Blockchain-Enabled Self-Sovereign Identity Applications in Health Care: Scoping Review

Clinical Snapshot

Key Findings

• P Value: Not applicable for scoping review

• Effect Size: 37 peer-reviewed studies identified over 12-month search period

• Primary Outcome: BC-SSI research in healthcare remains at early maturity stage with most studies proposing conceptual models or prototypes

• Nnt Or Sensitivity: Structural gap identified between technological capability and clinical deployment readiness

• Confidence Interval: Not applicable for scoping review

Clinical Application

Currently limited due to early technology maturity, interoperability challenges, and insufficient integration with existing healthcare infrastructure Relevant to Australian Digital Health Strategy and My Health Record interoperability challenges, but requires alignment with Privacy Act 1988 and TGA digital therapeutics framework Healthcare organizations considering blockchain-based identity management systems, particularly for electronic health records and mobile health applications

Abstract

BACKGROUND: Self-sovereign identity (SSI) provides a decentralized approach to digital identity management, enabling individuals to control their personal data without reliance on centralized authorities. Blockchain technology offers a tamper-resistant and distributed infrastructure that can support secure and verifiable identity systems. In health care, where identity fragmentation, privacy risks, and interoperability challenges persist, blockchain-enabled SSI (BC-SSI) has been proposed as a potential solution. However, existing research remains heterogeneous, with varying levels of technical maturity and limited evidence of real-world deployment. OBJECTIVE: This study conducts a scoping review to systematically map BC-SSI applications in health care and to analyze their application domains, development stages, study aims, targeted challenges, and technological infrastructures. In addition, this study aims to identify structural gaps in current research and assess the readiness of BC-SSI systems for clinical deployment. METHODS: This review followed the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) methodology. A comprehensive literature search conducted between September 2024 and August 2025 identified 37 peer-reviewed studies that met predefined inclusion criteria. Data were extracted and synthesized using descriptive and thematic analyses across application areas, system maturity, technological components, and reported challenges. RESULTS: The findings indicate that BC-SSI research in health care remains at an early stage of maturity, with most studies proposing conceptual models or prototype implementations and limited real-world validation. Applications predominantly focus on identity verification, credential management, and privacy-preserving data exchange across domains such as electronic health records, mobile health, and access control systems. Commonly used technologies include decentralized identifiers, verifiable credentials, smart contracts, and privacy-enhancing mechanisms such as zero-knowledge proofs and selective disclosure. Despite rapid technical development, persistent challenges include interoperability limitations, governance gaps, usability concerns, and insufficient integration with health care infrastructures. Notably, a structural gap was identified between technological capability and system-level readiness for clinical deployment. CONCLUSIONS: BC-SSI technologies demonstrate potential for enabling secure, interoperable, and patient-centric identity management in health care. However, current research is predominantly technology-driven and lacks sufficient system-level validation. This study highlights the need for integrated architectural approaches, governance frameworks, and real-world evaluation to bridge the gap between conceptual innovation and clinical implementation. Advancing BC-SSI toward health care adoption will require coordinated progress across technical, organizational, and regulatory dimensions.

References

1. 1.Pokharel, A., & Kathayat, S. (2026). Blockchain-enabled self-sovereign identity applications in health care: Scoping review. Journal of Medical Internet Research, 28(5), e89574. https://doi.org/10.2196/89574