Healthcare 4.0 – fatores que influenciam a adoção de uma arquitetura blockchain em sistemas de informação de saúde

Abstract

In recent years, advances in information technology have revolutionized various sectors, including healthcare. Blockchain technology stands out as a promising solution for improving security, efficiency and interoperability in healthcare systems. However, the adoption of a new technology in the healthcare sector is a challenging task, requiring an in-depth understanding of the factors that influence the acceptance and implementation of this innovation by healthcare professionals and other stakeholders involved. The main objective of this study is to understand the relationships between the factors of ease of use, perceived usefulness, attitude, security and privacy, regulatory governance and health industry standards, as well as their relationship with the intention to adopt blockchain architecture in health information systems, using an extended version of the Technology Acceptance Model (TAM). State-of-the-art research reveals a growing interest in the application of blockchain in healthcare, with innovative projects such as Healthchain, which emphasizes security, integration with smart sensors and data sharing. However, challenges remain, including the need for infrastructure, interconnection and awareness among stakeholders. The evolution of blockchain and smart contracts, along with the emergence of the Internet of Health Things (IoHT), promise to transform the sector, but require care in addressing challenges such as interoperability, security and privacy. The study was conducted using applied, exploratory and quantitative research involving information technology professionals in hospital organizations in Rio Grande do Sul. Data analysis included descriptive analysis, Confirmatory Component Analysis (CCA) to validate the constructs of the proposed model, discriminant validation, normality testing and Structural Equation Modeling (SEM) with PLS-SEM as a pilot application for the proposed extended TAM model. The descriptive analysis showed that leaders had lower agreement on items about ease of use and perceived usefulness compared to leaders. The results indicate a promising positive relationship between the ease of use and perceived usefulness constructs and the attitude towards adopting blockchain architecture. In divergence with the main findings in the literature, adoption intention was not positively influenced by the factors of attitude and perceived usefulness. The prediction of the perceived security and privacy construct on the intention to adopt blockchain in health information systems was considered promising, although it did not show a positive influence on perceived usefulness. Another highlight was the promising finding of the hypothesis that regulatory governance and health industry standards have a positive influence on perceived security and privacy.