A Survey of Distributed Ledger Technologies in the Health Domain

Healthcare providers face critical challenges in managing and exchanging patient health and medical records. Traditional health and medical data management systems, which often include paper-based records and work as closed, isolated silos, have demonstrated limitations in terms of data usability, interoperability, and patient privacy. This translates into limitations not only for providers but also for the patients, healthcare professionals, and other participants of the health-care value chain, hindering potential innovations and efficiency gains. Distributed Ledger Technology (DLT), such as the blockchain, is emerging as a possible solution to challenges in data management and beyond across several operational and administrative processes in healthcare services. This paper begins with an extensive overview of the literature with an emphasis on DLT implementations and applications in the healthcare industry. We examine how DLT has been used in real-world initiatives across the healthcare domain, highlight notable initiatives, and outline potential improvements. This may result from its adoption, namely in areas such as healthcare data sharing and interoperability, verifiability, transparency, or patient privacy and control. Overall, some of DLT's native capabilities, such as data immutability, sharing and reconciliation across parties with varying levels of trust, and user self-sovereignty may translate into solutions for several caveats of the current healthcare technological infrastructures, and contribute to improving healthcare outcomes by fostering innovations, enabling broader sharing of healthcare data, enhancing transparency over the use of data, equipping patients with greater control over their data, and enabling new or improved services and processes in healthcare.