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      Application of Nonfungible Tokens to Health Care. Comment on “Blockchain Technology Projects to Provide Telemedical Services: Systematic Review”

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          Abstract

          In their systematic review, Koshechkin and colleagues [1] thoughtfully explored and summarized the potential applications of blockchain technology to solve unique challenges in health care. Blockchain technology is a highly secure but transparent method of tracing digital transactions of assets or information through a decentralized, immutable ledger [1]. Thanks to the expansion of cryptocurrency—digital currency traded through blockchain networks—blockchain has become a household term. Blockchain technology has been applied to numerous industries, and many possibilities exist for application within health care [2]. In their review, Koshechkin and colleagues [1] identified 18 studies addressing blockchain solutions for various health care challenges. These included medical data access, medical services processing, diagnostic support, payment transactions, and fundraising, among others. This review offers an excellent synopsis of ongoing blockchain projects in health care accompanied by discussion of future directions. One novel entity that utilizes blockchain technology not identified in this paper is the nonfungible token (NFT). NFTs are similar to cryptocurrency, such as Bitcoin, in that they are digital tokens existing within a blockchain that can be bought and sold. NFTs, however, are distinct tokens. While 1 Bitcoin is always equal to another Bitcoin, each NFT is singular and unique (ie, nonfungible) [3]. Interestingly, although NFTs are digital, they can, and often do, represent physical items. Regarding health care, NFTs have been suggested as a means to streamline and simplify blood [4] and stem cell [5] product supply chains. While the full discussion of NFT potential in health care warrants a lengthier article, we will touch on the simplest application: capital. NFTs represent an untapped method of fundraising and revenue generation. They allow the monetization of unique items and content, digital or physical, new or old. NFTs offer the added benefits of transaction tracing, verifiable authenticity, and shared ownership of physical objects (analogous to stockholders of a company). One can imagine NFT auctions of historic medical equipment or journal articles, recorded lectures from renowned experts, and even naming rights to a lecture series. Much like baseball cards or stamps, medicine could find its own niche in collecting NFTs. NFTs also open an avenue for monetization of original creations such as reflective art and literature or unique medical education content. Medical education resources are constantly evolving, and many are free to learners (tweetorials, podcasts, YouTube channels, etc). If collectors agree to maintain open access after purchase, leveraging this content as NFTs could represent a new market to raise funds for scholarships, research, advocacy, or public health projects. Many will argue that buyers are unlikely to permit open access to their NFT. However, as already seen in other NFT markets, because NFTs are unique and traceable digital tokens, ownership can still be boasted despite public access [3]. As illustrated by Koshechkin and colleagues’ [1] review, blockchain technology is an exciting entity offering much potential for the advancement of health care. NFTs are yet another example of blockchain technology with innumerable possibilities and potential in health care.

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          Blockchain in healthcare and health sciences – a scoping review

          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.
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            Non-fungible tokens: Stem cell transplantation in the blockchain.

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              Blockchain Technology Projects to Provide Telemedical Services: Systematic Review

              Background One of the most promising health care development areas is introducing telemedicine services and creating solutions based on blockchain technology. The study of systems combining both these domains indicates the ongoing expansion of digital technologies in this market segment. Objective This paper aims to review the feasibility of blockchain technology for telemedicine. Methods The authors identified relevant studies via systematic searches of databases including PubMed, Scopus, Web of Science, IEEE Xplore, and Google Scholar. The suitability of each for inclusion in this review was assessed independently. Owing to the lack of publications, available blockchain-based tokens were discovered via conventional web search engines (Google, Yahoo, and Yandex). Results Of the 40 discovered projects, only 18 met the selection criteria. The 5 most prevalent features of the available solutions (N=18) were medical data access (14/18, 78%), medical service processing (14/18, 78%), diagnostic support (10/18, 56%), payment transactions (10/18, 56%), and fundraising for telemedical instrument development (5/18, 28%). Conclusions These different features (eg, medical data access, medical service processing, epidemiology reporting, diagnostic support, and treatment support) allow us to discuss the possibilities for integration of blockchain technology into telemedicine and health care on different levels. In this area, a wide range of tasks can be identified that could be accomplished based on digital technologies using blockchains.
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                Author and article information

                Contributors
                Journal
                J Med Internet Res
                J Med Internet Res
                JMIR
                Journal of Medical Internet Research
                JMIR Publications (Toronto, Canada )
                1439-4456
                1438-8871
                May 2022
                30 May 2022
                : 24
                : 5
                : e34276
                Affiliations
                [1 ] Department of Internal Medicine Ohio State University Wexner Medical Center Columbus, OH United States
                [2 ] Department of Pediatrics Nationwide Children's Hospital Columbus, OH United States
                [3 ] Hansjörg Wyss Department of Plastic Surgery New York University Langone Health New York, NY United States
                [4 ] Department of Anesthesiology and Perioperative Medicine University of Alabama at Birmingham School of Medicine Birmingham, AL United States
                Author notes
                Corresponding Author: John Gambril alangambril@ 123456gmail.com
                Author information
                https://orcid.org/0000-0001-9797-5979
                https://orcid.org/0000-0002-1421-6852
                https://orcid.org/0000-0003-2074-5272
                Article
                v24i5e34276
                10.2196/34276
                9153915
                35635749
                d271e9ad-b7a1-46e5-9056-992da49eb4f7
                ©John Gambril, Carter Boyd, Jamal Egbaria. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 30.05.2022.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on https://www.jmir.org/, as well as this copyright and license information must be included.

                History
                : 14 October 2021
                : 5 May 2022
                Categories
                Letter to the Editor
                Letter to the Editor

                Medicine
                telemedicine,distributed ledger,health information exchange,blockchain,cryptocurrency,nonfungible token,non-fungible token,medical education,internet,finance

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