TY - JOUR AU - Fatoum, Hanaa AU - Hanna, Sam AU - Halamka, John D AU - Sicker, Douglas C AU - Spangenberg, Peter AU - Hashmi, Shahrukh K PY - 2021 DA - 2021/11/2 TI -区块链与数字技术的整合和卫生保健生态系统的未来:JO - J Med Internet Res SP - e19846 VL - 23 IS - 11 KW -区块链，物联网KW -数字KW -人工智能KW -机器学习KW - eHealth KW -账本KW -分布式账本技术AB -背景:在大数据、人工智能(AI)和物联网(IoT)的时代，数字数据已经成为我们日常运作和医疗保健服务中必不可少的一部分。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。可以使用大型节点网络(主要是计算机)维护和广泛分布区块链，每个节点都存储数据的完整副本。区块链协议是一组预定义的规则或过程，用于管理节点如何与网络交互、查看、验证以及向分类帐添加数据。目的:在本文中，我们旨在探索区块链技术、它的框架、目前的应用、与其他创新的集成，以及在医疗保健和临床研究的不同领域的机会，并阐明其对医疗保健生态系统的未来影响。我们还阐明了2个案例研究，以实例说明区块链在医疗保健中的潜在作用。方法:为了确定现有的相关工作，使用了基于医学主题标题的术语。 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. SN - 1438-8871 UR - //www.mybigtv.com/2021/11/e19846 UR - https://doi.org/10.2196/19846 UR - http://www.ncbi.nlm.nih.gov/pubmed/34726603 DO - 10.2196/19846 ID - info:doi/10.2196/19846 ER -