Mapping Distributed Ledger Technology Characteristics to Use Cases in Healthcare: A Structured Literature Review

Following the success of the Bitcoin blockchain, distributed ledger technology (DLT) has received extensive attention in health informatics research. Yet, the healthcare industry is highly complex with many different stakeholders, information systems, regulations, and challenges. Thus, DLT may be used in various settings and for different purposes. First surveys have started to synthesize our knowledge of the different use cases, in which healthcare may benefit from DLT implementations. However, an in-depth understanding of whether and how these use cases differ concerning their requirements of DLT characteristics (i.e., technical or administrative design features) is still lacking. In this work, we conducted a structured review of 185 studies on DLT-based applications in healthcare. The results reveal six pertinent use cases, each with its own combination of different purposes that DLT is used for. Furthermore, our study shows that each of these use cases has a unique set of requirements with regard to the most important DLT characteristics. In doing so, we seek to guide practitioners in the development of highly effective DLT-based applications in various healthcare settings and pave the way for future research to investigate the understudied areas of DLT-based applications in healthcare.