Blockchain Technology Impacts on Electronic Health Records: Literature Review Table (2021 - 2026)

Between 2021 and 2026, blockchain technology has emerged as a transformative force in electronic health record (EHR) management, fundamentally addressing long-standing challenges of security, privacy, interoperability, and patient control. The literature reveals a mature and rapidly evolving field where blockchain has transitioned from theoretical propositions to practical frameworks and implementations. The core impacts identified are the following: 1. Enhanced Security and Privacy 2. Patient-Centric Control 3. Interoperability Across Systems 4. Performance and Scalability Advancements 5. Integration with Emerging Technologies Key Challenges Remaining Despite significant progress, the literature identifies persistent challenges: scalability limitations (Ethereum processes only ~15 transactions per second), regulatory conflicts (GDPR's "right to be forgotten" vs blockchain immutability), energy consumption concerns (proof-of-work systems), lack of standardised EHR data formats, and the absence of fully implemented real-world compatible systems. Future Directions (2024–2026) Research priorities include cross-chain EHR transactions, integration with calendar applications for alert systems, national ID-based patient identification (e.g., Aadhar, PAN), edge computing to reduce latency, AI/ML for fraudulent data detection, and developing governance models that balance decentralisation with regulatory compliance. Blockchain technology has matured from a promising concept to a viable solution for EHR security and management. The literature from 2021–2026 demonstrates tangible frameworks, performance benchmarks, and implementation strategies that collectively point toward a future where patients control their health data, providers securely share information across platforms, and healthcare systems achieve unprecedented levels of trust, transparency, and efficiency.2021年至2026年间，区块链技术已成为电子健康记录（electronic health record, EHR）管理领域的变革性力量，从根本上解决了长期困扰行业的安全、隐私、互操作性以及患者数据控制权等核心难题。现有研究文献表明，该领域已趋于成熟且正快速发展，区块链技术也已从理论构想落地为实用框架与落地实践。 经梳理，其核心应用价值体现在以下五个方面： 1. 强化安全与隐私保护 2. 以患者为中心的数据控制权 3. 跨系统互操作性提升 4. 性能与可扩展性优化 5. 与新兴技术的融合 二、尚存的核心挑战 尽管当前已取得显著进展，但相关研究仍指出了诸多长期存在的痛点：包括可扩展性瓶颈（以太坊每秒仅可处理约15笔交易）、监管冲突（《通用数据保护条例》（General Data Protection Regulation, GDPR）的“被遗忘权”与区块链不可篡改特性的矛盾）、能源消耗争议（工作量证明（Proof-of-Work, PoW）机制）、电子健康记录数据格式缺乏统一标准，以及尚未出现完全适配真实场景的落地系统。 三、2024-2026年的未来研究方向 当前的重点研究方向包括：跨链电子健康记录交易、与日历应用集成的告警系统、基于国民身份标识的患者身份认证（如印度Aadhar、PAN系统）、用于降低延迟的边缘计算、用于检测欺诈数据的人工智能/机器学习技术，以及构建兼顾去中心化特性与监管合规性的治理框架。 区块链技术已从一项颇具前景的概念，发展为可落地应用的电子健康记录安全与管理解决方案。2021至2026年的相关研究文献均提出了可落地的技术框架、性能基准与实施策略，共同勾勒出这样的未来图景：患者掌握自身健康数据的控制权，医疗服务提供者可跨平台安全共享信息，医疗系统也将实现前所未有的信任度、透明度与效率提升。