Blockchain and Distributed Ledger Technology - enabled architectures for improving healthcare

Blockchain solutions offer efficient approaches for trustworthy data management, especially in the medical field when storing and processing sensitive patient data. Many institutional and industrial facilities have already recognized the importance of the technology for the health sector and have also formulated basic ideas, concepts and main use cases, but concrete implementations and executions are comparatively rare. This mini review examines current research on specific blockchain implementations in healthcare that go beyond the state of concept studies or theoretical implementation ideas and describes the most promising systems based on systematic literature research. The review shows that secure storage and easy access to complete patient data is becoming increasingly important. Blockchain technology can be used as a secure, transparent and digital way to meet these needs. Hybrid solutions consisting of conventional data storage and blockchain-based access management are increasingly being developed and implemented. The automation of blockchain processes through smart contracts is also recommended. The review further reveals ambiguities in the use of permissioned and permissionless blockchain frameworks, machine learning (ML) integration as well as the question of which data should be stored in the blockchain and how this should be viewed legally. Therefore, there is still a need for further research, especially on these aspects, in order to further establish the use of blockchains in healthcare.