  No one can dispute the disruptive impact of blockchain technology, which has
long been considered one of the major revolutions of contemporary times. Its
integration into the healthcare ecosystem has helped overcome numerous
difficulties and constraints faced by healthcare systems. This has been notably
demonstrated in the meticulous management of electronic health records (EHR)
and their access rights, as well as in its capabilities in terms of security,
scalability, flexibility, and interoperability with other systems. This article
undertakes the study and analysis of the most commonly adopted approaches in
healthcare data management systems using blockchain technology. An evaluation
is then conducted based on a set of observed common characteristics,
distinguishing one approach from the others. The results of this analysis
highlight the advantages and limitations of each approach, thus facilitating
the choice of the method best suited to the readers' specific case study.
Furthermore, for effective implementation in the context of e-health, we
emphasize the existence of crucial challenges, such as the incomplete
representation of major stakeholders in the blockchain network, the lack of
regulatory flexibility to ensure legal interoperability by country, and the
insufficient integration of an official regulatory authority ensuring
compliance with ethical and legal standards. To address these challenges, it is
necessary to establish close collaboration between regulators, technology
developers, and healthcare stakeholders.
