Blockchain for electronic medical record: assessing stakeholders' readiness for successful blockchain adoption in health-care

Purpose: This paper aims to provide a helpful tool for those who plan to implement blockchain-based solutions for the governance of the electronic medical record (EMR) in health-care settings. The goals are to identify each type of stakeholders involved in these projects and to clarify the relevance, to achieve success, of their readiness, intended as availability and ability to adopt blockchain. Design/methodology/approach: The chosen methodology is a multiple case study on three initiatives that used blockchain to manage EMRs. This study relied on multiple sources of evidence. The primary data consisted of two rounds of semi-structured interviews with different informants. This study followed a grounded theory approach and performed within- and cross-case analyses. Findings: This study identified the types of stakeholders - nodes and not-nodes - of the network and how their readiness level affects the implementation of blockchain-based projects applied to EMR. The nodes (e.g. patients and doctors) are pivotal in making the network working once this has been constructed. Out of the four readiness dimensions suggested by literature, motivational readiness, has the higher impact. Not-nodes stakeholders play a pivotal role in the project's pre-implementation phase. For them, structural readiness is the dimension with the higher relevance. Originality/value: To the best of the authors' knowledge, it is the first time that a paper analyses the differences between nodes and not-nodes stakeholders of the blockchain network, in terms not only of type but also of readiness. Identifying the readiness level to implement successful projects is a fundamental step that has never been analysed in the health field.