani V, Ahmad I, Braeken A, Harjula E, Ylianttila M. Blockchain utilization in healthcare: Key requirements and challenges. In:
2018 IEEE 20th International conference on e-health networking, applications and services (Healthcom). IEEE; 2018. p. 1–7.
13. Pawczuk L, Massey R, Schatsky D. Breaking Blockchain: Open Deloitte’s 2018 Global Blockchain Survey. Deloitte Consult Denver, CO, USA. 2018.
14. Batubara FR, Ubacht J, Janssen M. Challenges of blockchain technology adoption for e-government: a systematic literature review. In:
Proceedings of the 19th Annual International Conference on Digital Government Research: Governance in the Data Age. 2018. p. 1–9.
15. Kshetri N. Blockchain and electronic healthcare records [cybertrust]. Computer (Long Beach Calif). 2018;51(12):59–63.
16. Guo S, Zhao H. Fuzzy best-worst multi-criteria decision-making method and its applications. Knowledge-Based Syst. 2017;121:23–31.
17. Ahmad WNKW, Rezaei J, Sadaghiani S, Tavasszy LA. Evaluation of the external forces affecting the sustainability of oil and gas supply chain
using Best Worst Method. J Clean Prod. 2017;153:242–52.
18. Ozturan M, Atasu I, Soydan H. Assessment of blockchain technology readiness level of banking industry: Case of Turkey. Int J Bus Mark
Manag. 2019;4(12):1–13.