Current application of blockchain technology in healthcare and its potential roles in Urology

OBJECTIVE: To assess the current uses of blockchain technology in surgery and explore potential applications in urology. METHODS: A systematic literature review and critical appraisal was performed. The PubMed database was searched for all relevant papers published in English, between 2003 and 2023, on blockchain and surgery, and urology. RESULTS: Our search yielded 59 results (35 eligible studies) for blockchain and surgery, and only six for urology. Current application of blockchain is limited in surgery and sparse in urology. The two main uses are in secured decentralised dataset across multi-national research centres, and personal health records (patient wallet) in parts of Europe. CONCLUSION: Blockchain is a highly secure technology. Particularly data decentralisation and immutability (once data entered and stored becomes permanently irreversible). Blockchain has the potential to revolutionise digital surgery and urology, especially in the era of artificial intelligence. Our proposed utilisations for blockchain in urology include: decentralised two-level secured operative consent, ureteric stent tracing, supply chain of bacille Calmette-Guérin, improving electronic medical records and large-scale research, optimising surgery and complication reporting and intraoperative documentation, and universal management of low-risk prostate cancer. Widespread awareness and gradual integration of the technology is required within the healthcare system and to the public.