BLOCKCHAIN Y CONTRATOS INTELIGENTES: OPTIMIZACIÓN DE LA AUDITORÍA EN LA GESTIÓN DE LA SALUD
DOI:
https://doi.org/10.56238/revgeov17n1-081Palabras clave:
Auditoría, Cadena de Bloques, Contratos Inteligentes, Costos Operativos, Gestión de la SaludResumen
La auditoría en la gestión de la salud desempeña un papel esencial para garantizar la calidad, el cumplimiento normativo y la seguridad de los pacientes, pero se enfrenta a limitaciones derivadas de los procesos manuales, los altos costes y la vulnerabilidad al fraude. Este estudio, caracterizado como una revisión bibliográfica narrativa, tuvo como objetivo analizar el potencial de la tecnología blockchain y los contratos inteligentes como herramientas de optimización para la auditoría en el ámbito de la salud. Los resultados evidencian que la cadena de bloques, al proporcionar registros inmutables, transparentes y distribuidos, amplía la trazabilidad de la información y reduce la susceptibilidad a la manipulación. Los contratos inteligentes, por su parte, automatizan los flujos y las verificaciones de conformidad, lo que reduce los errores humanos, acelera los procesos y reduce los costes operativos. Además de reforzar la detección de fraudes y fallos, estas tecnologías ofrecen una mayor eficiencia e integridad a las auditorías, lo que beneficia tanto a las instituciones sanitarias como a los pacientes. A pesar de los beneficios identificados, persisten los retos relacionados con la regulación, la interoperabilidad y la privacidad, que deben superarse para que su adopción a gran escala sea viable. Se concluye que el blockchain y los contratos inteligentes representan soluciones prometedoras para una gestión sanitaria más eficiente, segura y transparente.
Descargas
Referencias
CHENG, Mengyuan; CHONG, Heap-Yih; XU, Yongshun. Blockchain-smart contracts for sustainable project performance: bibliometric and content analyses. Environment, Development and Sustainability, Dordrecht, v. 26, n. 4, p. 8159–8182, 2024. DOI: https://doi.org/10.1007/s10668-023-03063-w.
CNA7 NOTÍCIAS. Blockchain se destaca em soluções para governos digitais. CNA7 Notícias, 13 maio 2025. Disponível em: https://www.cna7.com.br/noticia/44669/blockchain-se-destaca-em-solucoes-para-governos-digitais. Acesso em: 22 set. 2025.
CONTADORES.CNT.BR. Blockchain e IA: como essa relação impulsiona o mundo jurídico. Contadores CNT, 16 maio 2024. Disponível em: https://www.contadores.cnt.br/noticias/artigos/2024/05/16/blockchain-e-ia-como-essa-relacao-impulsiona-o-mundo-juridico.html. Acesso em: 22 set. 2025.
COSTA, Marcus Vinicius da Silva; CAMARGOS, Mirela Castro Santos; VIANA, Sônia Maria Nunes; MENDES, Ueliton Vieira de Souza. Avanços e desafios da interoperabilidade no Sistema Único de Saúde. Journal of Health Informatics, São Paulo, v. 17, n. 1, p. 1–12, 2025. DOI: https://doi.org/10.59681/2175-4411.v17.2025.1112.
ETECHPT. 13 empresas de auditoria de contratos inteligentes mais bem avaliadas em 2023. Etechpt, 2023. Disponível em: https://etechpt.com/13-empresas-de-auditoria-de-contratos-inteligentes-mais-bem-avaliadas-em-2023. Acesso em: 22 set. 2025.
FUKUOKA, Danilo Marcos Leme; DE QUEIROZ SILVA, A.; DOS REIS, B. D.; DE ARAÚJO, D. G.; ELIAS, S. I. Os obstáculos ao uso da tecnologia blockchain e sua relação com as criptomoedas. Revista Amor Mundi, v. 4, n. 8, p. 27–36, 2023. Disponível em: https://revistaamormundi.com.br. Acesso em: 22 set. 2025.
GAO, Lixia. Enterprise internal audit data encryption based on blockchain technology. PLOS ONE, San Francisco, v. 20, n. 1, e0315759, 2025. DOI: https://doi.org/10.1371/journal.pone.0315759.
HARRELL, Daniel Toshio. Technical design and development of a self-sovereign identity management platform for patient-centric healthcare using blockchain technology. Blockchain in Healthcare Today, 2022. Disponível em: https://blockchainhealthcaretoday.com. Acesso em: 22 set. 2025.
KAAFARANI, Rima; ISMAIL, Leila; ZAHWE, Oussama. Automatic recommender system of development platforms for smart contract-based health care insurance fraud detection solutions. Journal of Medical Internet Research, Toronto, v. 26, e50730, 2024. DOI: https://doi.org/10.2196/50730.
MA, Liangxiao; LIAO, Yong; FAN, Hao; ZHENG, Xin; ZHAO, Jun; XIAO, Zhen; XIONG, Yuxuan. PHDMF: a flexible and scalable personal health data management framework based on blockchain technology. Frontiers in Genetics, Lausanne, v. 13, 2022. DOI: https://doi.org/10.3389/fgene.2022.858357.
MACKEY, Tim K.; CUOMO, Raphael E. An interdisciplinary review of digital technologies to facilitate anti-corruption, transparency and accountability in medicines procurement. Global Health Action, Londres, v. 13, supl. 1, 2020. DOI: https://doi.org/10.1080/16549716.2020.1695241.
MACKEY, Tim K.; MIYACHI, Kosuke; FUNG, Daniel; QIAN, Shun; SHORT, Jonathan. Combating health care fraud and abuse: conceptualization and prototyping study of a blockchain antifraud framework. Journal of Medical Internet Research, Toronto, v. 22, n. 9, e18623, 2020. DOI: https://doi.org/10.2196/18623.
MEINERT, Edward. Blockchain implementation in health care: protocol for a systematic review. JMIR Research Protocols, Toronto, v. 8, n. 2, e10994, 2019. DOI: https://doi.org/10.2196/10994.
MIGALHAS. A revolução jurídica impulsionada pela blockchain. Migalhas, 24 set. 2024. Disponível em: https://www.migalhas.com.br/depeso/415843/a-revolucao-juridica-impulsionada-pela-blockchain. Acesso em: 22 set. 2025.
MUSAMIH, Ahmad; SALAH, Khaled; JAYARAMAN, Rajesh; ARSHAD, Junaid; DEBE, Mouza; AL-HAMMADI, Yousof; ELLAHHAM, Samer. A blockchain-based approach for drug traceability in healthcare supply chain. IEEE Access, New York, v. 9, p. 9728–9743, 2021. DOI: https://doi.org/10.1109/ACCESS.2021.3052100.
RIZZARDI, Alessandra; SICARI, Sabrina; COEN-PORISINI, Alberto. IoT-driven blockchain to manage the healthcare supply chain and protect medical records. Future Generation Computer Systems, Amsterdam, v. 161, p. 415–431, 2024. DOI: https://doi.org/10.1016/j.future.2024.03.019.
ROMAN-MARTINEZ, Isabel; FERNANDEZ-ALEMAN, Jose Luis; TOVAR, Manuel. Blockchain-based service-oriented architecture for consent management, access control, and auditing. IEEE Access, New York, v. 11, p. 12727–12741, 2023. DOI: https://doi.org/10.1109/ACCESS.2023.3240942.
SETHI, Bijaya Kumar; SINGH, Debabrata; SARANGI, Prakash Kumar. Medical insurance fraud detection based on blockchain and deep learning approach. In: IEEE INTERNATIONAL CONFERENCE. IEEE, 2022. DOI: https://doi.org/10.1109/ICCMC53470.2022.9754011.
TITH, Dara; LEE, Jae Sung; SUZUKI, Hiroshi; WIJESUNDARA, W. M. A. B.; TAIRA, Nobuyuki; OBI, Takashi; OHYAMA, Naoki. Patient consent management by a purpose-based consent model for electronic health record based on blockchain technology. Healthcare Informatics Research, Seul, v. 26, n. 4, p. 265–273, 2020. DOI: https://doi.org/10.4258/hir.2020.26.4.265.
ULLAH, Faheem; HE, Jian; ZHU, Ning; WAJAHAT, Ali; NAZIR, Ahsan; QURESHI, Salman; DEV, Saurabh. Blockchain-enabled EHR access auditing: enhancing healthcare data security. Heliyon, Londres, v. 10, n. 16, e34407, 2024. DOI: https://doi.org/10.1016/j.heliyon.2024.e34407.
ZHUANG, Yan; CHEN, Yi Wen; SHAE, Zhe Yi; SHYU, Chi-Ren. Generalizable layered blockchain architecture for healthcare applications. Journal of Medical Internet Research, Toronto, v. 22, n. 7, e19029, 2020. DOI: https://doi.org/10.2196/19029.
