Scalability Challenges in Healthcare Blockchain System—A Systematic Review

Abstract

Blockchain technology is a private, secure, trustworthy, and transparent information exchange performed in a decentralised manner. In this case, the coordination and validation efforts are simplified as the records are designed to update regularly and there is no difference in the two databases. This review focuses on how the blockchain addresses scalability challenges and provides solutions in the healthcare field through the implementation of blockchain technology. Accordingly, 16 solutions fell under two main areas, namely storage optimization and redesign of blockchain. However, limitations persist, including block size, high volume of data, transactions, number of nodes, and protocol challenges. This review consists of six stages, namely identification of research question, procedures of research, screening of relevant articles, keywording based on the abstract, data extraction, and mapping process. Through Atlas.ti software, the selected keywords were used to analyse through the relevant articles. As a result, 48 codes and 403 quotations were compiled. Manual coding was performed to categorise the quotations. The codes were then mapped onto the network as a mapping process. Notably, 16 solutions fell under two main areas, namely storage optimization and redesign of blockchain. Basically, there are 3 solutions compiled for storage optimization and 13 solutions for the redesign of the blockchain, namely blockchain modelling, read mechanism, write mechanism, and bi-directional network.

The role of blockchain technology in telehealth and telemedicine

“…Blockchain-enabled telemedicine and telehealth services require close coordination and collaboration among healthcare participants to maintain a consistent and up-to-date medical history of a patient to minimize medical diagnosis errors. Thus, telehealth services can generate an enormous amount of data that requires fast data processing to obtain insights from the health data [87] . However, in the current blockchain platforms, the large amount of healthcare data affects transaction fees and total waiting time of a transaction to be confirmed [88] , [89] .…”

Blockchain-based framework for secure and reliable land registry system

“…The blockchain categorized based on Public or private and the permission of peer in the network. The tampering with the authentic transitions in land registry record or the efforts to temper the old records creates the audit trail on the ledger [28]. The blockchain technology permits to have peer defined chains for the entry of the transactions, Peer-based validation of entries, a consensus mechanism for storing the entries and a medium to guarantee the security of the system [5,29].…”

The Role of Blockchain Technology in Telehealth and Telemedicine

“…Blockchain-enabled telemedicine and telehealth services require close coordination and collaboration among healthcare participants to maintain a consistent and up-to-date medical history of a patient to minimize medical diagnosis errors. Thus, telehealth services can generate an enormous amount of data that requires fast data processing to obtain insights from the health data [65]. However, in the current blockchain platforms, the large amount of healthcare data affects transaction fees and total waiting time of a transaction to be confirmed [66,67].…”