{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T18:38:38Z","timestamp":1774895918802,"version":"3.50.1"},"reference-count":53,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2022,3,11]],"date-time":"2022-03-11T00:00:00Z","timestamp":1646956800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Digital"],"abstract":"<jats:p>Blockchain is now utilized by a diverse spectrum of applications and is proclaimed as a technological innovation that transforms the way that data are stored. This technology has the potential to transform the healthcare sector, especially the prevalent issues of patient\u2019s data-privacy and fragmented healthcare data. However, there is no evidence-based effort to develop a readiness assessment framework for blockchain that combines all the different social and economic factors and involves all stakeholders. Based on a systematic literature review, the proposed framework is applied to Portugal\u2019s healthcare sector and its applicability is outlined. The findings in this paper show the unique importance of regulators and the government in achieving a globally acceptable regulatory framework for the adoption of blockchain technology in healthcare and other sectors. The business entities and solution providers are ready to leverage the opportunities of blockchain, but the absence of a widely acceptable regulatory framework that protect stakeholders\u2019 interests is slowing down the adoption of blockchain. There are several misconceptions regarding blockchain laws and regulations, which has slowed stakeholder readiness. This paper will be useful as a guideline and knowledge base to reinforce blockchain adoption.<\/jats:p>","DOI":"10.3390\/digital2010005","type":"journal-article","created":{"date-parts":[[2022,3,11]],"date-time":"2022-03-11T12:58:36Z","timestamp":1647003516000},"page":"65-87","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["A Regulatory Readiness Assessment Framework for Blockchain Adoption in Healthcare"],"prefix":"10.3390","volume":"2","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0168-4219","authenticated-orcid":false,"given":"Olanrewaju","family":"Sanda","sequence":"first","affiliation":[{"name":"School of Architecture, Technology and Engineering, Moulsecoomb Campus, University of Brighton, Brighton BN2 4GJ, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9135-2340","authenticated-orcid":false,"given":"Michalis","family":"Pavlidis","sequence":"additional","affiliation":[{"name":"School of Architecture, Technology and Engineering, Moulsecoomb Campus, University of Brighton, Brighton BN2 4GJ, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4249-4953","authenticated-orcid":false,"given":"Nikolaos","family":"Polatidis","sequence":"additional","affiliation":[{"name":"School of Architecture, Technology and Engineering, Moulsecoomb Campus, University of Brighton, Brighton BN2 4GJ, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,3,11]]},"reference":[{"key":"ref_1","unstructured":"Nakamoto, S. (2021, December 07). Bitcoin: A Peer-to-Peer Electronic Cash System. Available online: https:\/\/www.researchgate.net\/publication\/228640975_Bitcoin_A_Peer-to-Peer_Electronic_Cash_System."},{"key":"ref_2","first-page":"23","article-title":"Understanding Blockchain Technology","volume":"8","author":"Sarmah","year":"2018","journal-title":"Comput. Sci. Eng."},{"key":"ref_3","first-page":"6","article-title":"Blockchain Technology: Beyond Bitc\u2019in","volume":"2","author":"Crosby","year":"2016","journal-title":"Appl. Innov. Rev."},{"key":"ref_4","unstructured":"Lim, M. (2021, November 13). 81 of Top 100 Companies Use Blockchain Technology. Available online: https:\/\/forkast.news\/81-of-top-100-companies-use-blockchain-technology-blockdata\/."},{"key":"ref_5","unstructured":"Genov, E. (2021, December 07). The Longest Running Blockchain Has Existed on NYT Pages Since 1995. Available online: https:\/\/toshitimes.com\/the-longest-running-blockchain-has-existed-on-nyt-pages-since-1995\/."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1145\/3471140","article-title":"A Survey on Blockchain Interoperability: Past, Present, and Future Trends","volume":"54","author":"Belchior","year":"2022","journal-title":"ACM Comput. Surv."},{"key":"ref_7","first-page":"18","article-title":"Blockchain Compliance by Design: Regulatory Considerations for Blockchain in Clinical Research","volume":"2","author":"Charles","year":"2019","journal-title":"Blockchain Distrib. Res."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"132","DOI":"10.69554\/LQZW4343","article-title":"The Challenges Faced by Blockchain Technology","volume":"2","author":"Tasca","year":"2017","journal-title":"J. Digit. Bank."},{"key":"ref_9","first-page":"27","article-title":"Improving the Benefits of IT Compliance Using Enterprise Management Information Systems","volume":"12","author":"Dameri","year":"2009","journal-title":"Electron. J. Inf. Syst. Eval."},{"key":"ref_10","unstructured":"Haar, R. (2021, October 10). New Bitcoin ETF Grows at Record Speed. Available online: https:\/\/time.com\/nextadvisor\/investing\/cryptocurrency\/bitcoin-etf-approved\/."},{"key":"ref_11","unstructured":"Dore, K. (2021, November 13). What the First Bitcoin Futures Exchange-Traded Fund Means for the Cryptocurrency Industry. Available online: https:\/\/www.cnbc.com\/2021\/10\/24\/what-first-bitcoin-futures-etf-means-for-cryptocurrency-industry.html."},{"key":"ref_12","first-page":"653","article-title":"A survey of blockchain security issues and challenges","volume":"19","author":"Lin","year":"2017","journal-title":"Int. J. Netw. Secur."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Ekblaw, A., Azaria, A., Halamka, J.D., Lippman, A., Original, I., and Vieira, T. (2016, January 22\u201324). A Case Study for Blockchain in Healthcare: \u201cMedRec\u201d prototype for electronic health records and medical research data MedRec: Using Blockchain for Medical Data Access and Permission Management. Proceedings of the 2016 2nd International Conference on Open and Big Data (OBD), Vienna, Austria.","DOI":"10.1109\/OBD.2016.11"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"19","DOI":"10.17705\/2msqe.00023","article-title":"A case study of using blockchain technology in regulatory technology","volume":"19","author":"Gozman","year":"2020","journal-title":"MIS Q. Exec."},{"key":"ref_15","unstructured":"Hermstr\u00fcwer, Y. (2020). The Limits of Blockchain Democracy: A Transatlantic Perspective on Blockchain Voting Systems, Stanford-Vienna Transatlantic Technology Law Forum. TTLF Working Papers No. 49."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1109\/MCC.2018.011791712","article-title":"Blockchain: A Panacea for Healthcare Cloud-Based Data Security and Privacy?","volume":"5","author":"Esposito","year":"2018","journal-title":"IEEE Cloud Comput."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Ismail, L., and Materwala, H. (2019). A review of blockchain architecture and consensus protocols: Use cases, challenges, and solutions. Symmetry, 11.","DOI":"10.20944\/preprints201908.0311.v1"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"102397","DOI":"10.1016\/j.ipm.2020.102397","article-title":"A Survey on Blockchain for Information Systems Management and Security","volume":"58","author":"Berdik","year":"2021","journal-title":"Inf. Process. Manag."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Dorri, A., Kanhere, S.S., Jurdak, R., and Gauravaram, P. (2017, January 13\u201317). Blockchain for IoT security and privacy: The case study of a smart home. Proceedings of the 2017 IEEE International Conference on Pervasive Computing and Communications Workshops, PerCom Workshops, Kona, HI, USA.","DOI":"10.1109\/PERCOMW.2017.7917634"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"102426","DOI":"10.1016\/j.ipm.2020.102426","article-title":"B-FERL: Blockchain based framework for securing smart vehicles","volume":"58","author":"Oham","year":"2021","journal-title":"Inf. Process. Manag."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"121","DOI":"10.3934\/mfc.2018007","article-title":"A survey on security and privacy issues of blockchain technology","volume":"1","author":"Prashanth","year":"2018","journal-title":"Math. Found. Comput."},{"key":"ref_22","first-page":"50","article-title":"The Blockchain Ethical Design Framework","volume":"12","author":"Lapointe","year":"2019","journal-title":"Innov. Technol. Gov. Glob."},{"key":"ref_23","unstructured":"Correia, T., Correia, H., Gamito, C., and Kindylidi, I. (2021, November 12). Evolution of Blockchain Market. Available online: https:\/\/practiceguides.chambers.com\/practice-guides\/blockchain-2021\/portugal."},{"key":"ref_24","unstructured":"GSMA (2021, October 15). Blockchain for Development: Emerging Opportunities for Mobile, Identity and Aid. Available online: https:\/\/www.gsma.com\/mobilefordevelopment\/wp-content\/uploads\/2017\/12\/Blockchain-for-Development.pdf."},{"key":"ref_25","unstructured":"Prisco, G. (2021, November 27). The blockchain for Healthcare: Gem Launches Gem Health Care Network with Philips Blockchain Lab. Available online: https:\/\/bitcoinmagazine.com\/articles\/the-blockchain-for-heathcare-gem-launches-gem-health-network-with-philips-blockchain-lab-1461674938."},{"key":"ref_26","first-page":"60587","article-title":"A case study in blockchain healthcare innovation","volume":"9","author":"Heston","year":"2017","journal-title":"Int. J. Curr. Res."},{"key":"ref_27","unstructured":"Batubara, F.R., Ubacht, J., and Janssen, M. (June, January 30). Challenges of blockchain technology adoption for e-government. Proceedings of the 19th Annual International Conference on Digital Government Research Governance in the Data Age\u2014Dgo \u201918, Delft, The Netherlands. Available online: http:\/\/dl.acm.org\/citation.cfm?doid=3209281.3209317."},{"key":"ref_28","unstructured":"Guardtime (2021, August 27). Estonia e-Health Authority Partners with Guardtime to Accelerate Transparency and Auditability in Healthcare. Available online: https:\/\/guardtime.com\/blog\/estonian-ehealth-partners-guardtime-blockchain-based-transparency."},{"key":"ref_29","unstructured":"Park, J., and Parkm, H. (2021, November 13). Regulation by Selective Enforcement: The SEC and Initial Coin Offerings. Available online: https:\/\/openscholarship.wustl.edu\/law_journal_law_policy\/vol61\/iss1\/11\/."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1108\/JFRC-08-2016-0068","article-title":"Regulatory Issues in Blockchain Technology","volume":"25","author":"Yeoh","year":"2017","journal-title":"J. Financ. Regul. Compliance"},{"key":"ref_31","unstructured":"Marques, F., Albuquerque, M., and Verissimo, D. (2021, November 17). Blocckchain & Cryptocurrency Laws and Regulation 2022. Available online: https:\/\/www.globallegalinsights.com\/practice-areas\/blockchain-laws-and-regulations\/23Portugal."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"95730","DOI":"10.1109\/ACCESS.2021.3093633","article-title":"Blockchain and AI-Based Solutions to Combat Coronavirus (COVID-19)-Like Epidemics: A Survey","volume":"9","author":"Nguyen","year":"2021","journal-title":"IEEE Access"},{"key":"ref_33","unstructured":"Monteiro, A. (2021, October 10). First GDPR Fine in Portugal Issued against Hospital for Three Violations. Available online: https:\/\/iapp.org\/news\/a\/first-gdpr-fine-in-portugal-issued-against-hospital-for-three-violations\/."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Mettler, M. (2016, January 14\u201316). Blockchain technology in healthcare: The revolution starts here. Proceedings of the 2016 IEEE 18th International Conference on E-Health Networking, Applications and Services, Healthcom, Munich, Germany.","DOI":"10.1109\/HealthCom.2016.7749510"},{"key":"ref_35","unstructured":"Dewey, J. (2021, October 02). Global Legal Insight\u2014Blockchain & Cryptocurrency Regulations. Available online: https:\/\/www.mlgts.pt\/xms\/files\/site_2018\/publicacoes\/2020\/GLI_Blockchain__Cryptocurrency_Regulation_2021_Portugal.pdf."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"107133","DOI":"10.1016\/j.cie.2021.107133","article-title":"A literature review of blockchain technology applications in supply chains: A comprehensive analysis of themes, methodologies, and industries","volume":"154","author":"Lim","year":"2021","journal-title":"Comput. Ind. Eng."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"45","DOI":"10.2753\/MIS0742-1222240302","article-title":"A design science research methodology for information systems","volume":"24","author":"Peffers","year":"2008","journal-title":"J. Manag. Inf. Syst."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/j.tele.2018.11.006","article-title":"A systematic literature review of blockchain-based applications: Current status, classification, and open issues","volume":"36","author":"Casino","year":"2019","journal-title":"Telemat. Inform."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Filippi, P.D., and Hassan, S. (2016). Blockchain Technology as a Regulatory Technology. First Monday. arXiv.","DOI":"10.5210\/fm.v21i12.7113"},{"key":"ref_40","first-page":"366","article-title":"Blockchain Transaction Processing","volume":"2019","author":"Gupta","year":"2019","journal-title":"Encycl. Big Data Technol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"2447","DOI":"10.1080\/13683500.2018.1513460","article-title":"Is blockchain technology a watershed for tourism development","volume":"22","author":"Kwok","year":"2018","journal-title":"Curr. Issues Tour."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Siyal, A.A., Junejo, A.Z., Zawish, M., Ahmed, K., Khalil, A., and Soursou, G. (2019). Applications of blockchain technology in medicine and healthcare: Challenges and future perspectives. Cryptography, 3.","DOI":"10.3390\/cryptography3010003"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"520","DOI":"10.1108\/IJIS-07-2020-0094","article-title":"Blockchain: A strategic resource to attain and sustain competitive advantage","volume":"13","author":"Kant","year":"2021","journal-title":"Int. J. Innov. Sci."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"100414","DOI":"10.1016\/j.hitech.2021.100414","article-title":"Blockchain for business management: Applications, challenges, and potentials","volume":"32","author":"Pal","year":"2021","journal-title":"J. High Technol. Manag. Res."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Rejeb, A., Keogh, J.G., Zailani, S., Treiblmaier, H., and Rejeb, K. (2020). Blockchain Technology in the Food Industry: A Review of Potentials, Challenges and Future Research Directions. Logistics, 4.","DOI":"10.3390\/logistics4040027"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1481","DOI":"10.1108\/JEIM-12-2020-0532","article-title":"Understanding of blockchain-based identity management system adoption in the public sector","volume":"34","author":"Sung","year":"2021","journal-title":"J. Enterp. Inf. Manag."},{"key":"ref_47","unstructured":"Donovan, A. (2021, October 03). Blockchain: Developing Regulatory Approaches for the Use of Technology in Legal Services. Available online: https:\/\/www.legalservicesboard.org.uk\/wp-content\/uploads\/2019\/10\/Blockchain-Developing-Regulatory-Approaches-for-the-Use-of-Technology-in-Legal-Services.pdf."},{"key":"ref_48","unstructured":"Kshetri, N. (2021, December 10). Strengthen the Internet of. Securing IT, August. 2017; pp. 68\u201372. Available online: https:\/\/pdfs.semanticscholar.org\/e870\/9e2906361ade9064cc605b9c7637bec474a0.pdf."},{"key":"ref_49","unstructured":"European Parliament (2020, December 05). Blockchain and the General Data Protection Regulation\u2019. European Parliamentary Research Service. Available online: https:\/\/www.europarl.europa.eu\/RegData\/etudes\/STUD\/2019\/634445\/EPRS_STU(2019)634445_EN.pdf."},{"key":"ref_50","unstructured":"Siegel, S. (2021, November 02). Is Blockchain HIPAA Complaint?. Available online: https:\/\/masur.com\/lawtalk\/is-blockchain-hipaa-compliant\/#:~:text=HIPAA%20prohibits%20the%20use%20of,industry%20non%2Dcompliant%20with%20HIPA."},{"key":"ref_51","unstructured":"Sayegh, E. (2021, September 11). When Crypto Meets Compliance: Is Blockchain Ready for Enterprise?. Available online: https:\/\/www.forbes.com\/sites\/emilsayegh\/2020\/07\/07\/when-crypto-meets-compliance-is-blockchain-ready-for-the-enterprise\/#713d7fab4aad."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"67","DOI":"10.15302\/J-FEM-2017006","article-title":"The outlook of blockchain technology for construction engineering management","volume":"4","author":"Wang","year":"2017","journal-title":"Front. Eng. Manag."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"126130","DOI":"10.1016\/j.jclepro.2021.126130","article-title":"Blockchain technology and the circular economy: Implications for sustainability and social responsibility","volume":"293","author":"Upadhyay","year":"2021","journal-title":"J. Clean. Prod."}],"container-title":["Digital"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2673-6470\/2\/1\/5\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:34:58Z","timestamp":1760135698000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2673-6470\/2\/1\/5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,11]]},"references-count":53,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,3]]}},"alternative-id":["digital2010005"],"URL":"https:\/\/doi.org\/10.3390\/digital2010005","relation":{},"ISSN":["2673-6470"],"issn-type":[{"value":"2673-6470","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3,11]]}}}