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.

Keywords

• Blockchain
• healthcare
• scalability
• systematic review