Quayson, Ma hew; A o nu, E ic Ko i; Bediako, Albe Kweku
A icle
Modeling he enable s o blockchain echnology
implemen a ion o in o ma ion managemen in
heal hca e supply chains
Mode n Supply Chain Resea ch and Applica ions
P o ided in Coope a ion wi h:
Eme ald Publishing Limi ed
Sugges ed Ci a ion: Quayson, Ma hew; A o nu, E ic Ko i; Bediako, Albe Kweku (2024) : Modeling
he enable s o blockchain echnology implemen a ion o in o ma ion managemen in heal hca e
supply chains, Mode n Supply Chain Resea ch and Applica ions, ISSN 2631-3871, Eme ald, Bingley,
Vol. 6, Iss. 2, pp. 101-121,
h ps://doi.o g/10.1108/MSCRA-06-2023-0028
This Ve sion is a ailable a :
h ps://hdl.handle.ne /10419/314921
S anda d-Nu zungsbedingungen:
Die Dokumen e au EconS o dü en zu eigenen wissenscha lichen
Zwecken und zum P i a geb auch gespeiche und kopie we den.
Sie dü en die Dokumen e nich ü ö en liche ode komme zielle
Zwecke e iel äl igen, ö en lich auss ellen, ö en lich zugänglich
machen, e eiben ode ande wei ig nu zen.
So e n die Ve asse die Dokumen e un e Open-Con en -Lizenzen
(insbesonde e CC-Lizenzen) zu Ve ügung ges ell haben soll en,
gel en abweichend on diesen Nu zungsbedingungen die in de do
genann en Lizenz gewäh en Nu zungs ech e.
Te ms o use:
Documen s in EconS o may be sa ed and copied o you pe sonal
and schola ly pu poses.
You a e no o copy documen s o public o comme cial pu poses, o
exhibi he documen s publicly, o make hem publicly a ailable on he
in e ne , o o dis ibu e o o he wise use he documen s in public.
I he documen s ha e been made a ailable unde an Open Con en
Licence (especially C ea i e Commons Licences), you may exe cise
u he usage igh s as speci ied in he indica ed licence.
h ps://c ea i ecommons.o g/licenses/by/4.0/
Modeling he enable s o
blockchain echnology
implemen a ion o in o ma ion
managemen in heal hca e
supply chains
Ma hew Quayson
Ho Technical Uni e si y, Ho, Ghana, and
E ic Ko i A o nu and Albe Kweku Bediako
Depa men o Logis ics and Supply Chain Managemen , Ho Technical Uni e si y,
Ho, Ghana
Abs ac
Pu pose –Blockchain echnology enhances in o ma ion managemen in heal hca e supply chains by secu ing
heal hca e in o ma ion and p o iding medical esou ce aceabili y. Howe e , he e is no decision amewo k
o suppo blockchain implemen a ion o managing in o ma ion, especially in eme ging economies’heal hca e
supply chains. This pape de elops a hie a chical decision model o implemen ing blockchain echnology o
in o ma ion managemen in eme ging economies’heal hca e supply chains.
Design/me hodology/app oach –This s udy uses 20 heal h supply chain expe s in Ghana o ank 17
decision c i e ia o implemen ing blockchain o heal hca e in o ma ion managemen using he bes -wo s
me hod (BWM) mul i-c i e ia decision echnique.
Findings –The esul s show ha “secu i y”and “p i acy,”“in as uc u al acili y”and “p esence o aining
acili ies”a e he op h ee c i ical ac o s impac ing blockchain adop ion in he heal h supply chain o
heal hca e in o ma ion managemen . O he sub- ac o s a e p io i ized.
P ac ical implica ions –To implemen blockchain e ec i ely o enhance in o ma ion managemen in he
heal hca e supply chain, heal h ins i u ions, blockchain echnology p o ide s and s a e au ho i ies should
concen a e on he highly c i ical ac o s ex ac ed om he s udy.
O iginali y/ alue –This is he i s s udy ha de elops a hie a chical decision model o implemen ing
blockchain echnology in eme ging economies’heal h supply chains.
Keywo ds Heal hca e in o ma ion managemen , TOE, Blockchain echnology, Bes -wo s me hod,
Eme ging economies
Pape ype Resea ch pape
1. In oduc ion
Cos con ol has d i en heal hca e o ganiza ions o make supply chain managemen (SCM) a
c i ical phenomenon o achie e he o ganiza ion’s objec i es. SCM in ol es he low o
p oduc s, inances and in o ma ion wi hin and be ween ac o s o mee consume s’needs
e ec i ely. E ec i e SCM is a challenge in he heal h indus y.
The inhe en isk o e o s in he supply chain exposes pa ien s o many dange s. The
si ua ion is mo e ala ming as he e a e inc easing epo s o iola ions o heal hca e
Enable s o
blockchain
echnology
101
© Ma hew Quayson, E ic Ko i A o nu and Albe Kweku Bediako. Published in Mode n Supply Chain
Resea ch and Applica ions. Published by Eme ald Publishing Limi ed. This a icle is published unde he
C ea i e Commons A ibu ion (CC BY 4.0) licence. Anyone may ep oduce, dis ibu e, ansla e and
c ea e de i a i e wo ks o his a icle ( o bo h comme cial and non-comme cial pu poses), subjec o ull
a ibu ion o he o iginal publica ion and au ho s. The ull e ms o his licence may be seen a h p://
c ea i ecommons.o g/licences/by/4.0/legalcode
The cu en issue and ull ex a chi e o his jou nal is a ailable on Eme ald Insigh a :
h ps://www.eme ald.com/insigh /2631-3871.h m
Recei ed 22 June 2023
Re ised 3 No embe 2023
Accep ed 22 No embe 2023
Mode n Supply Chain Resea ch
and Applica ions
Vol. 6 No. 2, 2024
pp. 101-121
Eme ald Publishing Limi ed
2631-3871
DOI 10.1108/MSCRA-06-2023-0028
in o ma ion, in o ma ion asymme y and coun e ei medicines in he heal h indus y (Hadid
e al., 2022). Fo ins ance, he global ma ke loses up o $200bn annually o he ake medicine
ma ke (Knudsen and Nickels, 2015).
S udies ha e disco e ed a hos o medica ions, medical de ices and biologics p one o
coun e ei ing in se e al coun ies. In A ica, mo e han 100,000 die om coun e ei ed
medicines (Glass, 2014). Besides coun e ei ing p oduc s and medicines, p oduc eco ding
and packaging mis akes can dis up he heal h supply chain.
Many heal h expe s desc ibe in o ma ion asymme y as he mos c i ical issue in he
heal hca e supply chain (Chang e al., 2023). In o ma ion asymme y means ha one side has
g ea e access o in o ma ion han ano he . This issue is c ucial when only doc o s o heal h
cen e s can access he eco ds o pa ien s in gene al heal hca e. The da a is cen alized in a
single heal h sys em and only hospi als o associa ions ha e access. As a esul , pa ien s need
o ollow complica ed and complex p o ocols o access hei medical eco ds. This si ua ion
o en leads o medical da a abuses in he heal hca e sec o .
As echnical ad ances ha e imp o ed condi ions in many o he aspec s o li e, applying
hem o enhance heal hca e deli e y is also essen ial. Blockchain is one o hose eme ging
echnologies. The e ha e been many applica ions o blockchain echnology o sol e p oblems
o aceabili y and secu i y in many sec o s.
In he heal hca e supply chain, blockchain echnology can p o ide in o ma ion isibili y
o enhance pa ien sa e y (Sha ma e al., 2023). I also add esses issues ela ing o aceabili y
and allows o sa e in e ope abili y ac oss heal h o ganiza ions. Howe e , mos heal h
p ac i ione s unde es ima e he blockchain and i s applica ion o he heal hca e supply chain.
The e o e, i is highly app op ia e o p ac ical pe spec i es and a deep unde s anding o
majo enable s, making i easie o he indus y o implemen blockchain echnology
success ully.
Al hough much li e a u e on blockchain echnology bene i s exis s in many sec o s, li le
is known abou i s heal h- ela ed dis up ion, pa icula ly o in o ma ion managemen in
eme ging economies’heal hca e supply chains (Kombe e al., 2019;Quayson e al., 2023b). In
ew exis ing s udies, A a an (2022) conduc ed a li e a u e e iew o disco e he pi o al oles
blockchain echnology plays in sol ing some o he mos c i ical and challenging issues
acing he heal hca e indus y. The s udy iden i ied challenges and oppo uni ies o
implemen ing blockchain echnology in heal hca e supply chains and summa ized heal h-
ela ed blockchain p oduc s and key playe s o e ing solu ions ac oss di e en applica ions.
Also, Ndayizigamiye and Dube (2019) p esen ed a case o using blockchain o os e
anspa ency and accoun abili y in pa ien -cen e ed ca e in Sou h A ican public heal hca e
ins i u ions.
Despi e he ele ance o p io s udies, hey a e p ima ily e iewed and concep ual wi h
li le heo e ical de elopmen . Again, he heal h supply chain has no decision-making
s uc u e ega ding blockchain adop ion o heal hca e in o ma ion managemen ,
pa icula ly in eme ging economies wi h a slow pace in blockchain echnology adop ion
and usage (Quayson e al., 2023b). Blockchain adop ion equi es a ca e ul decision-making
ool o aid such a decision-making p ocess. The e o e, a mul i-c i e ia decision-making
me hodology mus p o ide a decision s uc u e o inco po a e blockchain echnology in he
eme ging economies’heal h supply chain.
Theo e ically, he echnology-o ganiza ion-en i onmen (TOE) amewo k p o ides an
app op ia e lens o s udying blockchain adop ion a he o ganiza ional le el. This s udy
iden i ies a lis o enable s ha a ec blockchain adop ion o heal h in o ma ion
managemen in he heal h supply chain based on he TOE amewo k. In addi ion o he
echnology, implemen ing echnical inno a ion is based on in e nal en i onmen al and
o ganiza ional conside a ions. Se e al o ganiza ional echnology implemen a ion s udies
(e.g. Kamble e al., 2021;Bai e al., 2022) ha e used he TOE amewo k. The high applica ion
MSCRA
6,2
102
o he TOE amewo k in explaining and analyzing echnological adop ion inspi ed i s
adop ion o ou s udy.
The pape highligh s he li e a u e gaps o blockchain by d awing on exis ing adop ion
esea ch o de elop a decision amewo k o blockchain implemen a ion o heal hca e
in o ma ion managemen in he heal h sec o . In Ghana, he heal h sec o can use insigh s
in o he c ucial ac o s in blockchain adop ion o imp o e heal h in o ma ion managemen o
achie e compe i i eness. Resea ch in o new con ex s, especially in eme ging economies like
Ghana, is ecognized as c ucial guidance in esea ch on po en ial echnology adop ion.
Mo eo e , he socio-economic e ec o he Ghanaian heal h sec o on he na ion is subs an ial
and is s ill unde -in es iga ed.
Ghana’s Heal h sec o ’s socio-economic cos is high because o he massi e demand o
quali y heal hca e o achie e Uni ed Na ions (UN) Sus ainable De elopmen Goal-Th ee. As a
consequence, his pape con ibu es by;
Fi s ly, in oducing a hie a chical decision s uc u e ha builds upon he TOE amewo k
o guide he decision-making p ocess o inco po a ing blockchain echnology in heal hca e
in o ma ion managemen . This s uc u e enables heal hca e o ganiza ions o assess and
add ess a ious dimensions and le els o decision-making, anging om s a egic
conside a ions o ope a ional implemen a ion (Gongo a-Salaza e al., 2023).
Secondly, he pape con ibu es by adap ing he widely ecognized TOE amewo k o he
con ex o heal hca e in o ma ion managemen and he heal h supply chain. By inco po a ing
he TOE amewo k, he s udy p o ides a comp ehensi e pe spec i e ha conside s he
echnological, o ganiza ional and en i onmen al ac o s in luencing he success ul adop ion
and implemen a ion o blockchain echnology in Heal hca e (E ah e al., 2023).
Thi dly, he s udy ocuses on he heal h supply chain, acknowledging his domain’s
unique challenges and equi emen s. By conside ing he low o heal hca e in o ma ion
wi hin he supply chain and he po en ial bene i s o blockchain echnology in enhancing da a
in eg i y, aceabili y and anspa ency, he pape con ibu es o unde s anding blockchain’s
speci ic applicabili y and implica ions in his con ex (Quayson e al., 2023b).
The s udy achie ed hese esul s by ho oughly e iewing ele an li e a u e o iden i y
he enable s. These expe s in he Ghanaian heal h sec o e alua ed he enable s using bes -
wo s me hod (BWM) designed ques ionnai es. The eedback om hese ques ionnai es was
analyzed using he BWM Sol e o p io i ize he enable s o blockchain adop ion in he heal h
sec o . The BWM model gi es mo e consis en esul s han o he mul i-c i e ia decision
me hods (MCDM), which use pai wise compa ison (Rezaei, 2015). Again, he BWM is easie
o pai wise compa isons han analy ical hie a chy p ocess (AHP) (Bai e al., 2022). These
in luenced ou choice o he BWM MCDM echnique.
The pape con inues as ollows. Rela ed wo ks a e p esen ed in Sec ion 2.Sec ion 3
p esen s he esea ch me hodology. Sec ion 4 p esen s and discusses he esul s. Finally,
Sec ion 5 p esen s he conclusions o he s udy.
2. Rela ed wo ks
2.1 Blockchain and heal hca e in o ma ion managemen
Blockchain echnology has he po en ial o signi ican ly impac in o ma ion managemen in
heal hca e supply chain by enhancing secu i y, in e ope abili y and da a in eg i y (E ah
e al., 2023). The blockchain is a decen alized and enc yp ed da abase, a pe manen ,
inco up ible digi al in o ma ion a chi e. Blockchain echnology eco ds all ansac ions
au hen ica ed by he pa ies in ol ed, so only app o ed pa ies can use hese eco ds. The
con iden iali y and da a in eg i y o ansac ions wi hou he in e en ion o hi d pa ies is
one o he majo easons o using blockchain echnology. Besides, blockchain echnology
o e s a con inuous audi pa h o see pa icipan s’ ime and ac ions. This imp o es
Enable s o
blockchain
echnology
103
anspa ency and lowe s he isk o heal h in o ma ion manipula ions. Blockchain
echnology also ensu es eal- ime da a a ailabili y, con ibu ing o be e coo dina ion o
clinical ca e and imp o ed heal h adminis a ion.
Resea ch in o blockchain echnology in he heal h supply chain is a ising esea ch s eam,
especially ega ding in o ma ion managemen . Esmaeilzadeh and Mi zaei (2019)
in es iga ed he po en ial o blockchain echnology o in o ma ion managemen in he
heal hca e supply chain om pa ien s’pe spec i es. They ound signi ican di e ences in
pa ien s’pe cep ions o a ious in o ma ion exchange mechanisms abou pa ien p i acy
conce ns, us in compe ency and in eg i y, op -in in en ion and willingness o sha e
in o ma ion. Simila ly, Esmaeilzadeh (2022) applied a quali a i e echnique o explo e he
bene i s o blockchain-based heal h in o ma ion exchange (HIE) in he heal hca e supply
chain om physicians’pe spec i es. The NVIVO analysis ca ego ized he bene i s in o h ee
hemes: inno a i e echnological ea u es, collabo a i e ecosys em and sys em pe o mance.
Fu he mo e, Hajian e al. (2023) designed an empi ical s udy o blockchain-based
in o ma ion-sha ing sys ems in elec onic heal h eco ds. The esul s e ealed ha
blockchain-based in o ma ion sys ems could empowe pa ien s by p o iding he
pe cep ion o con ol o e hei heal h eco ds. Blockchain echnology mo i a es pa ien s
o sha e in o ma ion wi h heal hca e p o ide sys ems and has he ad an age o educing
heal hca e cos s and imp o ing diagnosis managemen .
Also, Pawa e al. (2022) p oposed eHeal hChain –a blockchain-based Pe sonal Heal h
In o ma ion Managemen Sys em (PHIMS) o managing heal h da a o igina ing om
medical In e ne o Things (IoT) de ices and connec ed applica ions. They a gued ha o
usabili y and wide accep ance, he PHIMS should ollow he design p inciples ha gua an ee
p i acy-awa e heal h in o ma ion sha ing, indi idual in o ma ion con ol, in eg a ion o
in o ma ion ob ained om mul iple medical IoT de ices, heal h in o ma ion secu i y and
lexibili y. Again, El as e al. (2023) p oposed adop ing a blockchain amewo k o enable he
anspa en sha ing o medical in o ma ion among heal h en i ies in a secu e en i onmen .
The pa ien -cen ic app oach may allow hospi als and heal h p o essionals’access o
hei da a.
Mo eo e , Randall e al., (2017) explo ed blockchain applica ions and use cases in heal h
in o ma ion managemen in he USA. They sugges ed ha blockchain can po en ially cause
issues wi h heal h in o ma ion managemen . They a gued ha a public p og am such as he
US Medicaid p og am, wi h US$553bn in o al p og am cos s and o e US$25bn spen on
heal h in o ma ion echnology and adminis a ion las iscal yea , could bene i om using
blockchain-based dis ibu ed ledge and sma con ac s. They u he posi ed ha a
decen alized bene i s adminis a ion sys em could p o ide g ea e e iciency o en ollmen ,
eligibili y, claims paymen and adjudica ion p ocesses, hus d i ing e iciency and educing
sys emic aud.
Ibo e al. (2023) p oposed a secu ed heal h in o ma ion sys em wi h blockchain
echnology in A ica. The p oposed sys em on a blockchain could c ea e a us - ee sys em
o bo h heal h pe sonnel and pa ien s, achie ing he decen aliza ion o he medical eco ds
da abase o enhance he secu i y and p i acy o da a on he modeled pee - o-pee ne wo k.
No wi hs anding many p e ious ela ed s udies, signi ican gaps in he li e a u e s ill
need o be add essed. Fi s ly, mos o hese p io wo ks (e.g. Pawa e al., 2022;El as e al.,
2023) ocus on ad ancing sys em design o blockchain echnology o in o ma ion
managemen in he heal hca e supply chain, neglec ing i s implemen a ion plans. The
e ec would be less impo an i he blockchain amewo k o in o ma ion managemen in
he heal hca e supply chain is buil wi hou implemen a ion plans.
Also, al hough pas s udies ha e po ayed blockchain as a undamen al echnology o
u u e supply chains, hese s udies a e gene ally hypo he ical. The e is a limi ed p ac ical
applica ion o blockchain echnology. Again, hese s udies do no p o ide much empi ical
MSCRA
6,2
104
e idence on blockchain implemen a ion o in o ma ion managemen in eme ging economies’
heal h supply chains, especially in Ghana (Quayson e al., 2020). Abekah -Nk umah e al.
(2014) empi ically illus a ed he impac o con ex ual a iables on implemen ing ICTs in he
heal h supply chains in Ghana. Eme ging in o ma ion echnology in he heal h supply chain
in Ghana is s ill in he new s ages. This is because o he pe cei ed high in es men cos s o
ad anced echnology and he lack o in as uc u al acili ies o in o ma ion echnology (IT)
echnologies.
Mo eo e , mos p e ious s udies su e ed heo e ical limi a ions as a basis o blockchain
adop ion analyses in he heal h supply chains o in o ma ion managemen (Khan and Mi ,
2019). To add ess hese gaps, we use Technology, O ganiza ions and En i onmen (TOE) as
ou basis o p o ide a obus heo e ical amewo k ha includes incen i es o inno a ions.
A heo e ical esea ch modeling echnique helps add ess hese gaps e ec i ely. We employ
he BWM MCDM echnique in he modeling me hod. BWM has se e al essen ial ea u es
(Rezaei, 2015). We ha e p o ided jus i ica ions o he BWM echnique and will p o ide
de ailed in o ma ion la e . The modeling p ocess assu es he managemen o he success ul
use o blockchains and p o ides insigh s in o wha o hink. This s udy o e s esea ch
implica ions o help heal h p o essionals inco po a e blockchain echnology o da a
p o ec ion and ope a ional e iciency.
2.2 Blockchain cha ac e is ics ele an o heal hca e in o ma ion managemen
Blockchain echnology has se e al cha ac e is ics ha make i ele an o heal hca e
in o ma ion managemen . These cha ac e is ics add ess a ious challenges in heal hca e
da a secu i y, in e ope abili y and in eg i y. We discuss some o hese cha ac e is ics.
2.2.1 Anonymi y and p i acy. A p i acy-p ese ing amewo k is buil in o he blockchain
o p o ec pa ien heal hca e in o ma ion p i acy, wi h op ions o p i a e ansac ions, ze o-
knowledge p oo s and selec i e da a sha ing. The blockchain p o ides he deploymen o a
c yp og aphic p i a e key ha gua an ees such in o ma ion p i acy and anonymi y.
Because blockchain uses ing signa u es, use s a e p o ec ed by anonymi y. A ing signa u e
is an enc yp ion ha checks o see i he pe son signing he message, one o he s akeholde s,
holds a p i a e key co esponding o a unique se o public keys wi hou elling which one i
is. The sel -so e eign iden i y wi h blockchain e ec i ely main ains he p i acy o pa ien
heal h in o ma ion. This ea u e enables pa ien s o own, con ol and manage hei heal h
in o ma ion, as shown in Figu e 1.
2.2.2 Audi abili y. One o he mos s iking ea u es o blockchain o heal hca e
in o ma ion managemen is ha i is audi able. Blockchain p o ides a us - ee, ampe -
p oo and au oma ed sys em ha can be aced secu ely and pe manen ly. Dis ibu ed
da abases a e made aul - ee using a blockchain, keeping an audi ail. The in eg i y o all
ansac ions is audi able o all pa icipan s, wi h con o ming e i ica ion o us . Blockchain
implemen a ion ac oss heal hca e supply chains will ensu e heal hca e in o ma ion in eg i y
and us wo hiness (G uchmann e al., 2023).
2.2.3 Sma con ac s. An asse o in o ma ion is digi ally ans e ed in o a blockchain
applica ion in a sma con ac (Lynbe g and Dei , 2023). A sma con ac , a s o ed se o
ules ha apply o ne wo k ac o s and he sys em, can help de ine ne wo k in e ac ion.
Ne wo k da a sha ing among supply chain pa icipan s and con inuous p ocess
imp o emen a e all possible because o sma con ac s. P oduc and ac o p o iles a e
associa ed wi h digi al ep esen a ions on he ne wo k, whe e use s can see addi ional
in o ma ion, such as a loca ion, ce i ica e, o endo semen . By logging in he key in o ma ion
o a gi en p oduc and i s s a us on he blockchain ne wo k, each supply chain playe can
access his in o ma ion.
Enable s o
blockchain
echnology
105
Sma con ac s can au oma e heal hca e in o ma ion lows, such as insu ance claims
p ocessing, appoin men scheduling and p esc ip ion managemen , educing adminis a i e
o e head and imp o ing e iciency. Since all heal h supply chain pa icipan s mus ha e a
consensus o conduc in o ma ion exchanges, hey mus i s ag ee on hei pa ame e s.
A sma con ac is ad an ageous because i holds he pa icipan s’ e ms in ag eemen . In a
blockchain-based supply chain, sma con ac go e nance and p ocess ce i ica ion ules
can con ol who is ce i ied, wha hey a e ce i ied o and who can app o e and execu e hei
o de s.
2.2.4 Secu ed da abase. A blockchain da abase is dis ibu ed. The ad an age o
blockchain echnology’s asymme ical c yp og aphy is ha i uses hash and block
exchange alida ion, making i highly secu e. I is di icul o manipula e he da a s o ed
on a block in he ledge . The e is a s ong a gumen in a o o using he secu e da abase
ea u e in helping in elligen o ganiza ions. Due o blockchain’s ad anced c yp og aphic
echniques o secu e da a, i ensu es ha heal hca e in o ma ion is s o ed and ansmi ed
secu ely, educing he isk o da a b eaches and unau ho ized access (A a an, 2022).
2.2.5 Immu abili y. Immu abili y is a e m used o desc ibe a hing’s inabili y o be
changed o e ime o i s consis ency o e ime. Blockchain’s egis y con ains an audi ail
ha keeps ack o all he ope a ions pe o med, which helps de e mine he au hen ici y o
eco ds. Because o he blockchain’s inhe en immu abili y, i s ne wo ks a e less ulne able
o da a manipula ion and o ge y ia cybe a acks. The e o e, once heal h in o ma ion is
added o a blockchain, i canno be al e ed o dele ed wi hou consensus om he ne wo k,
ensu ing he in eg i y and au hen ici y o heal hca e eco ds.
Figu e 1.
Sel -so e eign iden i y
wi h blockchain in he
heal h sec o
MSCRA
6,2
106
2.2.6 Decen alized da abase. Da a communica ion me ada a is dis ibu ed ac oss he
ledge in a blockchain, as a blockchain da abase is no cen alized. The da a is dis ibu ed
simul aneously on a ious nodes. The decen alized and dis ibu ed na u e o he blockchain
echnology da abase allows o a decen alized ecosys em. This enhances pa icipan s’ us
in he blockchain. I heal hca e in o ma ion is s o ed in his decen alized ledge , i educes
he eliance on a single cen al au ho i y and makes he sys em mo e obus agains single
poin s o ailu e. Also, pa ien s can ha e mo e con ol o e hei heal hca e in o ma ion,
g an ing access only o au ho ized pa ies h ough consen mechanisms.
2.2.7 T aceabili y. Blockchain can ace he sou cing, p ocessing, sha ing and ans e ing
o accu a e da a. In o ma ion in any o m can be acked down o he da e and ime o each
block on he blockchain using he imes amp. All blockchain has o do is ensu e a secu e,
sha ed da abase and ha e e y ansac ion is anspa en and aceable. Blockchain eco ds
a anspa en and immu able audi ail, allowing heal hca e p o ide s and pa ien s o ace
he his o y o heal h da a access and modi ica ions.
2.2.7.1 T anspa ency. A i ual copy o he blockchain ne wo k is gene a ed a each node,
allowing eal- ime audi ing and da a inspec ion. The mos signi ican bene i o anspa ency
in he a ious ne wo k ope a ions and ac i i ies is emo ing he need o a us ed
in e media y. Blockchain echnology can help build us and c edibili y by os e ing
anspa ency in heal h in o ma ion managemen . Fo blockchain, eb anding he ne wo k’s
epu a ion is a new on ie in edesigning he ne wo k and comba ing audulen ac i i ies.
The le el o au hen ici y in he blockchain is high, esul ing in mo e in o ma ion
anspa ency. Depending on p i acy and egula o y equi emen s, heal hca e
o ganiza ions can choose be ween public o p i a e blockchains o con ol who can access
he da a while main aining anspa ency wi hin he ne wo k.
2.2.8 Den i ying blockchain adop ion enable s. We use he heo e ical TOE lens o conside
di e en ac o s in luencing blockchain echnology implemen a ion ac oss he heal h supply
chain in eme ging economies. The TOE is a widely de ined heo e ical con ex o echnical
ad ancemen . The TOE asse s ha he echnical (T), o ganiza ional (O) and en i onmen al
(E) con ex s a e h ee majo componen s ha shape echnology usage (Shiau e al., 2023). The
TOE can be applied o blockchain adop ion because blockchain is a new echnical c ea ion.
Thus, we de eloped ou heo e ical amewo k based on he c i ical en i onmen al,
echnological and o ganiza ional ac o s ha di ec ly a ec he implemen a ion o blockchain
echnology in he heal h sec o .
2.2.9 Technological ac o s. Technological ac o s concen a e on how blockchain
echnical ea u es enhance da a p o ec ion and ope a ional e iciency in he heal h supply
chain (Wol and Madlene , 2019). The a ailabili y o speci ic blockchain esou ces, such as
sma con ac s, is essen ial o imp o ing pe o mance in he heal h indus y. The
in as uc u al acili y is ano he signi ican enable in luencing blockchain adop ion in he
heal h supply chain. In as uc u e acili ies include physical elemen s and so wa e
elemen s. The in as uc u al acili ies suppo cu en in as uc u e equi emen s (Da ko
e al., 2023). Ano he echnical issue is he complexi y o blockchains, which equi e speci ic
skills o make hei adop ion easie . The ease o use is also a signi ican ac o ha a ec s he
implemen a ion o blockchain echnology in he heal h sec o (T ipa hi e al., 2020).
Compa ibili y is also a key ac o in his con ex . I desc ibes he easy in eg a ion o
blockchain echnology wi h o he pla o ms. This iden i ies he expec ed alue ha
blockchain echnologies b ing o he heal h sec o . Mo eo e , in o ma ion p o ec ion and
p i acy a e i al echnological enable s (Raza e al., 2019). I ensu es he secu i y o sha ed
in o ma ion o p e en exploi a ion while adop ing blockchain- ela ed heal hca e
echnologies.
2.2.10 O ganiza ional enable s. The o ganiza ional ac o de ines he ea u es,
unc ionali y and ools ha p omo e o p e en blockchain echnology adop ion in he
Enable s o
blockchain
echnology
107
heal h sec o . Fi s ly, aining acili ies a e an essen ial o ganiza ional ac o (Kushwaha and
Talib, 2020). This p o ides su icien aining acili ies o wo ke s in he heal h sec o o
adop blockchain echnologies. Top Managemen suppo is also essen ial. Top manage s can
p o ide ad ice, se ices and necessi ies du ing and a e blockchain echnology acquisi ions
in he heal h sec o . Fu he mo e, o ganiza ional cul u e consis ing o he ac ions and
p ac ices o people wi hin heal h ins i u ions a ec s he implemen a ion o blockchain
echnology. The o ganiza ional ac o also a ec s pe cei ed in es men cos s, including
access o inances o subs an ial capi al in es men s while implemen ing blockchain
esou ces in he heal h indus y. The capaci y o human esou ces is also i al in ensu ing
heal h p o essionals p o ide he know-how o use he echnology.
2.2.11 En i onmen al con ex . This e e s o business-based ope a ing ac o s, like
go e nmen egula ions, compe i i e p essu e, ma ke ola ili y and p essu e on
s akeholde s. Compe i i e p essu e desc ibes an ongoing desi e o heal h ins i u ions o
display cus ome o in es o compe encies (Wong e al., 2020). Compe i ion, globaliza ion and
expendi u e ha e d i en heal h acili ies o de elop and boos hei compe i i e ad an age.
Also, Go e nmen policies and unding o en in luence he capaci y o en o ce egula ions
and ules ha acili a e blockchain adop ion in he heal h sec o by ele an go e nmen
agencies (Ya uz e al., 2023). The bu den on he ex e nal en i onmen is also c ucial o
s akeholde s and de ails he ex eme and cons an demands o a ious ac o s o heal h
in es o s. Companies ypically espond o ma ke demands on inno a ion di e en ly.
The e o e, ma ke ins abili y o inhe en heal h se ices ola ili y can a ec he adop ion o
he heal h sec o blockchains.
Table 1 p o ides a summa y o he blockchain adop ion enable s.
3. Me hodology
As shown in Table 1, implemen ing blockchain echnology is a mul i-c i e ia concep .
The e o e, we use MCDM o assess he a ious c i e ia. This s udy uses he BWM p ocess,
which was p e iously no used in his ield bu has speci ic bene i s o his pape .
Main enable Sub-enable s Re e ences
Technological
(TEC)
Compa ibili y (TEC1) Raza e al. (2019) and Bai e al. (2022)
Secu i y and p i acy (TEC2)
Immu abili y (TEC3)
In as uc u al acili y (TEC4)
Access o blockchain echnology and
ools (TEC5)
Ease o use (TEC6)
Pe cei ed bene i s (TEC7)
O ganiza ional
(ORG)
Capaci y o human esou ce (ORG1) Schumache e al. (2016) and Kushwaha and
Talib (2020)O ganiza ional cul u e (ORG2)
Top managemen suppo (ORG3)
Pe cei ed cos o in es men (ORG4)
P esence o aining acili ies (ORG5)
En i onmen al
(ENV)
Ma ke unce ain y (ENV1) Hani e al. (2018) and
Wong e al. (2020)Ex e nal s akeholde (ENV2)
Compe i i e p essu e (ENV3)
Go e nmen policy and suppo (ENV4)
Indus y in ol emen (ENV5)
Sou ce(s): Au ho s’own wo k
Table 1.
Blockchain adop ion
enable s in he heal h
supply chain
MSCRA
6,2
108
use due o he lack o s anda diza ion o blockchain a chi ec u es. Howe e , he exposu e o
simila echnologies and high pene a ion o echnologies in Ghana may make blockchain
echnology easie han en isaged.
4.3 Rank o subc i e ia in each main c i e ion
Figu e 3 p o ides he summa y esul s o he ankings o sub-c i e ia in each main c i e ion.
4.3.1 Technological main c i e ia. E alua ing he enable s o blockchain echnology
adop ion sugges s ha blockchain “secu i y and p i acy”has he highes ank. Imp o ed
secu i y wi h blockchain p e en s pa ien s’in o ma ion ampe ing, aud and cybe c ime.
The nex main sub-c i e ia is he in as uc u al acili y. I means adequa e acili ies a e
a ailable o mee in as uc u al equi emen s. Heal h ins i u ions mus p o ide adequa e
acili ies such as adio- equency iden i ica ion sys ems (RFID), su eillance models and
compa ible IT pla o ms o enhance blockchain adop ion. The hi d sub-c i e ia wi hin he
main echnological c i e ia is access o blockchain echnology. The adop ion o digi al
inno a ions equi es speci ic ools o ensu e i s success.
The nex in luen ial sub-c i e ia wi hin he main echnological c i e ia is immu abili y.
The heal h in o ma ion s o ed wi hin a blockchain becomes immu able because he
in o ma ion joins he linea chain (Wang e al., 2019). Ano he sub-c i e ion is he pe cei ed
bene i s o adop ing blockchain echnologies in heal h ca e. An in-dep h unde s anding o he
bene i s o blockchain echnology can encou age heal h ins i u ions o use i (Kamble e al.,
2019). De elope s need o p omo e he po en ial bene i s o blockchain echnology and i s use
based on he o ganiza ion’s esou ces and cha ac e is ics (Hasselg en e al.,2020).
Compa ibili y and ease o use a e he wo leas in luen ial wi hin he echnology con ex .
In e es ingly, i is also he leas signi ican on he global ank. We ha e gi en some possible
easons ea lie .
Figu e 3.
BWM model o
de e mine enable s o
blockchain adop ion
Enable s o
blockchain
echnology
115
4.3.2 O ganiza ional ac o s. The “p esence o aining acili ies” ank highes among he
o ganiza ional ac o s. The success ul adop ion o blockchain echnology depends on he
a ailabili y o sui able acili ies o aining employees o heal h ins i u ions. Blockchains
equi e specialized de elope s and many heal h ins i u ions s ill ha e li le knowledge. Also,
ew eady- o-use blockchain applica ions s ill exis (Rai, 2023).The pe cei ed cos o
in es men is he nex o ganiza ional ac o . In o ma ion collec ion and con e sion o new
sys ems b ing cos s o heal h o ganiza ions. This pe cei ed huge cos is also a ba ie o
heal h ins i u ions wi h limi ed inancial esou ces (Shahnaz e al., 2019).
Top managemen suppo anked hi d mos impo an o ganiza ional ac o . Top
manage s in heal h ins i u ions ensu e ha hey adop blockchain echnologies e ec i ely.
This is because op managemen in luences o ganiza ional decision ou comes.
The las bu one in luen ial ac o includes he capabili y o human esou ces. They may
no be signi ican in he heal h sec o because many wo ke s who in e ac wi h echnology
ha e some necessa y IT skills. Also, aining acili ies and go e nmen and managemen
suppo may help employ and build he equi ed capaci y o employees o use he echnology
e ec i ely. The leas anked ac o is o ganiza ional cul u e. This inding e eals ha expe s
in he heal h sec o hink ha blockchain echnology adop ion’simpac on hei
o ganiza ional cul u e is no oo signi ican o hem.
4.3.3 En i onmen al ac o s. The en i onmen al ac o s had he lowes ank among he
main c i e ia enable s. Among hem, go e nmen policy and suppo had he highes ank.
P io li e a u e has es ablished he ole o go e nmen policy and suppo in in luencing he
adop ion o inno a ions (Mahajan e al., 2023). Cu en ly, go e nmen laws a e s ill unclea
abou he use o blockchains. This a ec s he b oade usage o blockchain echnology.
Indus y in ol emen anked nex . I all ac o s and leade ship in he heal h indus y
in ol e hemsel es in he echnology adop ion p ocess, sus aining he echnology o i s
in ended bene i s will be easie . This is c i ical because he heal h supply chain consis s o
many ac o s. I an ac o o g oup o ac o s do no in ol e hemsel es, i will hinde he
indus y om adop ing he echnology. The hi d- anked en i onmen al ac o is he
in ol emen o ex e nal s akeholde s. Rela ed NGOs, communi ies and egula o y bodies
mus suppo blockchain echnology adop ion in heal h ins i u ions. Compe i i e p essu e is
he nex impo an enable . Compe i i e p essu e in he heal h indus y p e en s each heal h
ins i u ion om leaking i s in o ma ion h ough blockchains o a oid unde mining i s
compe i i e ad an age (Bai e al., 2022). Ma ke unce ain y anked he lowes among he
en i onmen al ac o s. Unce ain y abou ma ke demands o blockchain echnology
ela ing o cus ome s’beha io and p oduc i i y mus be conside ed.
4.4 Manage ial implica ions
The esul s p esen policymake s and heal h sec o manage s wi h a hie a chical blockchain
implemen a ion guide. This is because o hei incapabili y o inco po a e all c i ical ac o s
due o esou ce sca ci y simul aneously (Quayson e al., 2023a,b). Fo example, we sugges
ha heal h manage s build s a egies based on he impo ance o blockchain adop ion
enable s. Decision-make s should gi e blockchain’s“sa e y and p i acy conce ns”c i ical
a en ion. We encou age go e nmen agencies o enac policies and p o ide heal h
ins i u ions wi h a p ope suppo i e clima e o inco po a e blockchain echnology. We
also encou age blockchain de elope s o p o ide heal h ins i u ions wi h unique solu ions o
digi al inno a ion decisions.
Regula o y au ho i ies should p o ide inancial incen i es o minimize pe cei ed high
in es men s in blockchain echnology. They should also en o ce egula o y policies and
imp o e legal s uc u es o enable heal h ins i u ions o emb ace blockchains. In he USA,
legisla ion was in oduced o p omo e he blockchain (Tawiah e al., 2022). Fo example,
MSCRA
6,2
116
egula o y suppo is imp o ing, unlike in o he coun ies whe e egula ions p ohibi he
in oduc ion o a sma con ac .
Fu he mo e, heal hca e adminis a o s need o no e he possible isks o using
blockchain echnology. Fo example, s anda diza ion o blockchain a chi ec u es emains
missing, wi h mo e han 6,500 ac i e Gi Hub blockchain p ojec s in 2018, wi h p ojec s
ocused on a ious p i acy measu es.
Blockchain implemen a ion is in he ea ly s ages o adop ion in he heal h sec o . I equi es
a long-li e implemen a ion cycle, and i s impo ance in business p ocesses is unclea (Quei oz
and Fosso Wamba, 2019). Ad anced echnological in as uc u e is also necessa y o he
heal hca e sec o so ha compu e s can connec o he In e ne o p ocessing ansac ions.
Mo eo e , ega ding he simila na u e o many A ican coun ies’heal h indus ies, he
ou come o his s udy can be implemen ed in o he A ican coun ies such as Togo and Nige ia.
Fu he mo e, his s udy also p o ides signi ican implica ions o heal hca e supply chains.
Fi s , he indings sugges he impo ance o c ea ing awa eness by educa ing heal hca e
supply chain pa icipan s abou using blockchain echnology in heal hca e in o ma ion
managemen (Esmaeilzadeh and Mi zaei, 2019). Fo ins ance, na ional educa ional p og ams,
heal h con e ences and webina s ha a e easily accessible o a wide ange o heal hca e
supply chain pa icipan s can be adminis e ed o publicize blockchain-based heal hca e
in o ma ion managemen ’s key goals and ad an ages. Educa ional o ums a ailable on
o icial heal h websi es, Web-based u o ials accessible on pa icipan s’po als o web-based
heal h communi ies and compu e ized help p og ams can be used in he heal hca e supply
chain o imp o e he anspa ency o blockchain applica ions in in o ma ion managemen ,
b oadcas hei expec ed bene i s and inc ease public awa eness and amilia i y wi h his
exchange mechanisms.
Second, ega ding he impo ance o in o ma ion p i acy in blockchain-based heal hca e
in o ma ion managemen , heal hca e supply chain ac o s should conside using ac ics o
inc ease he anspa ency and comple eness o p i acy policy and in es conside able e o
in de eloping campaigns ha le e age he powe o blockchain image and epu a ion in he
heal hca e supply chain.
Thi d, supply chain ac o s mus e isi hei supply chain s a egy and add ess wha hey
cu en ly do ega ding heal hca e in o ma ion managemen , why blockchain is equi ed,
wha blockchain a chi ec u e is he bes op ion and how hey can implemen i (Esmaeilzadeh,
2022). The unau ho ized sha ing o sensi i e heal h in o ma ion can e ode public us in
heal hca e sys ems. Heal hca e supply chain pa icipan s can encou age inc eased adop ion
o blockchain o secu e and in e ope able in o ma ion managemen . Blockchain sys em
de elope s can also play an essen ial ole in designing blockchain-based heal hca e
in o ma ion managemen sys em ha imp o es in e ope abili y. Blockchain sys em
de elope s mus de elop ede a ed blockchain models o in o ma ion managemen ha
enable heal hca e supply chain pa icipan s o coope a e wi h a ious en i ies.
Finally, he adop ion o blockchain echnology may equi e heal hca e supply chain
pa icipan s o acqui e new skills and knowledge. This may equi e aining o ensu e
e ec i e implemen a ion.
5. Conclusion
Blockchain is one o he digi al echnologies o he nex decade. Despi e he many ad an ages
his echnology p o ides, he ies be ween he bene i s and he lack o awa eness a e e iden
in he heal hca e sec o , whe e manage s ha e li le o no in o ma ion abou he e iciency o
blockchain echnology and i s implemen a ion (Kumme e al., 2020).
This pape heo e ically cen e ed on he TOE amewo k o p opose a decision amewo k
o implemen ing blockchain echnology in Ghana’s heal h indus y. We de eloped a BWM
Enable s o
blockchain
echnology
117
modeling amewo k o ank he signi ican ac o s ha a ec he adop ion o blockchains.
We ga he ed da a om 20 heal h indus y expe s in Ghana. The esul s showed ha he
main echnological enable s a e he mos in luen ial c i e ia o adop ing blockchain han
o ganiza ional and en i onmen al enable s. Also, among he global anking o he indi idual
enable s, he op ou include he a ailabili y o secu i y and p i acy, in as uc u al
acili ies, p esence o aining acili ies and go e nmen policy and suppo .
The indings o e an in-dep h unde s anding o he c i ical ac o s ha encou age
blockchain adop ion in he heal h sec o , in con as o p e ious s udies ocusing on
blockchain implemen a ion in b oade supply chains. The s udy inco po a es essen ial heal h
conside a ions as a ea u e o blockchain adop ion. This s udy p o ides a aluable amewo k
o u he and mo e de ailed heo e ical esea ch on c ucial ac o s o implemen ing
blockchain echnology, pa icula ly in he heal h indus y’s eme ging economies.
5.1 Limi a ions and u u e esea ch di ec ions
While his esea ch con ibu es o he li e a u e, he e a e limi a ions like any o he esea ch.
Fo example, only 25 enable s we e iden i ied om he li e a u e and 17 we e used inally.
These cons ain s, howe e , p esen majo pa hways o u he s udies. Fo ins ance,
ano he MCDM echnique may be used o eplace he BWM model. Fo example, he AHP,
uzzy se and decision-making ial and e alua ion labo a o y (DEMATEL) analyze he
ela i e impo ance o essen ial ac o s a ec ing blockchains in he heal h indus y.
Addi ionally, o he sec o s may be analyzed o unde s and he c i ical ac o s in he
blockchain adop ion p ocess. Mo eo e , his s udy’s indings can be gene alized by
conside ing di e en heal h acili ies in Ghana and o he eme ging and de eloping coun ies
like China and India. O he esea che s can ca y ou a compa a i e s udy o in o m abou
di e ences in he signi icance o a iables in he a ious se ice con ex s and coun ies.
Finally, o he s udies can analyze he ac o s in luencing blockchain echnology
pe o mance. The ela ionship be ween “e ec i e blockchain use”and “pe o mance
imp o emen in he heal h sec o ”con inues o be limi ed by his s udy. Fu u e s udies
can analyze his ela ionship.
Re e ences
Abekah -Nk umah, G., Gue ie o, M. and Pu ohi , P. (2014), “ICTs and ma e nal heal hca e u iliza ion.
e idence om Ghana”,In e na ional Jou nal o Social Economics, Vol. 41 No. 7, pp. 518-541, doi:
10.1108/IJSE-11-2012-0218.
A a an, M. (2022), “Blockchain echnology in heal hca e: challenges and oppo uni ies”,In e na ional
Jou nal o Heal hca e Managemen , Vol. 15 No. 1, pp. 70-83, doi: 10.1080/20479700.2020.
1843887.
Bai, C., Quayson, M. and Sa kis, J. (2022), “Analysis o Blockchain’s enable s o imp o ing
sus ainable supply chain anspa ency in A ica cocoa indus y”,Jou nal o Cleane P oduc ion,
Vol. 358 No. Oc obe 2020, 131896, doi: 10.1016/j.jclep o.2022.131896.
Chang, V., Doan, L.M.T., A iel Xu, Q., Hall, K., Anna Wang, Y. and Mus a a Kamal, M. (2023),
“Digi aliza ion in omnichannel heal hca e supply chain businesses: he ole o sma wea able
de ices”,Jou nal o Business Resea ch, Vol. 156, 113369, doi: 10.1016/j.jbus es.2022.113369.
Da ko, D., Zhu, D., Quayson, M., Hossin, M.A., Omo uyi, O. and Bediako, A.K. (2023), “A mul ic i e ia
decision amewo k o go e nance o PPP p ojec s owa ds sus ainable de elopmen ”,Socio-
Economic Planning Sciences, Vol. 87, 101580, doi: 10.1016/j.seps.2023.101580.
E ah, D., Bai, C., Asan e, W.A. and Quayson, M. (2023), “The ole o a i icial in elligence in coping
wi h ex eme wea he -induced cocoa supply chain isks”,IEEE T ansac ions on Enginee ing
Managemen , pp. 1-22, doi: 10.1109/TEM.2023.3289258.
MSCRA
6,2
118
El as, L.B., Se ~
ao, C. and Fe ei a, J.C. (2023), “Sha ing heal h in o ma ion using a blockchain”,
Heal hca e (Swi ze land), Vol. 11 No. 2, pp. 1-14, doi: 10.3390/heal hca e11020170.
Esmaeilzadeh, P. (2022), “Bene i s and conce ns associa ed wi h blockchain-based heal h in o ma ion
exchange (HIE): a quali a i e s udy om physicians’pe spec i es”,BMC Medical In o ma ics
and Decision Making, Vol. 22 No. 1, pp. 1-18, doi: 10.1186/s12911-022-01815-8.
Esmaeilzadeh, P. and Mi zaei, T. (2019), “The po en ial o blockchain echnology o heal h
in o ma ion exchange: expe imen al s udy om pa ien s’pe spec i es”,Jou nal o Medical
In e ne Resea ch, Vol. 21 No. 6, p. e14184, doi: 10.2196/14184.
Glass, B. (2014), “Coun e ei d ugs and medical de ices in de eloping coun ies”,Resea ch and
Repo s in T opical Medicine, Vol. 5, pp. 11-22, doi: 10.2147/ m.s39354.
Gongo a-Salaza , P., Rocks, S., Fah , P., Ri e o-A ias, O. and Tsiach is as, A. (2023), “The use o
mul ic i e ia decision analysis o suppo decision making in heal hca e: an upda ed sys ema ic
li e a u e e iew”,Value in Heal h, Vol. 26 No. 5, pp. 780-790, doi: 10.1016/j.j al.2022.11.007.
G uchmann, T., Elgazza , S. and Ali, A.H. (2023), “Blockchain echnology in pha maceu ical supply
chains: a ansac ion cos pe spec i e”,Mode n Supply Chain Resea ch and Applica ions, Vol. 5
No. 2, pp. 115-133, doi: 10.1108/msc a-10-2022-0023.
Hadid, M., Elom i, A., El Mekkawy, T., Ke bache, L., El Om i, A., El Om i, H., Taha, R.Y., Hamad, A.A.
and Al Thani, M.H.J. (2022), “Bibliome ic analysis o cance ca e ope a ions managemen :
cu en s a us, de elopmen s, and u u e di ec ions”,Heal h Ca e Managemen Science, Vol. 25
No. 1, pp. 166-185, doi: 10.1007/s10729-021-09585-x.
Hajian, A., P ybu ok, V.R. and Chang, H.C. (2023), “An empi ical s udy o blockchain-based
in o ma ion sha ing sys ems in elec onic heal h eco ds: a media ion pe spec i e”,Compu e s
in Human Beha io , Vol. 138 No. Sep embe 2021, 107471, doi: 10.1016/j.chb.2022.107471.
Hani , M.S., Yun ei, S. and Hani , M.I. (2018), “G ow h p ospec s, ma ke challenges and policy
measu es: e olu ion o mobile b oadband in Pakis an”,Digi al Policy, Regula ion and
Go e nance, Vol. 20 No. 1, pp. 42-61, doi: 10.1108/DPRG-04-2017-0014.
Hasselg en, A., K ale ska, K., Gligo oski, D., Pede sen, S.A. and Fax aag, A. (2020), “Blockchain in
heal hca e and heal h sciences—a scoping e iew”,In e na ional Jou nal o Medical
In o ma ics, Vol. 134 No. May 2019, 104040, doi: 10.1016/j.ijmedin .2019.104040.
Ibo , A.E., Edim, E.B. and Ojugo, A.A. (2023), “Secu e heal h in o ma ion sys em wi h blockchain
echnology”,Jou nal o he Nige ian Socie y o Physical Sciences, Vol. 5 No. 2, pp. 1-8, doi: 10.
46481/jnsps.2023.992.
Kamble, S., Gunaseka an, A. and A ha, H. (2019), “Unde s anding he blockchain echnology adop ion
in supply chains-Indian con ex ”,In e na ional Jou nal o P oduc ionResea ch, Vol. 57 No. 7,
pp. 2009-2033, doi: 10.1080/00207543.2018.1518610.
Kamble, S.S., Gunaseka an, A., Kuma , V., Belhadi, A. and Fo opon, C. (2021), “A machine lea ning
based app oach o p edic ing blockchain adop ion in supply Chain”,Technological Fo ecas ing
and Social Change, Vol. 163, No embe 2020, 120465, doi: 10.1016/j. ech o e.2020.120465.
Khan, R.A. and Mi , A.H. (2019), “IP mobili y adop ion in e-heal h se ices: a solu ion o mode n
heal hca e moni o ing sys em”,In e na ional Jou nal o Heal hca e Technology and
Managemen , Vol. 17 No. 4, p. 278, doi: 10.1504/IJHTM.2019.104943.
Knudsen, D. and Nickels, B.P. (2015), “Sou h A ica alling Sho in coun e ei medicines Figh jIPI
global obse a o y”,Global Obse a o y.
Kombe, C., e al. (2019), “Blockchain echnology in sub-saha an A ica: whe e does i i in heal hca e
sys ems: a case o Tanzania”,Jou nal o Heal h In o ma ics in De eloping Coun ies, Vol. 13
No. 2, p. 1, a ailable a : h p://sea ch.ebscohos .com/login.aspx?di ec 5 ue&db5edb&AN
5140226561&lang5p -b &si e5eds-li e&scope5si e
Kumme , S., He old, D.M., Dob o nik, M., Mikl, J. and Sch€
a e , N. (2020), “A sys ema ic e iew o
blockchain li e a u e in logis ics and supply chain managemen : iden i ying esea ch ques ions
and u u e di ec ions”,Fu u e In e ne , Vol. 12 No. 3, p. 60, doi: 10.3390/ i12030060.
Enable s o
blockchain
echnology
119
Kushwaha, D. and Talib, F. (2020), Ranking o ba ie s o g een manu ac u ing implemen a ion in
SMEs using bes -wo s me hod, IOP Con e ence Se ies: Ma e ials Science and Enginee ing,
Vol. 748 No. 1, p. 18, doi: 10.1088/1757-899X/748/1/012017.
Lynbe g, L. and Dei , A. (2023), “Ne wo k e ec s in blockchain and supply chain: a heo e ical
esea ch syn hesis”,Mode n Supply Chain Resea ch and Applica ions, Vol. 5 No. 1, pp. 2-27,
doi: 10.1108/msc a-07-2022-0016.
Mahajan, H.B., Rashid, A.S., Junna ka , A.A., Uke, N., Deshpande, S.D., Fu ane, P.R., Alkhayya , A.
and Alhayani, B. (2023), “In eg a ion o Heal hca e 4.0 and blockchain in o secu e cloud-based
elec onic heal h eco ds sys ems”,Applied Nanoscience (Swi ze land), Vol. 13 No. 3,
pp. 2329-2342, doi: 10.1007/s13204-021-02164-0.
Minis y o Heal h (2018), “Ghana heal h commodi y supply chain mas e plan logis ics managemen
in o ma ion sys em assessmen epo ”.
Ndayizigamiye, P. and Dube, S. (2019), “Po en ial adop ion o blockchain echnology o enhance
anspa ency and accoun abili y in he public heal hca e sys em in Sou h A ica”,P oceedings -
2019 In e na ional Mul idisciplina y In o ma ion Technology and Enginee ing Con e ence, 2019,
IMITEC, doi: 10.1109/IMITEC45504.2019.9015920.
O ji, I.J., Kusi-Sa pong, S., Huang, S. and Vazquez-B us , D. (2020), “E alua ing he ac o s ha
in luence blockchain adop ion in he eigh logis ics indus y”,T anspo a ion Resea ch Pa
E: Logis ics and T anspo a ion Re iew, Vol. 141, July, 102025, doi: 10.1016/j. e.2020.102025.
Pawa , P., Pa olia, N., Shinde, S., Edoh, T.O. and Singh, M. (2022), “eHeal hChain—a blockchain-based
pe sonal heal h in o ma ion managemen sys em”,Annales des Telecommunica ions/Annals o
Telecommunica ions, Vol. 77 Nos 1-2, pp. 33-45, doi: 10.1007/s12243-021-00868-6.
Quayson, M., Bai, C. and Sa kis, J. (2020), “Technology o social good ounda ions : a pe spec i e om
he smallholde a me in sus ainable supply chains”,IEEE T ansac ions on Enginee ing
Managemen , Vol. 68 No. 3, pp. 894-898, doi: 10.1109/ em.2020.2996003.
Quayson, M., Bai, C., Mahmoudi, A., Hu, W., Chen, W. and Omo uyi, O. (2023a), “Designing a decision
suppo ool o in eg a ing ESG in o he na u al esou ce ex ac ion indus y o sus ainable
de elopmen using he o dinal p io i y app oach”,Resou ces Policy, Vol. 85, PA, 103988, doi: 10.
1016/j. esou pol.2023.103988.
Quayson, M., Bai, C. and Sa kis, J. (2023b), Building Blockchain-D i en Dynamic Capabili ies o
De eloping Ci cula Supply Chain : Re hinking he Role o Sensing, Seizing, and Recon igu ing’,
May 2022, pp. 1-20, doi: 10.1002/bse.3395.
Quei oz, M.M. and Fosso Wamba, S. (2019), “Blockchain adop ion challenges in supply chain: an
empi ical in es iga ion o he main d i e s in India and he USA”,In e na ional Jou nal o
In o ma ion Managemen , Vol. 46, July, pp. 70-82, doi: 10.1016/j.ijin omg .2018.11.021.
Rai, B.K. (2023), “PcBEHR: pa ien -con olled blockchain enabled elec onic heal h eco ds o
heal hca e 4.0”,Heal h Se ices and Ou comes Resea ch Me hodology, Vol. 23 No. 1, pp. 80-102,
doi: 10.1007/s10742-022-00279-7.
Randall, D., Goel, P. and Abujam a, R. (2017), “Blockchain applica ions and use cases in heal h
in o ma ion echnology”,Jou nal o Heal h & Medical In o ma ics,Vol.8No.3,pp.8-11,
doi: 10.4172/2157-7420.1000276.
Raza, M.H., Abid, M., Yan, T., Ali Naq i, S.A., Akh a , S. and Faisal, M. (2019), “Unde s anding
a me s’in en ions o adop sus ainable c op esidue managemen p ac ices: a s uc u al
equa ion modeling app oach”,Jou nal o Cleane P oduc ion, Vol. 227, pp. 613-623, doi: 10.1016/
j.jclep o.2019.04.244.
Rezaei, J. (2015), “Bes -wo s mul i-c i e ia decision-making me hod”,Omega (Uni ed Kingdom),
Vol. 53, pp. 49-57, doi: 10.1016/j.omega.2014.11.009.
Rezaei, J. (2016), “Bes -wo s mul i-c i e ia decision-making me hod: some p ope ies and a linea
model”,Omega (Uni ed Kingdom), Vol. 64, pp. 126-130, doi: 10.1016/j.omega.2015.12.001.
MSCRA
6,2
120
Schmid , C.G. and Wagne , S.M. (2019), “Blockchain and supply chain ela ions: a ansac ion cos
heo y pe spec i e”,Jou nal o Pu chasing and Supply Managemen , Vol. 25 No. 4, 100552,
doi: 10.1016/j.pu sup.2019.100552.
Shahnaz, A., Qama , U. and Khalid, A. (2019), “Using blockchain o elec onic heal h eco ds”,IEEE
Access, Vol. 7, pp. 147782-147795, doi: 10.1109/ACCESS.2019.2946373.
Sha ma, P., Namasud a, S., Gonzalez C espo, R., Pa a-Fuen e, J. and Chand a T i edi, M. (2023),
“EHDHE: enhancing secu i y o heal hca e documen s in IoT-enabled digi al heal hca e
ecosys ems using blockchain”,In o ma ion Sciences, Vol. 629 No. Decembe 2021, pp. 703-718,
doi: 10.1016/j.ins.2023.01.148.
Shiau, W.-L., Liu, C., Zhou, M. and Yuan, Y. (2023), “Insigh s in o cus ome s’psychological mechanism in
acial ecogni ion paymen in o line con ac less se ices: in eg a ing belie –a i ude–in en ion and
TOE–I amewo ks”,In e ne Resea ch, Vol. 33 No. 1, pp. 344-387, doi: 10.1108/in -08-2021-0629.
Tawiah, V., Zaka i, A., Li, G. and Kyiu, A. (2022), “Blockchain echnology and en i onmen al
e iciency: e idence om US-lis ed i ms”,Business S a egy and he En i onmen , Vol. 31 No. 8,
pp. 3757-3768, doi: 10.1002/bse.3030.
T ipa hi, G., Ahad, M.A. and Pai a, S. (2020), “S2HS- A blockchain based app oach o sma
heal hca e sys em”,Heal hca e, Vol. 8 No. 1, 100391, doi: 10.1016/j.hjdsi.2019.100391.
Tu ou , P., Opoku-Mensah, E., Asiedu-Ayeh, L.O. and Da ko, D. (2022), “Assessing go e nmen s
esponse o exogenous shocks: conside ing he COVID-19 pandemic in he Ghanaian con ex ”,
Jou nal o Public A ai s, Vol. 22 No. 4, doi: 10.1002/pa.2755.
Villa eal, E.R.D., Ga cia-Alonso, J., Moguel, E. and Aleg ia, J.A.H. (2023), “Blockchain o heal hca e
managemen sys ems: a su ey on in e ope abili y and secu i y”,IEEE Access, Vol. 11, Janua y,
pp. 5629-5652, doi: 10.1109/ACCESS.2023.3236505.
Wang, W., Hoang, D.T., Hu, P., Xiong, Z., Niya o, D., Wang, P., Wen, Y. and Kim, D.I. (2019), “A su ey
on consensus mechanisms and mining s a egy managemen in blockchain ne wo ks”,IEEE
Access, Vol. 7, pp. 22328-22370, doi: 10.1109/ACCESS.2019.2896108.
Wol , S. and Madlene , R. (2019), “D i en by change: comme cial d i e s’accep ance and e iciency
pe cep ions o ligh -du y elec ic ehicle usage in Ge many”,T anspo a ion Resea ch Pa C,
Vol. 105, June, pp. 262-282, doi: 10.1016/j. c.2019.05.017.
Wong, L.W., Leong, L.Y., Hew, J.J., Tan, G.W.H. and Ooi, K.B. (2020), “Time o seize he digi al
e olu ion: adop ion o blockchain in ope a ions and supply chain managemen among
Malaysian SMEs”,In e na ional Jou nal o In o ma ion Managemen , Vol. 52 No. Ma ch 2019,
101997, doi: 10.1016/j.ijin omg .2019.08.005.
Yada , A.K., Shwe a and Kuma , D. (2023), “Blockchain echnology and accine supply chain:
explo a ion and analysis o he adop ion ba ie s in he Indian con ex ”,In e na ional Jou nal o
P oduc ion Economics, Vol. 255 No. Ma ch 2022, 108716, doi: 10.1016/j.ijpe.2022.108716.
Ya uz, O., Une , M.M., Okumus, F. and Ka a epe, O.M. (2023), “Indus y 4.0 echnologies, sus ainable
ope a ions p ac ices and hei impac s on sus ainable pe o mance”,Jou nal o Cleane
P oduc ion, Vol. 387, 135951, doi: 10.1016/j.jclep o.2023.135951.
Co esponding au ho
Ma hew Quayson can be con ac ed a : mquayson@h u.edu.gh
Fo ins uc ions on how o o de ep in s o his a icle, please isi ou websi e:
www.eme aldg ouppublishing.com/licensing/ ep in s.h m
O con ac us o u he de ails: [email p o ec ed]
Enable s o
blockchain
echnology
121
