Introduction

The fusion of artificial intelligence (AI) and blockchain technology holds promise for revolutionising healthcare, reshaping how we diagnose, treat and manage disease. Health informatics,  budgeting, personnel management, patient care, legal matters, logistics and supplies typically involve a series of sequential steps that can be visualised as repeated activities in medical workflows.¹ In 2016, blockchain was first proposed for healthcare to streamline inefficient processes, tackle organisational challenges and facilitate secure electronic transfers and exchange of healthcare records.² With AI's capacity to analyse vast datasets and blockchain's secure, decentralised structure, the healthcare industry stands poised for significant advancements.

What is blockchain technology?

Blockchain operates as a decentralised peer-to-peer (P2P) network of personal computers known as nodes, responsible for maintaining, storing and recording transactional or historical data.

Blockchain revolutionises healthcare organisations by enabling enhanced patient care and high-quality health facilities. It addresses the inefficiencies of Health Information Exchange, reducing costs in the healthcare industry significantly. Citizens can participate in health study programs through Blockchain technology, promoting better research and sharing of public health data to improve treatment outcomes for diverse communities. Unlike centralised databases used in managing healthcare systems and organisations, Blockchain offers a decentralised approach that enhances security, transparency, and efficiency in data management and exchange.³

Significance of AI in healthcare

The integration of AI into hospitals and clinics marks a significant transformation in medical care delivery and management. AI in healthcare now covers a wide range of applications.⁴ In clinical settings, it aids in diagnosing diseases, predicting patient outcomes and personalising treatment plans.⁵ In hospital management, AI enhances operational efficiency, streamlines administrative tasks and improves patient flow and scheduling.⁶ In medical diagnostics, AI boosts the accuracy and speed of image analysis in radiology and pathology. Additionally, AI revolutionises patient care through remote monitoring, telemedicine and virtual assistance, fundamentally changing the patient–doctor interaction paradigm.⁷

Applications of blockchain with AI in healthcare

Maintaining patient records

During the stages of  clinical studies, substantial quantities of patient information and health data is generated including blood tests, quality assessments, estimates and wellness surveys. AI is used for  easy assembling of these records. Blockchain will verify the existence and integrity of these documents or records. Healthcare providers can seamlessly verify the validity of stored data by comparing it with the original records on the blockchain system. Blockchain uses cryptographic techniques, providing a secure framework for data sharing. Patient details, such as name, date of birth, diagnosis, treatments and medical history are recorded in EHR format and stored in cloud computing or existing databases.⁸

Safety and transparency

Consensus algorithms are a proven technique for collective decision-making in AI-based healthcare systems, especially for diagnosis and treatment. In blockchain, transactions are validated by algorithms before being linked to the chain, ensuring authenticity through encryption, digital signatures and secure storage. Healthcare companies, technology innovators and the industry are exploring blockchain's current capabilities and its potential to enhance safety and reduce costs. Blockchain can revolutionise the health ecosystem where healthcare management can effectively validate results.⁹

Patient monitoring

AI enhances patient monitoring through telemedicine integration and wearable biosensors, termed as an Internet of Things (IoT), whereas blockchain technology enhances patient monitoring by tracking room temperatures, bed usage and supply availability. A blockchain healthcare network can create a secure digital identity for healthcare institutions and providers. Integrating blockchain with IoT technologies improves supply chain responsiveness and traceability, making healthcare logistics more transparent and enabling better patient monitoring.¹⁰

Research initiatives

Blockchain has the potential to automate and modernise the processing of membership claims and disputes. Blockchain may mobilise new and creative research initiatives by exchanging patient data more efficiently. Further, the exchange of patient findings in greater depth will create new and creative research opportunities, leading to an extraordinary partnership between participants and researchers. This technology will positively impact the management of patient referrals. Once a patient consults the doctor and a therapy schedule is designed, the therapy package will be applied as part of the patient care record to the Blockchain.¹¹

Advantages of blockchain technology

Blockchain's decentralisation distributes data across a network, enhancing security and minimising the risk of data manipulation or centralised failures, giving users control over their data. Its immutability ensures data integrity, as recorded information cannot be altered or deleted, although errors are permanent. Extensive transparency, where all transactions are recorded on a public ledger, builds trust while also prompting privacy considerations. Strong cryptographic security protects the blockchain, though applications on it can be vulnerable. Blockchain cuts transaction costs by removing intermediaries but requires significant initial investments. It boosts efficiency by automating processes, crucial for sectors like finance and healthcare.¹² In healthcare, blockchain ensures credible clinical trial records, secure network infrastructure, verified participant identities, and standardised access to electronic health information. It also monitors pharmaceutical supply chains and tracks medication requirements.¹³

Limitations of blockchain technology

Even though integration of blockchain with AI has tremendous potential there are certain limitations to this technology. Scalability remains a critical issue for blockchain networks which struggle to maintain speed and efficiency as they grow. Self-maintenance of blockchain networks requires significant resources, particularly for Proof of Work systems, ensuring network integrity and performance. While innovations such as the Lightning Network and sharding are under exploration, more robust solutions are required. Moreover, blockchain’s unique data structure and operational mechanisms differ greatly from traditional databases, requiring companies to overhaul existing systems. This process is expensive, time-consuming, and demands technical expertise that may not be readily available, making user-friendly integration tools essential for broader adoption.

High Energy Consumption is a notable drawback for Blockchain, particularly for networks using Proof of Work (PoW), which requires substantial computational power. This results in high energy usage, raising environmental concerns as the energy often comes from non-renewable sources.

Complexity and interoperability issues also hinder adoption. Integration into existing systems is challenging due to compatibility issues and the need for substantial technical expertise. Understanding blockchain requires knowledge of distributed ledgers, encryption and consensus algorithms, posing a barrier for individuals and businesses. Simplifying the technology is crucial for wider use.Network security disruptions, around 51% of attacks, threaten blockchain integrity, requiring vigilant security measures and constant monitoring. Slow processing speed due to consensus mechanisms can hinder applications requiring rapid transactions. Balancing speed with security and decentralisation is crucial. Private key management is hence crucial for security but complex, posing a risk for users unfamiliar with digital asset management.

Governance Issues with uncertain regulations create an unpredictable environment, deterring investment and complicating blockchain project development. This can affect decentralised networks, where disagreements can lead to forks, disrupting network uniformity and trust.

In future, storage problems can arise as blockchain data grows, increasing operational costs and potentially limiting network participation.¹⁴

Summary

AI and blockchain are poised to transform healthcare by revolutionising diagnostics, treatment and management practices. Blockchain operates as a decentralised network of nodes storing and securing transactional data, offering enhanced patient care and reducing costs associated with Health Information Exchange. AI complements these advancements by analysing vast datasets to personalise treatment and optimise hospital operations. Together, they ensure data integrity and transparency while fostering innovative research collaborations and improving patient monitoring through IoT integration and wearable technology. However, challenges like scalability, high energy consumption, and regulatory uncertainties must be addressed to fully realise blockchain's potential in healthcare.