Blockchain Papers

Scott Jacques

Podcasts are a useful educational resource for improving student success, yet traditional methods of podcasting remain inefficient, vulnerable to censorship and deletion, and access-restricted. One approach to addressing these constraints is utilitarian digital pedagogy, which focuses on the use of digital tools to advance education for the greater good. Framed as such, this article outlines the conceptual and theoretical issues underlying how generative artificial intelligence (genAI), Web3, and open access (OA) improve podcasting’s utility relative to the alternatives: manual creation, Web2, and closed access. The article derives practical implications for instructors, institutions, and policymakers, and concludes by looking ahead to the major problems—hallucination, technical complexity, and rights management—to overcome in practice.

Murray A. Rudd

No abstract is available for this record.

Scott Jacques

Podcasts are a useful educational resource for improving student success, yet traditional methods of podcasting remain inefficient, vulnerable to censorship and deletion, and access-restricted. One approach to addressing these constraints is utilitarian digital pedagogy, which focuses on the use of digital tools to advance education for the greater good. Framed as such, this article outlines the conceptual and theoretical issues underlying how generative artificial intelligence (genAI), Web3, and open access (OA) improve podcasting’s utility relative to the alternatives: manual creation, Web2, and closed access. The article concludes by looking ahead to the major problems—hallucination, technical complexity, and rights management—to overcome in practice.

Sebastian Griewing, Johannes Knitza, Niklas Gremke, Markus Wallwiener · 7 authors

Emerging digital technologies promise to improve breast cancer care, however lack of awareness among clinicians often prevents timely adoption. This study aims to investigate current awareness and intention-to-use of three technologies among breast cancer healthcare professionals (HCP): (1) digital health applications (DHA), (2) artificial intelligence (AI), and (3) blockchain technology (BC). A 22-item questionnaire was designed and administered before and after a 30 min educational presentation highlighting technology implementation examples. Technology awareness and intention-to-use were measured using 7-point Likert scales. Correlations between demographics, technology awareness, intention-to-use, and eHealth literacy (GR-eHEALS scale) were analyzed. 45 HCP completed the questionnaire, of whom 26 (57.8%) were female. Age ranged from 24 to 67 {mean age (SD): 44.93 ± 12.62}. Awareness was highest for DHA (68.9%) followed by AI (66.7%) and BC (24.4%). The presentation led to a non-significant increase of intention-to-use AI {5.37 (±1.81) to 5.83 (±1.64)}. HCPs´ intention-to-use BC after the presentation increased significantly {4.30 (±2.04) to 5.90 (±1.67), p < 0.01}. Mean accumulated score for GR-eHEALS averaged 33.04 (± 6.61). HCPs´ intended use of AI significantly correlated with eHealth literacy (ρ = 0.383; p < 0.01), intention-to-use BC (ρ = 0.591; p < 0.01) and participants´ age (ρ = −0.438; p < 0.01). This study demonstrates the effect that even a short practical presentation can have on HCPs´ intention-to-use emerging digital technologies. Training potential professional users should be addressed alongside the development of new information technologies and is crucial to increase HCPs´ corresponding awareness and intended use.

Wendy Charles, Mark B. van der Waal, J. Flach, Arno Bisschop · 7 authors

BACKGROUND: Blockchain has been proposed as a critical technology to facilitate more patient-centric research and health information sharing. For instance, it can be applied to coordinate and document dynamic informed consent, a procedure that allows individuals to continuously review and renew their consent to the collection, use, or sharing of their private health information. Such has been suggested to facilitate ethical, compliant longitudinal research, and patient engagement. However, blockchain-based dynamic consent is a relatively new concept, and it is not yet clear how well the suggested implementations will work in practice. Efforts to critically evaluate implementations in health research contexts are limited. OBJECTIVE: The objective of this protocol is to guide the identification and critical appraisal of implementations of blockchain-based dynamic consent in health research contexts, thereby facilitating the development of best practices for future research, innovation, and implementation. METHODS: The protocol describes methods for an integrative review to allow evaluation of a broad range of quantitative and qualitative research designs. The PRISMA-P (Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols) framework guided the review's structure and nature of reporting findings. We developed search strategies and syntax with the help of an academic librarian. Multiple databases were selected to identify pertinent academic literature (CINAHL, Embase, Ovid MEDLINE, PubMed, Scopus, and Web of Science) and gray literature (Electronic Theses Online Service, ProQuest Dissertations and Theses, Open Access Theses and Dissertations, and Google Scholar) for a comprehensive picture of the field's progress. Eligibility criteria were defined based on PROSPERO (International Prospective Register of Systematic Reviews) requirements and a criteria framework for technology readiness. A total of 2 reviewers will independently review and extract data, while a third reviewer will adjudicate discrepancies. Quality appraisal of articles and discussed implementations will proceed based on the validated Mixed Method Appraisal Tool, and themes will be identified through thematic data synthesis. RESULTS: Literature searches were conducted, and after duplicates were removed, 492 articles were eligible for screening. Title and abstract screening allowed the removal of 312 articles, leaving 180 eligible articles for full-text review against inclusion criteria and confirming a sufficient body of literature for project feasibility. Results will synthesize the quality of evidence on blockchain-based dynamic consent for patient-centric research and health information sharing, covering effectiveness, efficiency, satisfaction, regulatory compliance, and methods of managing identity. CONCLUSIONS: The review will provide a comprehensive picture of the progress of emerging blockchain-based dynamic consent technologies and the rigor with which implementations are approached. Resulting insights are expected to inform best practices for future research, innovation, and implementation to benefit patient-centric research and health information sharing. TRIAL REGISTRATION: PROSPERO CRD42023396983; http://tinyurl.com/cn8a5x7t. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/50339.

Dominic Arjuna Ugarte, Sean D. Young

It is essential to continually assess and find new ways to recruit and retain participants for research studies. Cryptocurrency is growing in popularity and may be a novel way to incentivize research participants. 100 participants, 50 of whom already had a cryptocurrency wallet and 50 of whom did not have a cryptocurrency wallet, were recruited through Facebook ads and completed a survey that asked about their experience with cryptocurrency and non-fungible tokens (NFTs) and potential interest in use of it for compensating research participants. The majority of respondents (79%) had some experience with cryptocurrency and 85% said they were comfortable trading cryptocurrency. Many participants had exchanged cryptocurrency within the past month (62%) and over their lifetime (70%). Respondents, however, were less familiar with NFTs, with only half having some experience with them. 18% of those without a cryptocurrency wallet and 42% of those with a cryptocurrency wallet chose to be compensated by cryptocurrency and NFT. Results suggest that, although cash and gift card incentives are preferred, there is an interest in cryptocurrency and NFTs. More studies will need to be done on a larger sample size and some of the challenges discussed (like cryptocurrency volatility) need to be addressed.

Daniel Toshio Harrell, Anjum Khurshid, Mustafa Abdul-Moheeth, Moderator Ryan Wright

BHTY authors Daniel Toshio Harrell, PhD, Mustafa Abdul-Moheeth MD, and Anjum Khurshid, MD, PhD and podcast host Ryan Wright, BHTY Missouri Ambassador, discuss the Medilinker project. &#x0D; Speakers discuss the scope of the two papers published in BHTY, choice of blockchain use, intention of the project and future growth for this and similar projects. Discover the growing ecosystem of distributed ledger technologies in the healthcare industry and the unique ways to prove concepts in a field where change is slow and graduated in achieving milestones.&#x0D; The articles may be accessed below. Readers may ersue the entire ConV2X 2021 Original Research Proceedings Issue here.&#x0D; Articles discussed:&#x0D; 1. Technical Design and Development of a Self-Sovereign Identity Management Platform for Patient-Centric Healthcare Using Blockchain Technology, DOI: https://doi.org/10.30953/bhty.v5.196&#x0D; 2. Improving Transitions of Care: Designing a Blockchain Application for Patient Identity Management, DOI: https://doi.org/10.30953/bhty.v5.200

Karen Yeung

BACKGROUND: Academic literature highlights blockchain's potential to transform health care, particularly by seamlessly and securely integrating existing data silos while enabling patients to exercise automated, fine-grained control over access to their electronic health records. However, no serious scholarly attempt has been made to assess how these technologies have in fact been applied to real-world health care contexts. OBJECTIVE: The primary aim of this paper is to assess whether blockchain's theoretical potential to deliver transformative benefits to health care is likely to become a reality by undertaking a critical investigation of the health care sector's actual experience of blockchain technologies to date. METHODS: This mixed methods study entailed a series of iterative, in-depth, theoretically oriented, desk-based investigations and 2 focus group investigations. It builds on the findings of a companion research study documenting real-world engagement with blockchain technologies in health care. Data were sourced from academic and gray literature from multiple disciplinary perspectives concerned with the configuration, design, and functionality of blockchain technologies. The analysis proceeded in 3 stages. First, it undertook a qualitative investigation of observed patterns of blockchain for health care engagement to identify the application domains, data-sharing problems, and the challenges encountered to date. Second, it critically compared these experiences with claims about blockchain's potential benefits in health care. Third, it developed a theoretical account of challenges that arise in implementing blockchain in health care contexts, thus providing a firmer foundation for appraising its future prospects in health care. RESULTS: Health care organizations have actively experimented with blockchain technologies since 2016 and have demonstrated proof of concept for several applications (use cases) primarily concerned with administrative data and to facilitate medical research by enabling algorithmic models to be trained on multiple disparately located sets of patient data in a secure, privacy-preserving manner. However, blockchain technology is yet to be implemented at scale in health care, remaining largely in its infancy. These early experiences have demonstrated blockchain's potential to generate meaningful value to health care by facilitating data sharing between organizations in circumstances where computational trust can overcome a lack of social trust that might otherwise prevent valuable cooperation. Although there are genuine prospects of using blockchain to bring about positive transformations in health care, the successful development of blockchain for health care applications faces a number of very significant, multidimensional, and highly complex challenges. Early experience suggests that blockchain is unlikely to rapidly and radically revolutionize health care. CONCLUSIONS: The successful development of blockchain for health care applications faces numerous significant, multidimensional, and complex challenges that will not be easily overcome, suggesting that blockchain technologies are unlikely to revolutionize health care in the near future.

Tamara Zaza, Hunter Boudreau, Carter J. Boyd

No abstract is available for this record.

Daniel Cabrera, Christopher P Nickson, Damian Roland, Elissa Hall · 5 authors

UNSTRUCTURED Current health professions education (HPE) institutions are based on an assembly-line hierarchical structure. The last decade has witnessed the advent of sophisticated networks allowing the exchange of information and educational assets. Blockchain provides an ideal data management framework that can support high-order applications such as learning systems and credentialing in an open and a distributed fashion. These system management characteristics enable the creation of a distributed autonomous organization of learning (DAOL). This new type of organization allows for the creation of decentralized adaptive competency curricula, simplification of credentialing and certification, leveling of information asymmetry among educational market stakeholders, assuring alignment with societal priorities, and supporting equity and transparency.

Jedidiah Carlson, Kelley Harris

Engagement with scientific manuscripts is frequently facilitated by Twitter and other social media platforms. As such, the demographics of a paper's social media audience provide a wealth of information about how scholarly research is transmitted, consumed, and interpreted by online communities. By paying attention to public perceptions of their publications, scientists can learn whether their research is stimulating positive scholarly and public thought. They can also become aware of potentially negative patterns of interest from groups that misinterpret their work in harmful ways, either willfully or unintentionally, and devise strategies for altering their messaging to mitigate these impacts. In this study, we collected 331,696 Twitter posts referencing 1,800 highly tweeted bioRxiv preprints and leveraged topic modeling to infer the characteristics of various communities engaging with each preprint on Twitter. We agnostically learned the characteristics of these audience sectors from keywords each user's followers provide in their Twitter biographies. We estimate that 96% of the preprints analyzed are dominated by academic audiences on Twitter, suggesting that social media attention does not always correspond to greater public exposure. We further demonstrate how our audience segmentation method can quantify the level of interest from nonspecialist audience sectors such as mental health advocates, dog lovers, video game developers, vegans, bitcoin investors, conspiracy theorists, journalists, religious groups, and political constituencies. Surprisingly, we also found that 10% of the preprints analyzed have sizable (>5%) audience sectors that are associated with right-wing white nationalist communities. Although none of these preprints appear to intentionally espouse any right-wing extremist messages, cases exist in which extremist appropriation comprises more than 50% of the tweets referencing a given preprint. These results present unique opportunities for improving and contextualizing the public discourse surrounding scientific research.

J. I. M. de Souza, Denise Sampaio de Araújo, Gentil Veloso Barbosa, Patrick Letouzé

For health practitioners, accreditation processes are necessary for their career development. The importance is not restricted to attesting competencies and skills, it may even certify that some professionals are legally capable and authorized to perform a specific complex procedures, such as kidney transplantation. For example, physicians are crossing national borders with their practice, especially in Europe, and patients are becoming more demanding, thus in need of reliable information regarding health professionals. In this context, we propose a scenario to exemplify and to elucidate an emerging problem, that is, an opportunity. Let us consider that a group of national societies on transplantation biology and medicine decides to create an International Accreditation System for health professionals. The system would be a decentralized institution composed of multiple organizations, because accreditation is about trustworthiness, which naturally suggests the use of blockchain technology. Hence, in this work, we propose the use of blockchain and service design in healthcare, as fundamentals for the conceptual design of an international accreditation system for health professionals. Additionally, this work may be understood as a strategy for modeling, designing and developing healthcare systems based on blockchain technology.

Mandy M. Archibald, Alexander M. Clark

All is not well for nursing in the new world. The use of social media to share research, access information and build professional networks – although gaining in popularity – has been met mostly with a slow response from those in nursing and its research (Ferguson 2013). Twitter is used by over 550 million people, with 135,000 new users every day (Statistics Brain 2012). Approximately 11% of nurses use Twitter compared with 20% of adults – which places nurses a year behind the general population's usage (Robinson 2013). This inertia is curious, given that reputable health organizations, such as the World Health Organization, now use Twitter (Redfern 2013). Do nurses understand the potential benefits of Twitter? With mainstream popularity and increasing reliance in daily social life, Twitter can allow nurse researchers to connect directly, rapidly and cheaply with communities, disseminate information, and promote translation of research into practice and policy. It has also been found to be effective in engaging with and recruiting potentially hard-to-reach populations (O'Connor et al. 2014). This provides huge potential for methods and dissemination and broadens our understanding of change. Academic institutions now have to consider the merits of ‘virtual impact’ alongside traditional metrics of evaluation, such as publications. As Ferguson lamented in JAN: ‘it is time for the nursing profession to leverage social media’ (2013, p. 745). However, identifying this need does nothing to address how nurses can use Twitter better. Diffusion of Innovations Theory can help. Proposed by sociologist Everett Rogers in 1962, Diffusion of Innovations Theory has become a commonly applied theory for understanding how and at what rate innovations are adopted in different settings. Five characteristics of innovations influence this rate (Rogers 1962/2003): • Relative advantage: ‘…the degree to which an innovation is perceived as being better than the idea it supersedes’. (Rogers 1962/2003, p.229) The purpose of Twitter may not be apparent to nurse researchers. Is Twitter a social networking site; a venue to confer and communicate celebrity status; a networking platform; a venue to disseminate research findings; a site for recruiting participants; or all of the above? This versatility of Twitter actually reduces its perceived relative advantage because it is unclear what Twitter can and should be compared to. Most of these appraisals of Twitter occur in an evidence vacuum. While other widely used forms of media – such as textbooks, television and the internet – are not subject to a similar burden of proof, academics focused on evidence and value may well bemoan the lack of evaluation measures available for Twitter. Given the lack of previous comparable social media platforms, the added value of Twitter to busy professional lives may be unclear. Twitter can create a new world that is highly responsive to each member's needs and interests. Because only tweets (messages of 140 characters or fewer) from followers are viewed, twitter ‘feeds’ tend to reflect common themes. Hashtags can be used to categorize tweets and organize twitter feeds. Based on these tailored preferences, papers, blogs and news stories come to one's attention that would not otherwise have done so. This ability to both benefit from and contribute to tailored twitter feeds is a reciprocal advantage that is very useful. The relative advantage of innovations such as Twitter can be expressed through economic gains and social visibility. Academics can ‘tweet’ at zero cost. Other cost investments such as buying open access for publications can be leveraged through Twitter by tweeting links to online papers and web profiles. Academics may conflate social visibility with social prestige – reflecting a lingering perception of Twitter as a celebrity-oriented/pop culture social platform. However, as high-profile organizations such as the Canadian Nurses Association and leading journal editors in nursing harness Twitter, the social status draw of Twitter may gain appeal for nursing academics. Using Twitter may come to symbolize contemporary thinking and innovation. • Compatibility: ‘The degree to which an innovation is perceived as consistent with existing values, past experiences and needs of potential adopters’. (Rogers 1962/2003, p. 229). (Rogers 1962/2003, p. 240) Twitter's predecessors, particularly Facebook, also influence perceptions of Twitter. Largely a social platform, Facebook's infamous ‘status updates’ contributed to perceptions of Twitter as a social site for quick quips and celebrity updates. Although researchers may not distinguish between such forms of social media, in reality, different platforms can serve distinct purposes (Ferguson 2013). This perception of Twitter as another social media site means that it has come to be seen as being part of a ‘technology cluster’ – a ‘set of distinguishable elements of technology that are perceived by individuals as being interrelated’ (Rogers 1962/2003, p. 249). The implication of the technology cluster is the tendency for users to group otherwise distinguishable technological innovations together (e.g. Twitter, Facebook, LinkedIn) without recognizing their distinctive nature and merits. When the blurring of boundaries occurs for adopters, the potential benefits of specific platforms may not be recognized. That said, introducing innovations as part of a technology cluster may increase uptake and harness synergies between innovations. Twitter can be used with LinkedIn (a professional networking profile site) through which strategic use of a tweet can refer followers to a full professional profile. As the introduction of technologies has been sequential, beginning with email, faculty websites, LinkedIn, Facebook and many more that have preceded Twitter, the ‘added benefit’ of new social media innovations may not be recognized. It is natural to contrast the anticipated processes of Twitter to how academic dissemination has previously occurred – through longer formal academic journal articles that are read mostly by other academics. Twitter has been proposed as an alternative means to disseminate academic research; however, assuming that Twitter would be accepted readily as a supplementary form of dissemination risks committing the ‘empty vessels fallacy’ (Rogers 1962/2003, p. 256) wherein the previous knowledge and experiences of potential adopters are neglected. Compatibility with existing experiences is important and necessary for Twitter to ‘fit’ with nurse's existing knowledge related to academic dissemination. Developing links between Twitter and traditional avenues of dissemination can increase compatibility. For instance, integrating Twitter into conference activities by use of a conference hashtag, for example, may help. Indeed, Twitter's name alone could challenge many academics' values. Twitter is synonymous with chatter – the antithesis of academic discourse. Views of Twitter as a time-consuming platform not meritorious for academic career progression and promotion can further reduce its compatibility with extant values. As such, how Twitter is positioned within the nursing community, how it is incentivized as a knowledge translation tool and which of its benefits are emphasized influence its adoption. • Complexity: ‘The degree to which an innovation is perceived as relatively difficult to understand and use’ (Rogers 1962/2003, p. 257) As with any innovation, Twitter has a learning curve. New terminology (e.g. Tweet, Twittersphere, twitterites) and ostensibly mysterious abbreviations (e.g. RT, FFF, BFN, T/J etc.) abound and necessitate a ‘Twittonary (n.d)’ of key definitions (see http://twittonary.com/ for an example). This learning is complex, especially for people less familiar with technology. Generally, different generations define and use social media in different ways (Cain et al. 2010, Taylor et al. 2010, Jones & Hayter 2013). Generational divides in the use of Twitter persist, but may diminish as technological literacy increases (Cresci et al. 2010). As such, the demographic characteristics and background of researchers in nursing also influence perceptions of complexity and use. • Trialability: ‘degree to which an innovation may be experimented with on a limited basis’ (Rogers 1962/2003, p. 258) Trialability is a mixed bag for Twitter. Twitter can be experimented with easily through establishing, trying and deleting a user account. However, it takes time and effort to establish followers, identify other users to follow and both read and produce tweets regularly. Time and efforts are needed to understand the potential benefits of Twitter, but these also reduce its perceived trialability. This trialability is also constrained by preconceptions. For many academics, tweeting is a formative risk – tweets can potentially be read by many people, cannot be retracted and have been subject to high-profile legal debate and litigation in some countries. For those who have experimented with or regularly use Twitter, perceptions of such risk are diminished as tweets are only shared with and read by one's followers. Trialability is greatly enhanced by personal trials – suggesting a potential avenue for institutions looking to facilitate the uptake of Twitter by academic staff – via peer presentations on social media or hands-on ‘Twitter-sessions’ similar to library database search sessions. • Observability: ‘The degree to which the results of an innovation are visible to others’ (Rogers 1962/2003, p. 258) Twitter is a virtual innovation that requires no new hardware and an internet connection. The platform itself is less observable. Aside from the occasional tweet showcased in print, radio or television, tweets are not visible to those not on Twitter. Promoting Twitter through educational sessions and generating awareness of communities of scholars who have adopted the innovation may enhance Twitter's observability. Finally, as researchers and academic institutions alike can be outcomes-driven, finding ways to qualify the impact and effectiveness of Twitter, and to communicate and value these measures within academic research communities are important. Diffusion of Innovations Theory promotes understanding of how academics use Twitter and offers some direction for developing strategies to increase its use in academic settings. Twitter's popularity is increasing and may soon reach a critical mass, tipping the balance in favour of further adoption (Toole et al. 2012). As the time for early adoption of Twitter has passed, waiting for this critical mass is not enough. Institutions can help by emphasizing the relative advantages of Twitter, such as its low cost, possible reach and high impact potentials. Highlighting parallels between Twitter and other dissemination strategies can promote compatibility with values and experiences. To minimize complexities, promote trialability and increase observability guidelines on Twitter, researchers should benefit from guidelines (e.g. Mollett et al. 2011), Twitter training opportunities and better integration of Twitter into professional conferences and meetings. M.A. acknowledges the Canadian Child Health Clinician Scientist Program and the Women and Children's Health Research Institute.