Blockchain technology

: the future basis for german electronic patient records or just hype?

Abstract

In January 2021, Germany launched its electronic patient record (ePA) based on the telematic infrastructure. Its introduction is accompanied by several concerns around domains like security, interoperability, usability, and the technological architecture in general. Blockchain technology for patient records pledges to solve some of these issues along with providing additional value. However, blockchain research often lacks consistent definitions. This paper seeks to analyze the actual impact blockchain could have on the German ePA. Incorporating case studies and expert interviews, it concludes that the impact of blockchain is dependent on its application. If applied to specific features of the ePA, it could increase integrity, prevent fraud, and therefore might lower healthcare expenses. If blockchain were to serve as a basic framework for the ePA, it would break data silos, enhance patient self-sovereignty, also paving the way for monetization of data and improving data quality and quantity for scientific research. If blockchain were to be applied in a broader context, it might lead to a new paradigm of a decentralized economy and society. A scenario planning approach indicates that the integration of specific blockchain-supported features in the ePA such as recording of patient consent is the most likely prospect within the next ten years. An ePA architecture completely supported by blockchain or even a broader application of blockchain in German healthcare seems less realistic.

Date of Award	9 Jul 2021
Original language	English
Awarding Institution	Universidade Católica Portuguesa
Supervisor	Peter V. Rajsingh (Supervisor) & André de Almeida Pinho (Co-Supervisor)