Qualitative Study of Participant Impressions as Simulated Patients of MediLinker—A Blockchain-Based Identity Verification Application

Abstract

Objective In this study, we obtained participants' views on using MediLinker—a blockchain-based identity verification and personal health information management application. We also gathered their views about the use of blockchain technology for controlling and managing personal health information, especially in the context of a global health crisis such as a pandemic. Methods Online semistructured interviews were conducted with 29 simulated patients (i.e., avatars) who used MediLinker between February and May 2020. Interview data were analyzed qualitatively using a phenomenological approach to thematic analysis. Results Most of the participants noted that they do not know what blockchain is nor understand how it works. Nonetheless, in the context of the study, they trust blockchain as a technology that can enhance data protection and privacy of their personal health information. Participants noted that MediLinker is a useful application that allows patients to easily input, share, and revoke personal health information. As a proof-of-concept application, participants also noted several issues and recommendations that can serve as points of improvement when developing subsequent versions of MediLinker. In the context of using MediLinker as part of a telemedicine system during a pandemic, participants noted that it facilitates social distancing, makes clinical transactions efficient and convenient, and enhances identity verification. Conclusion In general, the findings lay the foundation for a user-centered approach in developing future iterations of MediLinker and other patient-facing blockchain-based health information technologies. Also, the findings provide important insights into how people perceive blockchain-based health information technologies, especially during a pandemic.

MediLinker: a blockchain-based decentralized health information management platform for patient-centric healthcare

“…In addition, patients can share their data, such as medication lists, research consent, credit card, and digital guardianship, with their healthcare providers (Harrell et al, 2022 ). Our results showed the feasibility of MediLinker's framework and workflows through simulated primary care clinic scenarios during in-person and virtual sessions using synthetic patient data (for more details, see Khurshid et al, 2021 ) and usability study with simulated patients (for more details, see Bautista et al, 2022a ). More importantly, a focus group discussion with experts provided us with valuable insights on clinical (e.g., integration with existing clinical systems and adoption of clinicians), organizational and regulatory (e.g., accountability compliance, and legal safeguards), and ethical and social (e.g., trust, transparency, digital divide, health-related digital autonomy) issues when implementing MediLinker in clinical settings (for more details, see Bautista et al, 2022b ).…”

“…Initially, we compiled findings from our team's previous studies (e.g., Kelly et al, 2019 ; Abdul-Moheeth et al, 2022 ; Bautista et al, 2022a , b ; Harrell et al, 2022 ) to guide the design and development of a fully functional MediLinker iOS application that could be used by patients and healthcare staff in primary care clinics. Moreover, we conducted a survey in August 2022 among 913 US adults (recruited via Amazon Mechanic Turk) to understand their willingness to use MediLinker, including factors that lead to potential adoption.…”