@文章{info:doi/10.2196/19846，作者="Fatoum, Hanaa和Hanna, Sam和Halamka, John D和Sicker, Douglas C和Spangenberg, Peter和Hashmi, Shahrukh K"，标题="区块链与数字技术的集成和医疗保健生态系统的未来:系统综述"，期刊="J医学互联网研究"，年="2021"，月="11"，日="2"，卷="23"，数="11"，页="e19846"，关键词="区块链，物联网;数字;人工智能;机器学习;电子健康;分类帐;背景:在大数据、人工智能(AI)和物联网(IoT)的时代，数字数据对我们的日常运作和医疗保健服务已经变得至关重要。医疗保健数据的敏感性提出了一些关键问题，如隐私、安全性、互操作性和可靠性，这些问题在任何医疗保健数据管理系统中都必须解决。然而，目前大多数卫生保健系统仍然面临着重大障碍，在其中一些领域还存在不足。这就是去中心化、安全和可扩展的数据库(尤其是区块链)在不影响安全的情况下满足这些需求方面发挥关键作用的地方，从而在医疗保健社区中吸引了相当大的兴趣。 A blockchain can be maintained and widely distributed using a large network of nodes, mostly computers, each of which stores a full replica of the data. A blockchain protocol is a set of predefined rules or procedures that govern how the nodes interact with the network, view, verify, and add data to the ledger. Objective: In this article, we aim to explore blockchain technology, its framework, current applications, and integration with other innovations, as well as opportunities in diverse areas of health care and clinical research, in addition to clarifying its future impact on the health care ecosystem. We also elucidate 2 case studies to instantiate the potential role of blockchains in health care. Methods: To identify related existing work, terms based on Medical Subject Headings were used. We included studies focusing mainly on health care and clinical research and developed a functional framework for implementation and testing with data. The literature sources for this systematic review were PubMed, Medline, and the Cochrane library, in addition to a preliminary search of IEEE Xplore. Results: The included studies demonstrated multiple framework designs and various implementations in health care including chronic disease diagnosis, management, monitoring, and evaluation. We found that blockchains exhibit many promising applications in clinical trial management such as smart-contract application, participant-controlled data access, trustless protocols, and data validity. Electronic health records (EHRs), patient-centered interoperability, remote patient monitoring, and clinical trial data management were found to be major areas for blockchain usage, which can become a key catalyst for health care innovations. Conclusions: The potential benefits of blockchains are limitless; however, concrete data on long-term clinical outcomes based on blockchains powered and supplemented by AI and IoT are yet to be obtained. Nonetheless, implementing blockchains as a novel way to integrate EHRs nationwide and manage common clinical problems in an algorithmic fashion has the potential for improving patient outcomes, health care experiences, as well as the overall health and well-being of individuals. ", issn="1438-8871", doi="10.2196/19846", url="//www.mybigtv.com/2021/11/e19846", url="https://doi.org/10.2196/19846", url="http://www.ncbi.nlm.nih.gov/pubmed/34726603" }