Digital transformation in the healthcare sector through blockchain technology. Insights from academic research and business developments

Highlights

• Despite the potential benefits, practitioners seem to be skeptical to the application of blockchain in healthcare.

• Comparing results from papers and patents could help clarify the research-practice gap.

• Results indicate that the two approaches are converging but also show the development of a dark side.

• Social dominance, use of grand theories, value creation, and technology acceptance are insights for scholars.

• The human element and the need for standards are relevant for practitioners and policymakers.

Abstract

Healthcare research is a multidisciplinary field that looks at the entire stakeholder ecosystem. Digital transformation could assist in the resolution of problems in medical practice by introducing new value creation trends. Blockchain technology has the potential to help speed up this digital transformation process by reducing certain elements, such as data management issues. As with any new technology, its actual value must be shown because it is based on expectations rather than solid facts. This study compares the findings of a content analysis focused on papers and patents with the aim of presenting data on the expectations for blockchain implementation in the healthcare sector. While the papers provide the perspective of researchers, patents should depict the expectation of the companies and investors patenting their inventions. Comparing data from papers and patents, this paper aims to help close the research-practice gap by showing how the two expectations for blockchain application in the healthcare sector are evolving.

Introduction

While the existing literature has improved our understanding of specific aspects of digital transformation (Gong and Ribiere, 2021), in several contexts we still lack a detailed picture of its existence and consequences (Sebastian et al., 2017). Previous studies have focused on the role of digital technologies to trigger strategic changes (Urbinati et al., 2019), disrupt the way organizations create and transfer value (Chirumalla, 2021; Tian et al., 2021), and manage the social and organizational structural modifications required (Vial, 2019). However, according to Sebastian et al. (2017, p. 198), “Most big old companies' digital transformations are at an early stage—in most industries, the vast majority of established companies’ revenues still come from traditional products and services.” Similarly, digital transformation can have multiple positive effects within the healthcare sector in supporting current challenges, such as empowering a patient-centric approach, increasing operational efficiency, and supporting workflow practices (Kraus et al., 2021). However, although digital transformation has been widely analyzed and has become a trendy topic for many streams of business research, it still lacks appropriate attention to the various managerial applications (Kraus et al., 2021). While there is growing attention to digital transformation in many sectors, research and practical applications in the healthcare sector still seem fragmented and at the beginning of the journey.

Trust in data handling and security are considered among the most important reasons the healthcare sector lags behind in the implementation of digital transformation (Kraus et al., 2021). Interestingly, blockchain technology could be helpful in handling, sharing, and processing personal health records, reducing data security issues and supporting the digital transformation of the healthcare sector (Tandon et al., 2020). However, while organizations are making significant investments in blockchain-based technology, they are also taking a conservative approach due to a widespread view that the benefits might be exaggerated (Iansiti and Lakhani, 2017). Thus, while digital transformation potentially affects healthcare, the lack of trust and the fear of data security combine to limit its development. Blockchain technology can reduce the problem, but further studies are required to test its validity.

This paper contributes to the special issue on digital transformation in healthcare, understanding “the potential applications of novel digital technologies … for innovating the healthcare ecosystem.” More precisely, following the call for the special issue, this study investigates “technological trends and breakthroughs for disruptive innovation in healthcare,” with a focus on blockchain technology. As a young research field, most of the studies focused on this topic employ qualitative approaches based on case studies that allow in-depth analysis but limit the generalizability of the findings (Kraus et al., 2021). Previous studies have also highlighted that the potential benefits derived from academic research are not applied due to a gap between research and practice (Makin, 2021). In further analyzing the theoretical benefits of blockchain solutions, there is therefore also a need to understand how business entities are implementing blockchain solutions to support further practical applications of this technology.

This study seeks to answer this call by analyzing how blockchain has been studied in published papers and implemented in patented inventions through content analysis. Content analysis is an umbrella term used to extract information from a broad set of documents (Krippendorff, 2013). When employed with patents, it is used for handling technology analysis, forecasting technological developments, and providing highlights on future competitions based on emerging technology. When applied to research papers, it is used for reviewing a corpus of scholarly literature to generate new ideas, engage in critical reflections, identify future research directions, and create research questions (Massaro et al., 2016). Patent and publication sources are commonly used to chart the evolution of technologies, and the use of multiple data sources allows comparison of different outcomes of research and inventions (Goeldner et al., 2015). Indeed, patent databases provide information on technical innovations and patterns of technological advancement, while publication databases provide information on scientific advances (Kumari et al., 2019).

This paper is novel in several ways. First, to the best of our knowledge, this is the first attempt that combines scientific papers and patent inventions in the field of blockchain in the healthcare sector, and therefore enlarges previous studies that mainly focused on scientific sources (Abu-elezz et al., 2020; Attaran, 2020; Hasselgren et al., 2020). Previous studies have used this approach to study several other technologies, such as care robotics (Goeldner et al., 2015) and emerging technologies in general (Daim et al., 2006). Second, this study enlarges previous literature reviews using broader keyword search terms that includes smart contracts and distributed ledgers (Tandon et al., 2020). Third, an analysis of word co-occurrences was used for theme extraction. This approach makes “the analyst aware of the global context and significance of concepts and … help avoid fixation on particular anecdotal evidence, which may be atypical or erroneous” (Smith and Humphreys, 2006, p. 262).

The rest of the paper is organized as follows. The next section describes the background of the study, beginning with the current challenges of digital transformation in healthcare, followed by a presentation of blockchain technology, and a discussion of how blockchain technology is a controversial topic, as well as presenting the research questions. The following section illustrates the methodology used. The findings and discussion sections depict the main results. The conclusion section ends the paper.