Applications of blockchain technology in long-term care: use cases, potentials, and barriers.

AAL Blockchain Care ecosystems Care service management Health data Long-term care Privacy Security Systematic review

Journal

BMC health services research
ISSN: 1472-6963
Titre abrégé: BMC Health Serv Res
Pays: England
ID NLM: 101088677

Informations de publication

Date de publication:
28 Oct 2024
Historique:
received: 11 03 2024
accepted: 27 09 2024
medline: 29 10 2024
pubmed: 29 10 2024
entrez: 29 10 2024
Statut: epublish

Résumé

Digitalization in long-term care (LTC) is being discussed as a means of easing pressures on care service delivery, optimizing care coordination and planning processes, and improving service quality. With its advanced data protection and process automation features, blockchain technology could help solve data security and privacy issues, especially for the implementation of assistive technologies. Blockchain (BC) is thus a new technology being tapped in LTC. However, little is known about the fields, scope, and experiences of BC applications in this sector. This systematic review aims to provide an extensive overview of current discussions of BC technology in LTC settings. Particular attention was given to the use cases, the objectives behind applying the new technology, and barriers as well as facilitating factors for the implementation. According to the PRISMA methodology, we conducted a systematic literature review of academic articles and conference papers published between 2016 and 2023. The search through the Scopus database yielded 194 results, 29 of which were selected according to our inclusion and exclusion criteria. Research on BC technologies has taken off in LTC since 2016. Scientific interest centers around use cases for Ambient Assisted Living (AAL), care service management, and the improved integration of care ecosystems. However, most of the selected studies discuss prototypes that have neither yet been extensively evaluated nor been implemented and tested in real-world scenarios. Among the implementation barriers, technical immaturity, stakeholder cooperation, organizational change management, access to adequate IT infrastructure and end-user acceptance issues were most evident. Future research is needed to gain insights into context-specific implementation efforts, user experiences, benefits, and pitfalls of using BC technologies in LTC settings. While many expectations are tied to BC applications, potential negative effects have received little attention in the literature. Whether BC technology can serve as a mitigator between privacy and security preservation and improved information sharing in LTC settings is an important topic for further research.

Sections du résumé

BACKGROUND BACKGROUND
Digitalization in long-term care (LTC) is being discussed as a means of easing pressures on care service delivery, optimizing care coordination and planning processes, and improving service quality. With its advanced data protection and process automation features, blockchain technology could help solve data security and privacy issues, especially for the implementation of assistive technologies. Blockchain (BC) is thus a new technology being tapped in LTC. However, little is known about the fields, scope, and experiences of BC applications in this sector.
OBJECTIVE OBJECTIVE
This systematic review aims to provide an extensive overview of current discussions of BC technology in LTC settings. Particular attention was given to the use cases, the objectives behind applying the new technology, and barriers as well as facilitating factors for the implementation.
METHOD METHODS
According to the PRISMA methodology, we conducted a systematic literature review of academic articles and conference papers published between 2016 and 2023. The search through the Scopus database yielded 194 results, 29 of which were selected according to our inclusion and exclusion criteria.
RESULTS RESULTS
Research on BC technologies has taken off in LTC since 2016. Scientific interest centers around use cases for Ambient Assisted Living (AAL), care service management, and the improved integration of care ecosystems. However, most of the selected studies discuss prototypes that have neither yet been extensively evaluated nor been implemented and tested in real-world scenarios. Among the implementation barriers, technical immaturity, stakeholder cooperation, organizational change management, access to adequate IT infrastructure and end-user acceptance issues were most evident.
CONCLUSION CONCLUSIONS
Future research is needed to gain insights into context-specific implementation efforts, user experiences, benefits, and pitfalls of using BC technologies in LTC settings. While many expectations are tied to BC applications, potential negative effects have received little attention in the literature. Whether BC technology can serve as a mitigator between privacy and security preservation and improved information sharing in LTC settings is an important topic for further research.

Identifiants

pubmed: 39468706
doi: 10.1186/s12913-024-11670-0
pii: 10.1186/s12913-024-11670-0
doi:

Types de publication

Journal Article Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

1292

Subventions

Organisme : Österreichische Forschungsförderungsgesellschaft
ID : 'COMET'
Organisme : Österreichische Forschungsförderungsgesellschaft
ID : 'COMET'

Informations de copyright

© 2024. The Author(s).

Références

Alfayez FA, Bhatia Khan S. IoT-blockchain empowered Trinet: optimized fall detection system for elderly safety. Front Bioeng Biotechnol. 2023;11.  https://doi.org/10.3389/fbioe.2023.1257676
Aloini D, Benevento E, Stefanini A, Zerbino P. Transforming healthcare ecosystems through blockchain: opportunities and capabilities for business process innovation. Technovation. 2023;119:102557. https://doi.org/10.1016/j.technovation.2022.102557 .
doi: 10.1016/j.technovation.2022.102557
Alzahrani S, Daim T, Choo KKR. Assessment of the blockchain technology adoption for the management of the electronic health record systems. IEEE Transactions on Engineering Management. 2022;70(8):2846–63. https://doi.org/10.1109/tem.2022.3158185 .
Balasubramanian S, Shukla V, Sethi JS, Islam N, Saloum R. A readiness assessment framework for Blockchain adoption: a healthcare case study. Technol Forecast Soc Chang. 2021;165. https://doi.org/10.1016/j.techfore.2020.120536 .
Bastos D, Ribeiro JC, Silva F, Rodrigues M, Rabadão C, Fernández-Caballero A, Barraca JP, Rocha NP, Pereira A. Security mechanisms of a Mobile Health application for promoting physical activity among older adults. Sensors. 2021;21(21):7323. https://doi.org/10.3390/s21217323 .
doi: 10.3390/s21217323 pubmed: 34770631 pmcid: 8588378
Bazel MA, Mohammed F, Ahmad M. A systematic review on the adoption of blockchain technology in the healthcare industry. EAI Endorsed Trans Pervasive Health Technol. 2023;9(1). https://doi.org/10.4108/eetpht.v9i.2844 .
Bezboruah K, Paulson DF, Smith JD. Management attitudes and technology adoption in long-term care facilities. J Health Organ Manag. 2014;28(3):344–65. https://doi.org/10.1108/jhom-11-2011-0118 .
doi: 10.1108/jhom-11-2011-0118 pubmed: 25080649
Chang SE, Chen Y, Lu M, Luo HL. Development and evaluation of a smart contract-enabled Blockchain System for Home Care Service Innovation: mixed methods study. JMIR Med Inf. 2020;8(7):e15472. https://doi.org/10.2196/15472 .
doi: 10.2196/15472
Chen H, Chu YC, Lai F. Mobile time banking on blockchain system development for community elderly care. J Ambient Intell Humaniz Comput. 2023;14(10):13223–35. https://doi.org/10.1007/s12652-022-03780-6 .
doi: 10.1007/s12652-022-03780-6
Chou HM. A Smart-Mutual Decentralized System for Long-Term Care. Appl Sci. 2022;12(7):3664. https://doi.org/10.3390/app12073664 .
doi: 10.3390/app12073664
Chukwu E, Garg L. A systematic review of blockchain in healthcare: frameworks, prototypes, and implementations. Ieee Access. 2020;8:21196–214. https://doi.org/10.1109/access.2020.2969881 .
doi: 10.1109/access.2020.2969881
Cui L, Yuan K, Zhao X, Mou LY. Construction of Elderly Mutual Aid Time Bank Based on Blockchain. In: 2019 20th IEEE International Conference on Mobile Data Management (MDM). 2019. p. 462–6. https://doi.org/10.1109/mdm.2019.000-1 .
doi: 10.1109/mdm.2019.000-1
Dubovitskaya A, Novotny P, Thiebes S, Sunyaev A, Schumacher M, Xu Z, Wang F. Intelligent health care data management using blockchain: current limitation and future research agenda. In: Heterogeneous Data Management, Polystores, and Analytics for Healthcare: VLDB 2019 Workshops, Poly and DMAH, Los Angeles, CA, USA, August 30, 2019, Revised Selected Papers 5, 277–288. Springer International Publishing. 2019; https://doi.org/10.1007/978-3-030-33752-0_20
Dulce E, Hurtado J. The Role of the Blockchain Technology in the Elderly Care Solutions: A Systematic Mapping Study. In: International Workshop on Gerontechnology (pp. 23–34). Cham: Springer International Publishing. 2021; https://doi.org/10.1007/978-3-030-72567-9_3
Elahi H, Castiglione A, Wang G, Geman O. A human-centered artificial intelligence approach for privacy protection of elderly app users in smart cities. Neurocomputing. 2021;444:189–202. https://doi.org/10.1016/j.neucom.2020.06.149 .
doi: 10.1016/j.neucom.2020.06.149
Endter C. Skripting age – the negotiation of age and aging in ambient assisted living. Ageing and technology: perspectives from the Social Sciences. Bielefeld: transcript; 2016. pp. 121–40. https://doi.org/10.1515/9783839429570-006 .
doi: 10.1515/9783839429570-006
Endter C. Die Ko-Konstitution Von Alter(n) in Der Entwicklung eines intelligenten Erinnerungsportals für ältere Nutzerinnen Und Nutzer. Kulturgerontologie: Konstellationen, Relationen, Distinktionen. Sektion Alter(n) und Gesellschaft, Deutsches Zentrum für Altersfragen, Sektion Alter(n) und Gesellschaft, Berlin. Springer VS; 2021. pp. 237–59. https://doi.org/10.1007/978-3-658-31547-4_13 .
doi: 10.1007/978-3-658-31547-4_13
Fang L, Wu Y, Wu C, Yu Y. A nonintrusive Elderly Home Monitoring System. IEEE Internet Things J. 2021;8:2603–14. https://doi.org/10.1109/jiot.2020.3019270 .
doi: 10.1109/jiot.2020.3019270
Fischer F, Endter C. Establishing health-promoting structures in professional long-term care through digitization: call for a perspective change/Etablierung gesundheitsfördernder Strukturen in Der stationären Langzeitversorgung Durch Digitalisierung: Aufruf zu Einem Perspektivwechsel. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2023;66(5):557–61. https://doi.org/10.1007/s00103-023-03686-4 .
doi: 10.1007/s00103-023-03686-4 pubmed: 37060379 pmcid: 10163109
Florea AI, Anghel I, Tudor C. A review of Blockchain Technology Applications in Ambient assisted living. Future Internet. 2022;14(5):150. https://doi.org/10.3390/fi14050150 .
doi: 10.3390/fi14050150
Gallistl V, Seifert A, Kolland F. COVID-19 as a Digital push? Research experiences from Long-Term Care and recommendations for the post-pandemic era. Front Public Health. 2021;9:660064. https://doi.org/10.3389/fpubh.2021.660064 .
doi: 10.3389/fpubh.2021.660064 pubmed: 34041216 pmcid: 8141793
Gupta MPR, Wallet-Based. Blockchain Access Protocol to secure EHRs. In: Blockchain and IoT Integration: approaches and applications. Auerbach Publications. 2021;65–75. https://doi.org/10.1201/9781003094210 .
Haddaway NR, Page MJ, Pritchard CC, McGuinness LA. PRISMA2020: an R package and Shiny app for producing PRISMA 2020-compliant flow diagrams, with interactivity for optimised digital transparency and open synthesis. Campbell Syst Reviews. 2022;18(2):e1230. https://doi.org/10.1002/cl2.1230 .
doi: 10.1002/cl2.1230
Haslinger-Baumann E. Rolle Und Zukunft Assistiver Technologien in Der Gesundheits- Und Krankenpflege. In: Technisierung Der Pflege, Goldegger Dialogforum Mensch und Endlichkeit. Bioethik Wissenschaft Und Gesellschaft Band. 2022;15:153–66. https://doi.org/10.5771/9783748928720 .
doi: 10.5771/9783748928720
Hasselgren A, Kralevska K, Gligoroski D, Pedersen SA, Faxvaag A. Blockchain in healthcare and health sciences—A scoping review. Int J Med Informatics. 2020;134:104040. https://doi.org/10.1016/j.ijmedinf.2019.104040 .
doi: 10.1016/j.ijmedinf.2019.104040
Hölbl M, Kompara M, Kamišalić A, Nemec Zlatolas L. A systematic review of the use of blockchain in healthcare. Symmetry. 2018;10(10):470. https://doi.org/10.3390/sym10100470 .
doi: 10.3390/sym10100470
Hu M, Sheng F. Blockchain-enabled cross-chain collaboration model for elderly health information from a whole process perspective. Front Public Health. 2023;11. https://doi.org/10.3389/fpubh.2023.1081539 .
Hu M, Zhang Y, Liu X. Research on Information Coordination Mechanism of Multi-participants in Community-based Elderly Care by Blockchain. In: 2022 IEEE International Conference on Dependable, Autonomic and Secure Computing, International Conference on Pervasive Intelligence and Computing, International Conference on Cloud and Big Data Computing, International Conference on Cyber Science and Technology Congress, 1–4, 2022; https://doi.org/10.1109/dasc/picom/cbdcom/cy55231.2022.9927804
Khezr S, Benlamri R, Yassine A. Blockchain-based Model for Sharing Activities of Daily Living in Healthcare Applications. In: 2020 IEEE Intl Conf on Dependable, Autonomic and Secure Computing, Intl Conf on Pervasive Intelligence and Computing, Intl Conf on Cloud and Big Data Computing, Intl Conf on Cyber Science and Technology Congress (DASC/PiCom/CBDCom/CyberSciTech), 627–633, 2020; https://doi.org/10.1109/dasc-picom-cbdcom-cyberscitech49142.2020.00109
Kubek V. Digitalisierung in Der Pflege: Überblick über Aktuelle Ansätze. Digitalisierung in Der Pflege: Zur Unterstützung Einer Besseren Arbeitsorganisation. Berlin, Heidelberg: Springer Vieweg; 2020. pp. 15–20. https://doi.org/10.1007/978-3-662-61372-6_3 .
doi: 10.1007/978-3-662-61372-6_3
Lu L, Liang C, Gu D, Ma Y, Xie Y, Zhao S. What advantages of blockchain affect its adoption in the elderly care industry? A study based on the technology–organisation–environment framework. Technol Soc. 2021;67:101786. https://doi.org/10.1016/j.techsoc.2021.101786 .
doi: 10.1016/j.techsoc.2021.101786
Mackey T, Bekki H, Matsuzaki T, Mizushima H. Examining the potential of Blockchain Technology to meet the needs of 21st-Century Japanese Health Care: viewpoint on use cases and policy. J Med Internet Res. 2020;22(1):e13649. https://doi.org/10.2196/13649 .
doi: 10.2196/13649 pubmed: 31917371 pmcid: 6996742
Mayring P. Qualitative Inhaltsanalyse. Handbuch Qualitative Forschung in der Psychologie; Mey, G., Mruck, K., Eds, 495–511. 2019; https://doi.org/10.1007/978-3-658-26887-9_52
McGhin T, Choo K, Liu CZ, He D. Blockchain in healthcare applications: research challenges and opportunities. J Netw Comput Appl. 2019;135:62–75. https://doi.org/10.1016/j.jnca.2019.02.027 .
doi: 10.1016/j.jnca.2019.02.027
Mkpa A, Chin J, Winckles A. Holistic Blockchain Approach to Foster Trust, Privacy and Security in IoT Based Ambient Assisted Living Environment. In: 2019 15th International Conference on Intelligent Environments (IE), 52–55, 2019; https://doi.org/10.1109/ie.2019.00008
Oláh J, Krisán E, Kiss A, Lakner Z, Popp J. PRISMA Statement for reporting literature searches in systematic reviews of the Bioethanol Sector. Energies. 2020;13(9):2323. https://doi.org/10.3390/en13092323 .
doi: 10.3390/en13092323
Rahman MA, Abualsaud K, Barnes SJ, Rashid MM, Abdullah SM. A Natural User Interface and Blockchain-Based In-Home Smart Health Monitoring System. In: 2020 IEEE International Conference on Informatics, IoT, and Enabling Technologies (ICIoT), 262–266. 2020; https://doi.org/10.1109/iciot48696.2020.9089613
Rosa M, Fariab C, Barbosac AM, Martinsa AI, Almeidaa AF, Rocha NP. A platform of services to support community-dwelling older adults integrating fhir and complex security mechanisms. Procedia Comput Sci. 2019;160:314–21. https://doi.org/10.1016/j.procs.2019.11.085 .
doi: 10.1016/j.procs.2019.11.085
Rosa M, Barraca JP, Rocha NP. Blockchain structures to guarantee logging integrity of a digital platform to support community-dwelling older adults. Cluster Comput. 2020;23(3):1887–98. https://doi.org/10.1007/s10586-020-03084-4 .
doi: 10.1007/s10586-020-03084-4
Royal D, Rimba P, Staples M, Gilder S, Tran A, Williams E, Ponomarev A, Weber I, Connor C, Lim N. Making money smart: Empowering NDIS participants with blockchain technologies. Report by CSIRO and Commonwealth Bank of Australia. 2018; https://data61.csiro.au/en/our-research/our-work/smartmoney . Accessed 18 Feb 2021.
Rupasinghe T, Burstein F, Rudolph C, Strange S. Towards a Blockchain based Fall Prediction Model for Aged Care. In: Proceedings of the Australasian Computer Science Week Multiconference, 1–10, 2019; https://doi.org/10.1145/3290688.3290736
Saha B, Islam MS, Kamrul Riad A, Tahora S, Shahriar H, Sneha S, BlockTheFall. Wearable Device-based Fall Detection Framework Powered by Machine Learning and Blockchain for Elderly Care. In: 2023 IEEE 47th Annual Computers, Software, and Applications Conference (COMPSAC), 1412–1417, 2023; https://doi.org/10.48550/arXiv.2306.06452
Salim TA, El Barachi M, Mohamed AAD, Halstead S, Babreak N. The mediator and moderator roles of perceived cost on the relationship between organizational readiness and the intention to adopt blockchain technology. Technol Soc. 2022;71:102108. https://doi.org/10.1016/j.techsoc.2022.102108 .
doi: 10.1016/j.techsoc.2022.102108
Sanda O, Pavlidis M, Polatidis N. A Regulatory Readiness Assessment Framework for Blockchain Adoption in Healthcare. Digital. 2022;2(1):65–87. https://doi.org/10.3390/digital2010005 .
doi: 10.3390/digital2010005
Saraf K, Bajar K, Jain A, Barve A. Assessment of barriers impeding the incorporation of blockchain technology in the service sector: a case of hotel and health care. J Modelling Manage. 2023;19(2):407–40. https://doi.org/10.1108/jm2-06-2022-0159 .
doi: 10.1108/jm2-06-2022-0159
Schoville R. Discovery of implementation factors that lead to Technology Adoption in Long-Term Care. J Gerontol Nurs. 2017;43(10):21–6. https://doi.org/10.3928/00989134-20170914-06 .
doi: 10.3928/00989134-20170914-06 pubmed: 28945269
Seifert A, Thilo FJ. Digitale Transformation Im stationären Altersbereich. Zeitschrift für Gerontologie Und Geriatrie. 2020;54(8):795–801. https://doi.org/10.1007/s00391-020-01789-0 .
doi: 10.1007/s00391-020-01789-0 pubmed: 33005983 pmcid: 8636400
Sharma A, Venkatraman S. Towards a Standard Framework for Organizational Readiness for Technology Adoption. In: advances in Digital Manufacturing systems: technologies, Business models, and adoption. Singapore: Springer Nat Singap. 2023;197–219. https://doi.org/10.1007/978-981-19-7071-9 .
Spencer-Hicken S, Schutte CSL, Vlok PJ. Blockchain feasibility assessment: a quantitative approach. Front Blockchain. 2023;6:1067039. https://doi.org/10.3389/fbloc.2023.1067039 .
doi: 10.3389/fbloc.2023.1067039
Spinsante S, Poli A, Mongay Batalla J, Krawiec P, Dobre C, Bajenaru L, Mavromoustakis CX, Costantinou CS, Molan G, Herghelegiu AM, Prada GI, Drăghici R, González-Vélez H. Clinically-validated technologies for assisted living. J Ambient Intell Humaniz Comput. 2023;14(3):2095–116. https://doi.org/10.1007/s12652-021-03419-y .
doi: 10.1007/s12652-021-03419-y
Tanniru MR, Woo C, Dutta K. A conceptual model to Share resources and align goals: Building Blockchain Application to Support Care Continuity outside a hospital. J Risk Financial Manage. 2023;16(4):247. https://doi.org/10.3390/jrfm16040247 .
doi: 10.3390/jrfm16040247
Trukeschitz B, Österle A, Schneider U. Austria’s Long-Term Care System: challenges and Policy responses. J Long-Term Care. 2022. https://doi.org/10.31389/jltc.112 .
doi: 10.31389/jltc.112
Tsang YP, Wu CH, Leung PPL, Ip WH, Ching WK. Blockchain-IoT-Driven nursing workforce planning for effective long-term care management in nursing homes. J Healthc Eng. 2021;2021(1):9974059. https://doi.org/10.1155/2021/9974059 .
doi: 10.1155/2021/9974059 pubmed: 34804463 pmcid: 8604611
Vaigandla KK, Karne R, Siluveru M, Kesoju M. Review on blockchain technology: architecture, characteristics, benefits, algorithms, challenges and applications. Mesopotamian Journal of CyberSecurity, 2023, 73–84, 2023; https://doi.org/10.58496/MJCS/2023/012
Vasilateanu A, Diaconu AT. Ambient Assisted Living Environment based on Blockchain for Elderly Care. In: International Conference on e-Health and Bioengineering (EHB), pp. 1–4, 2020; https://doi.org/10.1109/ehb50910.2020.9280203
Velmovitsky PE, Miranda PADSES, Vaillancourt H, Donovska T, Teague J, Morita PP. A blockchain-based consent platform for active assisted living: modeling study and conceptual Framework. J Med Internet Res. 2020;22(12):e20832. https://doi.org/10.2196/20832 .
doi: 10.2196/20832 pubmed: 33275111 pmcid: 7748951
Wright SA. Organizational Readiness/Maturity considerations for Blockchain Adoption. In: Handbook of Research on Digital Transformation Management and Tools. IGI Global. 2022;344–65. https://doi.org/10.4018/978-1-7998-9764-4.ch016 .
Zhang W, Wei CP, Jiang Q, Peng CH, Zhao JL. Beyond the Block: a Novel Blockchain-based technical Model for Long-Term Care Insurance. J Manage Inform Syst. 2021;38(2):374–400. https://doi.org/10.1080/07421222.2021.1912926 .
doi: 10.1080/07421222.2021.1912926
Zhang X, Xu Q. Research on Time Bank’s Mutual-support Old-aged Care Mode Based on Blockchain Technology. In: E3S Web of Conferences, Vol. 251, p. 01068, EDP Sciences, 2021; https://doi.org/10.1051/e3sconf/202125101068
Zhang Y. Application of Blockchain Technology in Community-Based Home Elderly Care Services under Population Aging. In: Proceedings of the 11th International Conference on Software and Information Engineering, pp. 86–91, 2022; https://doi.org/10.1145/3571513.3571528

Auteurs

Beate Steurer (B)

Research Institute for Economics of Aging, WU Vienna University of Economics and Business, Welthandelsplatz 1, D5, Vienna, 1020, Austria. beate.steurer@wu.ac.at.

Birgit Trukeschitz (B)

Research Institute for Economics of Aging, WU Vienna University of Economics and Business, Welthandelsplatz 1, D5, Vienna, 1020, Austria.

Ulrike Schneider (U)

Institute for Social Policy, Department of Socioeconomics, WU Vienna University of Economics and Business, Welthandelsplatz 1, D4, Vienna, 1020, Austria.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH