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Cited by 676Blockchain Technology Applications and SecurityElectronic Health Records SystemsBlockchain Technology in Education and Learning

Blockchain in healthcare and health sciences—A scoping review

Open access
Hasselgren, Anton, Kralevska, Katina, Gligoroski, Danilo, Pedersen, Sindre A., Faxvaag, Arild·2020·International Journal of Medical Informatics
DOI 10.1016/j.ijmedinf.2019.104040
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Abstract

BACKGROUND: Blockchain can be described as an immutable ledger, logging data entries in a decentralized manner. This new technology has been suggested to disrupt a wide range of data-driven domains, including the health domain. OBJECTIVE: The purpose of this study was to systematically review, assess and synthesize peer-reviewed publications utilizing/proposing to utilize blockchain to improve processes and services in healthcare, health sciences and health education. METHOD: A structured literature search on the topic was conducted in October 2018 relevant bibliographic databases. RESULT: 39 publications fulfilled the inclusion criteria. The result indicates that Electronic Health Records and Personal Health Records are the most targeted areas using blockchain technology. Access control, interoperability, provenance and data integrity are all issues that are meant to be improved by blockchain technology in this field. Ethereum and Hyperledger fabric seem to be the most used platforms/frameworks in this domain. CONCLUSION: This study shows that the endeavors of using blockchain technology in the health domain are increasing exponentially. There are areas within the health domain that potentially could be highly impacted by blockchain technology.

AI snapshot

Written from the paper’s full text.

TL;DR

This scoping review systematically assessed 39 peer-reviewed publications on blockchain in healthcare, health sciences, and health education. It found that EHRs and PHRs are the most targeted areas, consortium blockchains and Ethereum/Hyperledger are common, but the field remains early and lacks evidence of real-world effects and regulatory compliance.

Key findings

  • Of 39 included publications, 43% targeted electronic health records, 15% personal health records, and 5% clinical trial support systems; 62% addressed some process of sharing health data.
  • Blockchain was proposed to improve access control in 35% of publications, interoperability in 27%, data integrity in 28%, and provenance in 12%.
  • Consortium blockchain was the preferred type (38%); Ethereum was used in 28%, Hyperledger Fabric in 10%, and Exonum in 4%; 36% developed a new blockchain and 21% did not specify a platform. PoW was the most frequent consensus algorithm (21%), PBFT was 15%, 41% did not state a consensus protocol, and 38% used smart contracts.
  • The average citation count was 21 ± 40 (up to March 2019); publications by year were 2016 (n = 4), 2017 (n = 11), and 2018 (n = 23); most studies were associated with Chinese (42%) or USA (20%) research institutes. Quality assessment total mean score was 5.7 ± 1.8, with a range of 1–9.

Methods

  • A structured literature search was conducted in October 2018 in MEDLINE, Embase, Cochrane Library, Scopus, Google Scholar, Compendex, Inspec, ACM, and IEEE, searching for “blockchain” combined with “health” and using backward/forward snowballing.
  • Titles, abstracts, and full articles were screened by reviewer 1, with doubtful cases reviewed by three additional reviewers; disagreements were resolved by discussion. Data were extracted into a pre-developed matrix and analyzed in Microsoft Excel.
  • Quality assessment used a tool adapted from Hölbl et al.; no papers were excluded in this process. All included papers were categorized as Proof-of-Concept design, and eleven were considered a hybrid between Proof-of-Concept and case-study design.

Limitations

  • The paper states that the review does not capture the whole picture, especially promising private-sector developments not covered in the included publications, such as genome management and medical credential systems.
  • The paper states that none of the included publications described how their blockchain-based solution complied with GDPR, HIPAA, or other national health data laws and regulations.
  • Evident from the text: many included publications failed to define their blockchain type, platform/framework, or consensus protocol, limiting comparability and feasibility assessment; the search was last updated in October 2018, so later work is not included.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1016/j.ijmedinf.2019.104040

Cites

45 of 45 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 32 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    Thirty-nine publications fulfilled the inclusion criteria.

    “39 publications fulfilled the inclusion criteria.”
    • Also stated in: § 4. Results · plain
      “The following section presents a summary of the extracted data from the included papers (n = 39).”
    Quote in the paperSubstantial claim
  • Findingown data

    More than half of the publications (62%) addressed some processes of sharing health data.

    “More than half of the publications (62 %) addressed some processes of sharing health data.”
    Quote in the paperNot a substantial claim
  • Findingown data

    The most frequently targeted system was EHR, with 43% of the publications addressing this topic.

    “The most frequently targeted system was EHR, with 43 % of the publications addressing this topic.”
    Quote in the paperNot a substantial claim
  • Findingown data

    Electronic Health Records and Personal Health Records are the most targeted areas using blockchain technology in the health domain.

    “The result indicates that Electronic Health Records and Personal Health Records are the most targeted areas using blockchain technology.”
    • Also stated in: § 4.1.1. Summary of proposed solutions · plain
      “The most frequently targeted system was EHR, with 43 % of the publications addressing this topic.Other systems of focus were PHR (15 %) and clinical trial support systems (5 %).”
    Quote in the paperSubstantial claim
  • Findingown data

    Many of the PHRs were proposed as patient-controlled and not tethered to a particular health institution or system.

    “Many of the PHRs were proposed as patient-controlled and not tethered to a particular health institution or system (Table 6).”
    Quote in the paperNot a substantial claim
  • Classified as probably not a substantial claim. 25
  • May combine two claims. 17

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    The included papers were published in 2016 (n = 4), 2017 (n = 11), and 2018 (n = 23).

    “The included papers were published during the following years; 2016 (n = 4), 2017 (n = 11) and 2018 (n = 23).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Most studies were associated with Chinese research institutes or research groups (42%), followed by institutes and groups in the USA (20%).

    “Most studies were associated with Chinese research institutes or research groups (42 %) followed by institutes and groups in the USA (20 %).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Access control, interoperability, provenance and data integrity are issues that are meant to be improved by blockchain technology in the health domain.

    “Access control, interoperability, provenance and data integrity are all issues that are meant to be improved by blockchain technology in this field.”
    • Also stated in: § 4.1.2. Challenges which blockchain aims to improve · plain
      “As illustraded in Table 5, blockchain was suggested as an improvement to access control in 35 % of the included publications.”
    • Also stated in: § Health Information system · plain
      “Blockchain solutions for the interoperability challenges were discussed in several papers (27 %) (Table 5).”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    The papers had an average citation count of 21 ± 40 (up to March 2019).

    “The papers had an average citation count of 21 ± 40 (up to March 2019).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    The included publications are evenly distributed between journal publications and conference proceedings.

    “As shown in Table 4, the included publications seem to be evenly distributed between journal publications and conference proceedings.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    A large proportion of included publications proposed a structural design (54%) as main contribution, followed by proposals including new algorithms or protocols (38%).

    “A large proportion proposed a structural design (54 %) as main contribution, followed by proposals including new algorithms or protocols (38 %) (Table 4).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    IEEE Access with five papers and The Journal of Medical Systems with six papers represented the journals with most included publications.

    “IEEE Access with five papers and The Journal of Medical Systems with six papers represented the journals with most included publications.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Other systems of focus were PHR (15%) and clinical trial support systems (5%).

    “Other systems of focus were PHR (15 %) and clinical trial support systems (5 %).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingnone given

    Eleven of the included papers could be considered as a hybrid between a Proof-of-Concept and a Case-study design.

    “In addition, eleven of the included papers could be considered as a hybrid between a Proof-of-Concept and a Casestudy design.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Findingnone given

    Not all concepts that are built using the Ethereum platform or Ethereum protocols used PoW.

    “In addition, it is also noteworthy that not all concepts that are built using the Ethereum platform or Ethereum protocols used PoW.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Exonum was utilized once (4%) in the included publications.

    “Ethereum was utilized in eleven (28 %) of the 39 included publications, Hyperledger Fabric four times (10 %) and Exonum once (4 %) (Fig. 4).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The quality of the included publications varies with a standard deviation of 1.8 for the total mean score and a range of 1-9.

    “The quality of the included publications varies with a standard deviation of 1.8 for the total mean score and a range of 1-9.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Ethereum and Hyperledger are so far the most popular existing blockchain frameworks/platforms.

    “Ethereum (decentralized platform) (5) and Hyperledger (framework) [9] are so far the most popular, and both allow developers to build new blockchain applications onto existing blockchains and to create new test-nets using their protocols.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [9]

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    Data extraction was mainly done by reviewer 1 and later re-examined by reviewers 2-4.

    “Data was extracted from the included papers in a pre-development matrix.The data extraction was mainly done by reviewer 1 [AH] and later re-examined by reviewers 2-4 [AF, KK and DG].”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    Titles, abstracts and full articles were screened by reviewer 1 applying inclusion and exclusion criteria, with publications meeting criteria or in doubt reviewed a second time by three additional reviewers, and disagreements resolved by discussion among all four reviewers.

    “Titles, abstracts and full articles were subsequently screened by reviewer 1 [AH] applying the inclusion and exclusion criteria (Appendix B -Protocol).Publications meeting the inclusive criteria, and those for which the first reviewer was in doubt, were reviewed a second time by three additional reviewers [AF, KK and DG].In cases of disagreement, a discussion between all four reviewers determined”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Premisenone given

    Access control, provenance, data integrity and interoperability are crucial to both maintain patient privacy and exchange data with other institutions in the healthcare ecosystem.

    “To both maintain the patient's privacy and exchange data with other institutions in the healthcare ecosystem, access control, provenance, data integrity and interoperability are crucial.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Ethereum is at this date the largest facilitator of smart contracts on blockchain.

    “The blockchain Ethereum is at this date the largest facilitator of smart contracts on blockchain [5].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [5]

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Bitcoin represents a solid use-case that blockchain technology works.

    “Bitcoin, with close to 400 million completed transactions (March 19, 2019) [2], represents a solid use-case that blockchain technology works.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [2]

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationreasoning

    Blockchain technology has many appealing properties that could be utilized to improve and obtain a higher level of interoperability, information sharing, access control, provenance and data integrity among stakeholders.

    “With some of its key attributes such as decentralization, distribution and data integrity, and without any necessary third party, blockchain technology has many appealing properties that could be utilized to improve and obtain a higher level of interoperability, information sharing, access control, provenance and data integrity among the mentioned stakeholders, thereby moving towards a new”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Premisecitation

    Blockchain technology is considered to have potential for real improvement of health information systems.

    “Although blockchain technology is considered to have potential for real improvement of health information systems [3], the recent hype surrounding this technology similarly entails unrealistic proposals and ideas and current literature provides little overview of applications that have been developed, tested and/or deployed.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [3]

      Not checked in the free run.

  • May combine two claims.

    Interpretationown data

    Research on the explorative use of blockchain in healthcare is an academic research topic in its infancy, but the number of research groups, approaches and proposed solutions is currently growing exponentially.

    “In this scoping literature review, we have found that the research on the explorative use of blockchain in healthcare is an academic research topic in its infancy but that the number of research groups approaches and proposed solutions currently is growing exponentially.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Interpretationreasoning

    A smart-contract function, which often has the purpose of reducing third party interaction, has the potential of making health informatic processes more efficient.

    “A smart-contract function, which often has the purpose of reducing third party interaction, has the potential of making health informatic processes more efficient.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

    Study design and conductreasoning

    The strength of this publication is its stringent inclusion criteria and the quality assessment approach.

    “The strength of this publication is its stringent inclusion criteria and the quality assessment approach.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

    Study design and conductreasoning

    Although this study provides a good overview of what has recently been investigated in an academic peer-reviewed setting, the review does not capture the whole picture of the development in the area.

    “Although this study provides a good overview of what has recently been investigated in an academic (peer-reviewed) setting, the review does not capture the whole picture of the development in the area.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: There are promising developments in the private sector in other areas of the health sector that are not covered in the included publications for this review, for example genome management and medical credential systems.

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Interpretationown data

    Judged from the number of blockchain-related publications on Google Scholar, the inauguration and growth of blockchain in healthcare as an academic field is in line with those in other academic sectors.

    “Judged from the number of blockchain-related publications on Google Scholar, the inauguration and growth of blockchain in healthcare as an academic field is in line with those in other academic sectors.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Interpretationcitation

    A consortium blockchain may be more appropriate than a public permissionless or private blockchain to ensure that data are not accessible by those without view rights and to comply with current health data regulations.

    “Since HIS deals with highly sensitive data [18], which usually entails that a limited number of entities should have access, a consortium blockchain may be more appropriate than a public permissionless and private to ensure that data are not accessible by those who have no view rights and also to comply with current health data regulations.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [18]

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    With stronger emphasis on team-based care and continuity of care across institutional borders, and identity management and access control across different health systems, the processes of sharing become important.

    “With stronger emphasis on team-based care and continuity of care across institutional borders, and identity management and access control across different health systems, the processes of sharing becomes important [58].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [58] source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Premisecitation

    Health information systems deal with highly sensitive data.

    “Since HIS deals with highly sensitive data [18], which usually entails that a limited number of entities should have access, a consortium blockchain may be more appropriate than a public permissionless and private to ensure that data are not accessible by those who have no view rights and also to comply with current health data regulations.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [18]

      Not checked in the free run.

  • May combine two claims.

    Interpretationown data

    Research on the use of blockchain in healthcare is now established as an academic field, and the number and quality of publications are increasing rapidly.

    “Research on the use of blockchain in healthcare is now established as an academic field, and the number and quality of publications are increasing rapidly.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Interpretationreasoning

    The evidence collected in this review gives a clear indication that blockchain-enhanced solutions for m-health have promising potential and need to be explored further.

    “The evidence collected in this review gives a clear indication that blockchain enhanced solutions for this area of the health system have a promising potential and needs to be explored further.”
    Quote in the paperSubstantial claim
    • The authors state this as an assumption: M-health will increase at a rapid pace in the coming years.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Interpretationcitation

    Using blockchain for personal health records is an alternative take on using health information to fix a broken healthcare system and improve continuity of care, building on the patient in a more empowered and controlling role.

    “This is an alternative take on the use of health information to fix a broken healthcare system and improve the continuity of care [59] which builds on the patient in a more empowered and controlling role.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [59] source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Interpretationreasoning

    The popularity of Hyperledger in the included publications correlates well with the overall popularity of blockchain platforms.

    “This correlates well with the overall popularity of blockchain platforms.”
    Quote in the paperNot a substantial claim
32 of 32

  • The paper relies on this without support.

    Current literature provides little overview of applications that have been developed, tested and/or deployed.

    “current literature provides little overview of applications that have been developed, tested and/or deployed.”

  • The authors state this as an assumption.

    M-health will increase at a rapid pace in the coming years.

    “There is a reasonable assumption that m-health will increase at a rapid pace in the coming years and the need to verify and access m-health generated data by the health systems becomes crucial for the continued development of HIS and to insure that these data-driven systems stay up to date.”

  • The paper relies on this without support.

    Healthcare institutions are in critical demand for new and improved trust-preserving solutions.

    “Due to the over-arching importance of maintaining trust while satisfying an ever-increasing demand for exchange of data within the healthcare ecosystem, healthcare institutions are in critical demand for new and improved trust-preserving solutions.”

  • The paper relies on this without support.

    M-health is a rather new field and lacks a common data infrastructure and, to some degree, lacks common regulation around dealing with health data and getting the data accepted by the established health system.

    “M-health is a rather new field and lacks a common data infrastructure and, to some degree, lacks common regulation around dealing with health data and getting the data accepted by the established health system.”

  • The paper relies on this without support.

    There are promising developments in the private sector in other areas of the health sector that are not covered in the included publications for this review, for example genome management and medical credential systems.

    “There are promising developments in the private sector in other areas of the health sector that are not covered in the included publications for this review; for example, genome management and medical credential systems.”

  • The paper relies on this without support.

    The blockchain technology market in the global healthcare industrial sector is expected to cross $500 million by 2022.

    “This trend is also noticeable in the global healthcare industrial sector, where the blockchain technology market is expected to cross $500 million by 2022.”
6 of 6

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Prior systematic literature reviews on blockchain in healthcare have focused primarily on synthesizing or delineating trends and areas of blockchain application.

    “While these SLRs have contributed to the extant body of knowledge, their focus has primarily been on synthesizing or delineating trends (e.g.Hasselgren et al., 2020) and areas of blockchain application (see Risius & Spohrer, 2017;Hölbl et al. 2018;Agbo et al. 2019;Jaoude & Saade, 2019).”

    From Blockchain in healthcare: A systematic literature review, synthesizing framework and future research agenda (2020) · cites this paper as Hasselgren et al., 2020

  • Data breaches of wearable data are expected as an eventuality rather than a mere possibility.

    “Given the sensitivity of wearable data, next-generation cybersecurity tools, such as blockchain111, should be considered because data breaches are expected as an eventuality rather than a mere possibility and because the data constantly move from one platform to another.”

    From Smart wearable devices in cardiovascular care: Where we are and how to move forward (2021) · cites this paper as [111]

  • Blockchain has proved its success in healthcare and biomedical applications with promising performances in terms of healthcare data security, secure data management, and transparent medical data storage.

    “Up to date, blockchain has proved its success in healthcare and biomedical applications with promising performances in terms of healthcare data security [49], secure data management [50], [51], and transparent medical data storage [52], [53].”

    From Blockchain and AI-Based Solutions to Combat Coronavirus (COVID-19)-Like Epidemics: A Survey (2021) · cites this paper as [49]

  • In one study, 72% of patients were willing to share their health data with their physician, but fewer were willing to share with their health insurer or manufacturing companies (53%).

    “In one study, patients who were willing to share their health data with their physician (72%) but fewer with their health insurer or manufacturing companies (53%).57”

    From Unlocking Tomorrow’s Health Care: Expanding the Clinical Scope of Wearables by Applying Artificial Intelligence (2024) · cites this paper as [57]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Table 6 category counts do not reach its grand total

    Major

    The counts in Table 6 sum to 33, not the reported grand total of 39. This leaves six included publications unaccounted for in the table's categorization.

    Reported 39 · recomputed 33

  • Exonum proportion is incorrect

    Minor

    One of 39 publications is about 2.56%, or 3% rounded to the nearest integer, rather than 4%.

    Reported 4 · recomputed 2.564103

  • Quality-assessment criterion Q5 has conflicting definitions

    Minor

    The quality-assessment query defines Q5 as solution feasibility, whereas Table 8 labels Q5 as problem-solution fit.

  • Study 8 has both a defined and an undefined consensus algorithm

    Minor

    Table 7 lists study 8 under Practical Byzantine Fault Tolerance and again under "Not defined" for its consensus algorithm.

4 of 4

Cites

Flagged first, then by citations

1 of the 46 references couldn’t be matched to a known paper.

Research works printed but not linked: 2

  1. blockchain.com [cited 2019 09.03]. Available from: https://www.blockchain.com/charts/n-transactions-total.
  2. Courtney, 1989, Some informal comments about integrity and the integrity workshop

Cited by

Sorted by citations

Related

Authors
Hasselgren, A., Kralevska, K., Gligoroski, D., Pedersen, S. A., & Faxvaag, A.
Affiliations
Norwegian University of Science and Technology (NO)
Corresponding author
Hasselgren, Anton
ORCID
Venue
International Journal of Medical Informatics
Publisher
Elsevier BV
Published
2020-02
Volume
134
Pages
104040
ISSN
1386-5056 (ISSN-L)
DOI
10.1016/j.ijmedinf.2019.104040
OpenAlex
W2996452324
Semantic Scholar
e21700b05fc480d4f2c18462dbeaaf90dadb378d
Cited by
676
References
46
Citations by year
2026: 58 · 2025: 98 · 2024: 123 · 2023: 135 · 2022: 127 · 2021: 109 · 2020: 26
FWCI
11.40
Type
journal article
Language
en
Open access
Licence
Locations
  • International Journal of Medical Informatics (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • NORA - Norwegian Open Research Archives (submittedVersion, cc-by-nc-nd)
Topics
  • Physical Sciences › Computer Science › Information Systems › Blockchain Technology Applications and Security
  • Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
  • Physical Sciences › Computer Science › Information Systems › Blockchain Technology in Education and Learning
Keywords
blockchain, health care, electronic health records, personal health records, interoperability, data integrity, access control, provenance, Ethereum, Hyperledger Fabric, health education
MeSH terms
Blockchain, Delivery of Health Care, Humans, Health Records, Personal, Electronic Health Records, Quality Improvement, Health Information Exchange

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-09.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-09.

Statistics and arithmetic are recomputed, not judged.

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