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Purpose

Despite empirical studies detailing the vulnerabilities of blockchain, minimal attention is directed to assessing blockchain performance during its adoption cycle. We examine potential competencies and requirements that impact blockchain performance in healthcare over three time periods, focusing on organizational readiness (ex ante), technical capabilities (in situ) and supportive institutions (ex post).

Design/methodology/approach

An extensive literature review encompasses three phases of data collection: an appraisal of publications from 2017 to mid-2021, totaling 111 publications; from mid-2021 to June 2024, totaling 52 publications, and a comprehensive update focused on selected features of healthcare blockchain, bringing the total review to 37 publications.

Findings

Using an assessment framework, findings prioritize conceptual and prescriptive papers (ex ante), blockchain technical requirements (in situ) and supportive institutions (ex post). It evaluates recent applications on patient health records privacy, security, scalability and interoperability.

Originality/value

This paper fills the gap in the literature that has minimal coverage of blockchain performance. It provides a comprehensive assessment framework to evaluate blockchain performance in healthcare over time and presents implications for research and guidance to practitioners on managing blockchain applications, with insights on societal impact.

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