Application of Blockchain Technology in Healthcare
273
Table 1. Major contributions classified by use cases
Use cases
Paper Framework
Data Storage Contribution
Year
Electronic
medical records
[7]
Ethereum
Off-chain
Provides a patient-centric system for
a transparent and accessible view of
medical history
2016
[24]
Ethereum
Off-chain
Propose a platform for shared
medical data in cloud repositories
2017
[22]
Specific
Off-chain
A PHR distributed model that
propose solutions for latency issues
2017
[25]
Ethereum
Hybrid
Proposes a blockchain-based EMR
application that meets ONC
requirements
2018
[8]
Proprietary
Off-chain
Provides a blockchain-based EMR
management system
2018
[16]
Proprietary
Off-chain
A healthcare system that Combines
both off-chain storage and on-chain
verification
2018
[6]
Ethereum
Hybrid
Proposes an electronic health records
system that protects personal health
information
2018
Remote patient
monitoring
[14]
Hyperledger Fabric Off-chain
A mobile Health blockchain-based
system for cognitive behavioral
therapy for insomnia
2017
[11]
Ethereum
Hybrid
Proposes to use blockchain-based
smart contracts to perform real-time
data analysis
2018
[21]
–
–
Propose an architecture that
integrates blockchain and IoT
sensory data collected from patients
2020
Pharmaceutical
supply chain
[4]
Ethereum
Off-chain
Maintains public temperature
records’ accessibility of drugs during
their transportation
2017
[12]
–
–
Explaines blockchain usability to
add traceability and visibility to
drugs supply
2018
[5]
Hyperledger Fabric On-chain
Design a blockchain-based control
system for the control of drugs
turnover
2019
[20]
Hyperledger Fabric On-chain
Design a secure, immutable and
traceable pharma supply chain
2019
Health
insurance claims
[26]
Ethereum
On-chain
Proposes a blockchain-based medical
insurance storage system
2018
We present a summary of the studied papers in Table 1. We have noticed that the
majority of these applications are developed on popular blockchain frameworks,
such as Ethereum and Hyperledger Fabric.
4 Research Challenges and Opportunities
Based on the proposed prototypes and developed applications, we can identify
different limitations of the healthcare Blockchain-Based applications.
First, EMR systems do not address semantic interoperability [3]. Consequently, manual inspection and mapping of predefined ontologies from medical
and health data experts are required. Second, clinical malpractice cannot be
273
Table 1. Major contributions classified by use cases
Use cases
Paper Framework
Data Storage Contribution
Year
Electronic
medical records
[7]
Ethereum
Off-chain
Provides a patient-centric system for
a transparent and accessible view of
medical history
2016
[24]
Ethereum
Off-chain
Propose a platform for shared
medical data in cloud repositories
2017
[22]
Specific
Off-chain
A PHR distributed model that
propose solutions for latency issues
2017
[25]
Ethereum
Hybrid
Proposes a blockchain-based EMR
application that meets ONC
requirements
2018
[8]
Proprietary
Off-chain
Provides a blockchain-based EMR
management system
2018
[16]
Proprietary
Off-chain
A healthcare system that Combines
both off-chain storage and on-chain
verification
2018
[6]
Ethereum
Hybrid
Proposes an electronic health records
system that protects personal health
information
2018
Remote patient
monitoring
[14]
Hyperledger Fabric Off-chain
A mobile Health blockchain-based
system for cognitive behavioral
therapy for insomnia
2017
[11]
Ethereum
Hybrid
Proposes to use blockchain-based
smart contracts to perform real-time
data analysis
2018
[21]
–
–
Propose an architecture that
integrates blockchain and IoT
sensory data collected from patients
2020
Pharmaceutical
supply chain
[4]
Ethereum
Off-chain
Maintains public temperature
records’ accessibility of drugs during
their transportation
2017
[12]
–
–
Explaines blockchain usability to
add traceability and visibility to
drugs supply
2018
[5]
Hyperledger Fabric On-chain
Design a blockchain-based control
system for the control of drugs
turnover
2019
[20]
Hyperledger Fabric On-chain
Design a secure, immutable and
traceable pharma supply chain
2019
Health
insurance claims
[26]
Ethereum
On-chain
Proposes a blockchain-based medical
insurance storage system
2018
We present a summary of the studied papers in Table 1. We have noticed that the
majority of these applications are developed on popular blockchain frameworks,
such as Ethereum and Hyperledger Fabric.
4 Research Challenges and Opportunities
Based on the proposed prototypes and developed applications, we can identify
different limitations of the healthcare Blockchain-Based applications.
First, EMR systems do not address semantic interoperability [3]. Consequently, manual inspection and mapping of predefined ontologies from medical
and health data experts are required. Second, clinical malpractice cannot be