BLOCKCHAIN AND SMART CONTRACTS: OPTIMIZING AUDITING IN HEALTHCARE MANAGEMENT
DOI:
https://doi.org/10.56238/revgeov17n1-081Keywords:
Auditing, Blockchain, Smart Contracts, Operating Costs, Health ManagementAbstract
Auditing in healthcare management plays an essential role in ensuring quality, regulatory compliance, and patient safety, but faces limitations due to manual processes, high costs, and vulnerabilities to fraud. This study, characterized as a narrative literature review, aimed to analyze the potential of blockchain technology and smart contracts as optimization tools for healthcare auditing. The results show that blockchain, by providing immutable, transparent, and distributed records, increases the traceability of information and reduces susceptibility to manipulation. Smart contracts, in turn, automate flows and compliance checks, reducing human error, speeding up processes, and reducing operating costs. In addition to strengthening the detection of fraud and failures, these technologies offer greater efficiency and integrity to audits, benefiting both healthcare institutions and patients. Despite the identified benefits, challenges related to regulation, interoperability, and privacy remain, which must be overcome to enable their large-scale adoption. It is concluded that blockchain and smart contracts represent promising solutions for more efficient, secure, and transparent healthcare management.
Downloads
References
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.