Smart Contracts and Shared Platforms in Sustainable Health Care: Systematic Review.

IF 3.1 3区 医学 Q2 MEDICAL INFORMATICS
Carlos Antonio Marino, Claudia Diaz Paz
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引用次数: 0

Abstract

Background: The benefits of smart contracts (SCs) for sustainable health care are a relatively recent topic that has gathered attention given its relationship with trust and the advantages of decentralization, immutability, and traceability introduced in health care. Nevertheless, more studies need to explore the role of SCs in this sector based on the frameworks propounded in the literature that reflect business logic that has been customized, automatized, and prioritized, as well as system trust. This study addressed this lacuna.

Objective: This study aimed to provide a comprehensive understanding of SCs in health care based on reviewing the frameworks propounded in the literature.

Methods: A structured literature review was performed based on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) principles. One database-Web of Science (WoS)-was selected to avoid bias generated by database differences and data wrangling. A quantitative assessment of the studies based on machine learning and data reduction methodologies was complemented with a qualitative, in-depth, detailed review of the frameworks propounded in the literature.

Results: A total of 70 studies, which constituted 18.7% (70/374) of the studies on this subject, met the selection criteria and were analyzed. A multiple correspondence analysis-with 74.44% of the inertia-produced 3 factors describing the advances in the topic. Two of them referred to the leading roles of SCs: (1) health care process enhancement and (2) assurance of patients' privacy protection. The first role included 6 themes, and the second one included 3 themes. The third factor encompassed the technical features that improve system efficiency. The in-depth review of these 3 factors and the identification of stakeholders allowed us to characterize the system trust in health care SCs. We assessed the risk of coverage bias, and good percentages of overlap were obtained-66% (49/74) of PubMed articles were also in WoS, and 88.3% (181/205) of WoS articles also appeared in Scopus.

Conclusions: This comprehensive review allows us to understand the relevance of SCs and the potentiality of their use in patient-centric health care that considers more than technical aspects. It also provides insights for further research based on specific stakeholders, locations, and behaviors.

可持续医疗中的智能合约和共享平台:系统综述。
背景:智能合约(SCs)对可持续医疗保健的好处是一个相对较新的话题,由于其与信任的关系以及医疗保健中引入的去中心化、不变性和可追溯性的优势,它引起了人们的关注。然而,更多的研究需要基于文献中提出的框架来探索SCs在这一领域的作用,这些框架反映了定制化、自动化和优先化的业务逻辑,以及系统信任。本研究解决了这一空白。目的:本研究旨在通过回顾文献中提出的框架,全面了解SCs在医疗保健中的作用。方法:根据PRISMA(系统评价和荟萃分析首选报告项目)原则进行结构化文献综述。选择web of Science (WoS)数据库是为了避免由于数据库差异和数据争用而产生的偏差。对基于机器学习和数据简化方法的研究进行了定量评估,并对文献中提出的框架进行了定性、深入、详细的审查。结果:70篇研究符合入选标准,占本课题研究的18.7%(70/374)。多重对应分析(74.44%的惯性)产生了描述该主题进展的3个因素。其中两个提到了SCs的主要作用:(1)改善医疗流程和(2)确保患者隐私保护。第一个角色包含6个主题,第二个角色包含3个主题。第三个因素包括提高系统效率的技术特征。对这3个因素的深入审查和利益相关者的识别使我们能够表征医疗保健SCs的系统信任。我们评估了覆盖偏倚的风险,获得了良好的重叠百分比——66%(49/74)的PubMed文章也出现在WoS中,88.3%(181/205)的WoS文章也出现在Scopus中。结论:这项全面的综述使我们能够了解SCs的相关性以及它们在以患者为中心的医疗保健中使用的潜力,而不仅仅是技术方面。它还为基于特定利益相关者、地点和行为的进一步研究提供了见解。
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来源期刊
JMIR Medical Informatics
JMIR Medical Informatics Medicine-Health Informatics
CiteScore
7.90
自引率
3.10%
发文量
173
审稿时长
12 weeks
期刊介绍: JMIR Medical Informatics (JMI, ISSN 2291-9694) is a top-rated, tier A journal which focuses on clinical informatics, big data in health and health care, decision support for health professionals, electronic health records, ehealth infrastructures and implementation. It has a focus on applied, translational research, with a broad readership including clinicians, CIOs, engineers, industry and health informatics professionals. Published by JMIR Publications, publisher of the Journal of Medical Internet Research (JMIR), the leading eHealth/mHealth journal (Impact Factor 2016: 5.175), JMIR Med Inform has a slightly different scope (emphasizing more on applications for clinicians and health professionals rather than consumers/citizens, which is the focus of JMIR), publishes even faster, and also allows papers which are more technical or more formative than what would be published in the Journal of Medical Internet Research.
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