Exploring a Model for the Acceptance of Blockchain Technology in Health and Wellness Centers

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The primary objective is to identify the key factors influencing the acceptance of blockchain within these centers. We conducted in-depth interviews with 15 professionals, including IT managers, cybersecurity experts, senior health center managers, technology specialists, and university professors in health-related fields. Data were collected using a snowball sampling method and analyzed through the Grounded Theory approach to identify the key influencing factors and components. The findings reveal that the acceptance of blockchain technology in health and wellness centers is influenced by four primary dimensions: 1. Organizational (management support, organizational culture, organizational structure, and human resources), 2. Technological (technology infrastructure, technology standards, practical and technological solutions, and technical expertise), 3. Social (awareness and understanding, attitudes and beliefs, social values and norms, and the role of social networks in adaption), and 4.Economic (cost management, achieving economic advantages, improving payment models and positive impacts on stakeholders). These dimensions form a comprehensive framework that can guide the successful implementation of blockchain technology in healthcare settings, with implications for improved efficiency and effectiveness in service delivery. Blockchain technology health and wellness centers technology acceptance grounded theory Figures Figure 1 Introduction A blockchain is essentially a distributed database of records, or public ledger of all transactions or digital events that have been executed and shared among participating parties.[ ] Blockchain is a shared, immutable record of peer-to-peer transactions built from linked transaction blocks and stored in a digital ledger [ ]. The rapid uptake of digitization in healthcare has led to the generation of massive electronic records about patients. Such growth poses unprecedented demands for healthcare data protection while in use and exchange.[ ] Blockchain, as is, currently lacks a number of elements needed to make it successful as a national record keeping framework to replace our current system. Many of these barriers are monetarily driven, such as the incentives to create this very large network of connected blocks of data. The current EHR market is valued at tens of billions of dollars, and very recently, many academic universities and other large health systems have poured millions of dollars into new vendor-led commercial health record systems in large part incentivized by the federal government.[ ] Emerging technological breakthroughs in blockchain and smart contracts are expected to provide promising solutions to secure patient data despite being shared and accessed through EHR.[ ] Healthcare records or medical records have proven their importance to patients because of the valuable asset recorded in consonance with their point of view. Although sharing patient information amongst various healthcare providers through EHR may boost diagnostic accuracy, the health information repository may become a single point of failure and may be targeted by attackers resulting in ransomware attacks or denial of services.[ ] Medical data is now accessible through a large number of smart devices, which may result in accidental or malicious leakage.[ ] Blockchain technologies are a promising solution that can address security and privacy issues associated to mobile devices and mobile applications. Through its chain of records, the blockchain can offer a secure, immutable and verifiable health data storage system and mechanisms.[ ]Considering the challenges and requirements related to the adoption of blockchain technology in healthcare, this paper seeks to present key findings that support the development of a comprehensive framework for effectively implementing blockchain in healthcare. Methodology Data collection methods in this study were divided into two categories: library and field methods. Both approaches were utilized to obtain necessary data from the following sources: - Library Resources: This included websites, English articles, and existing documents, reports, and writings. - Semi-Structured Interviews [i] : Expert interviews were conducted to identify components of the research model. 1. Research Community The research community comprised experts and specialists who met the necessary criteria to ensure the validity of the interviews. Participants included information technology managers, cybersecurity experts, senior health center managers, specialists in new technologies, and university professors in health-related fields, all involved in management processes and the implementation of digital technologies in health centers. 2. Sampling and Participant Selection Method A purposeful snowball sampling [ii] method was employed to select participants for the grounded theory [iii] analysis, allowing the sample size to expand until theoretical saturation was reached. Initial interviews were conducted with qualified experts, who were then asked to identify additional individuals in the field. 3. Criteria for Selecting Participants 3.1 Expertise and Experience : Specialized knowledge in blockchain technology and health centers, along with practical management experience. 3.2 Professional Position : Key management or decision-making roles in health-related organizations, ensuring comprehensive knowledge of new technology implementation. 3.3 Familiarity with Blockchain : At least a basic understanding of blockchain technology and its applications in health systems. 3.4 Publication Record : Preference for participants with published research in information technology, blockchain, and health. 3.5 Collaborative Project Experience : Involvement in innovative projects related to new technology in health centers, providing practical insights. - A total of 15 participants were included in the study, determined through theoretical saturation. 4. Reliability of Interviews To ensure the trustworthiness of the interviews, standards were maintained throughout the process, from question design to transcription. Following 13 interviews, data saturation was indicated by the repetition of main and secondary factors. Two additional interviews confirmed the saturation, resulting in a final sample size of 15 participants. Open and axial coding [iv] , along with research results, were shared with select interviewees for feedback, leading to revisions and confirmations of the findings. Data Analysis: The demographic profile of the participants in the qualitative interviews (Table 1 ) demonstrates significant diversity in terms of educational backgrounds, fields of activity, locations of activity, and work experience. This balanced gender distribution aids in understanding the various opinions and experiences regarding the acceptance of blockchain technology in health and wellness centers. In terms of education, the majority of participants hold advanced degrees, with 9 possessing a master’s degree and 6 holding a doctorate. This high level of education underscores the participants’ expertise and deep knowledge in fields related to information technology and health. Such diversity enriches the qualitative data and opens up new opportunities for detailed and practical analysis of the results. Additionally, the participants' work experience averages between 10 and 35 years, which significantly enhances the validity of the research findings. Table 1 Cognitive characteristics of experts Work Experience (Years) sex Level of education Field of activity Place of activity 15 female Master Information Technology Tehran University 1 30 female Master Information Technology Ministry of Petroleum 2 18 male Master Information Technology Ministry of Health 3 20 male Ph. D Computer Science Allameh Tabatabaei University 4 35 male Ph. D Computer Science Allameh Tabatabaei University 5 25 male Ph. D Physician Ministry of Health 6 10 male Master Nursing Ministry of Health 7 15 female Bachelor's degree Computer software Ministry of Health 8 11 male Bachelor's degree Computer software Ministry of Health 9 22 male Ph. D Computer Science Ministry of Communications 10 20 male Ph. D Information Technology Management Private company 11 11 female Bachelor's degree Electricity Private company 12 30 male Ph. D Electricity Private company 13 18 male Master Information Technology Management Bank 14 11 male Bachelor's degree Information Technology Management Private company 15 Following the implementation of interviews, open coding was conducted. Open coding is the first level of coding. In open coding, the researcher is identifying distinct concepts and themes for categorization. The first level of data is organized by creating initial broad thematic domains for data assemblage. “The first step [open coding] aims at expressing data and phenomena in the form of concepts. Units of meaning classifying expressions (single words, short sequences of words) in order to attach annotations and "concepts”. [v] In open coding, this process was termed the concept-indicator model. In brief, the concept-indicator model used constant comparison of [textual] indicators and focused on comparing regularly occurring textual material. This approach was accompanied by the ongoing coding of themes as an indicator of a concept, always comparing it to previous indicators that had been similarly coded [vi] . In practice, the researcher needs to sift through informant’s responses and organize similar words and phrases, concept-indicators, in broad initial thematic domains. [vii] Examples of open coding (labeling and categorization) from the interview texts are presented for clarity. One participant shared their journey into blockchain, highlighting its potential in healthcare, including secure storage and sharing of medical records, improved coordination, and reduced errors. They acknowledged challenges such as complexity and regulatory ambiguity but emphasized blockchain's transformative potential in healthcare. Below (Table 2) are some examples of open coding (labeling and concept determination), based on important points identified from the above interview. Table 2 Open coding example including quote identification, open coding, and category determination Speech Evidence (Meaningful Unit) Open coding M4: Blockchain can facilitate information sharing between patients, doctors, and researchers. Interoperability Identity management M4:Blockchain can help protect sensitive patient information from hacking. Security M4: The best way to increase awareness and facilitate understanding among various stakeholders is to hold seminars, workshops, and information sessions. Existence of a management strategy for adopting blockchain technology M4: Blockchain can help track medicines and medical devices from the point of production to the point of consumption. Supply chain management M4: Managers should be aware of the benefits and capabilities of this technology and support the budget and resources necessary for its implementation. Senior management commitment to blockchain technology M4: Staff should also receive the necessary training to familiarize themselves with its benefits and uses, and patients should be able to use this technology to improve their care and maintain privacy. Encouraging employee cooperation and participation in the implementation process M4: Providing financial and non-financial incentives to health centers can increase their motivation to implement blockchain solutions. Allocation of financial and human resources by the manager to implement blockchain technology M4: Investment in research and development can also help develop new and innovative applications of blockchain in the healthcare sector. Encouraging a culture of innovation and risk-taking M4: Establishing clear standards and guidelines is also essential for the use of this technology. Willingness to change and embrace new technology M4: Encouraging collaboration between healthcare providers, technology companies, and other stakeholders to develop and implement blockchain solutions, and addressing legal and regulatory challenges associated with the use of this technology, are other measures that can help promote blockchain acceptance in healthcare. The existence of values that support innovation and efficiency in an organization Accordingly, during open coding, 61 items were obtained as verbal evidence (labelling) from the interview transcripts. Next, during open coding, 50 initial concepts were extracted from the available speech evidence. Some results are presented in Table 3. Table 3 Examples of results from open coding of interviews Speech evidence (meaningful unit) Open coding M1: "Management commitment is not just talk, it must be demonstrated by tangible actions such as allocating resources, encouraging innovation, and supporting the implementation process." M4: Managers must be aware of the benefits and capabilities of this technology and support the budget and resources necessary for its implementation." Senior management commitment to blockchain technology M2: "Employees must be willing to change their ways of working and learn new skills to use this technology." M4: Establishing clear standards and guidelines for using this technology is also essential." Willingness to change and embrace new technology M5: "All parts of the organization, such as IT, clinical care, finance, and management, must work together to successfully implement this technology." Coordination between different parts of the organization M8: "To work with this new technology, we need experts and trained in the field of blockchain and health and wellness." The existence of skilled and trained human resources to implement and use technology M4: Blockchain can help protect sensitive patient information from hacking" M10: "Blockchain should protect the privacy and security of our patients' information, such as medical information, hospital records, and financial data. Otherwise, patient information will be leaked and there will be a lot of trouble." Security M4: Blockchain can help track medicines and medical equipment from the point of production to the point of consumption" M12: "Medicines and medical equipment can be tracked through all stages of the supply chain, from production to distribution, with blockchain to prevent them from being counterfeited and of poor quality. This way, we can rest assured that the medicines and equipment are genuine and of high quality." Supply chain management M9: "Patients can access their medical information more securely and conveniently using this new technology, easily share their information with different doctors, and make more informed decisions about their own health." The impact of blockchain technology on patients M10: "Insurance companies can use this new technology to reduce fraud, increase payment accuracy, and offer new services to customers, such as health data-based insurance." The impact of blockchain technology on insurance companies Axial coding is the second level of coding. In contrast to open coding, which focuses on identifying emergent themes, axial coding further refines, aligns, and categorizes the themes. With the completion of open coding and transition to axial coding, collected data can be sifted, refined, and categorized with the goal of creating distinct thematic categories in preparation for selective coding. “Axial coding identifies relationships between open codes, for the purpose of developing core codes. Major (core) codes emerge as aggregates of the most closely interrelated (or overlapping) open codes for which supporting evidence is strong”. [viii] Next, and according to the grounded theory; after determining the initial codes (previous section), axial coding and assigning the initial codes to subcategories were carried out. At this stage, the researcher's effort was to examine and organize the relationships between the codes identified in the open coding stage. The main goal of this stage was to identify the relationships between scattered concepts and organize them around subcategories, in such a way that the relationship structure between these categories becomes clear. At this stage, the researcher sought to place the scattered concepts and codes in a more organized framework and, by categorizing them into subcategories, create a coherent structure for analyzing the phenomenon under study. This structure facilitated the identification of relationships among various categories, enabling each category to aid in understanding the overall phenomenon within a broader context. The results are reported in Table 4. Table 4 Results from axial coding of interviews Open coding Axial coding Senior management commitment to blockchain technology Management support Allocation of financial and human resources by the manager to implement blockchain technology Existence of a management strategy for acceptance blockchain technology Encouraging a culture of innovation and risk-taking Employee awareness and understanding of blockchain technology Organizational culture Willingness to change and embrace new technology The existence of values that support innovation and efficiency in an organization Encouraging employee cooperation and participation in the implementation process The existence of appropriate decision-making processes for technology implementation Organizational structure The existence of an agile and flexible organizational structure Coordination between different parts of the organization Existence of change management processes to facilitate the acceptance process The existence of skilled and trained human resources to implement and use technology Human Resources Existence of human resources development programs to improve employee skills Incentives and rewards for employees involved in the admissions process Interoperability Technology infrastructure Security Scalability Reliability Data standards Technology standards Security standards Privacy standards Identity management Practical and technological solutions Supply chain management Data sharing Records management Availability of skilled staff Technical expertise Training and development Awareness of blockchain technology Awareness and understanding Understanding social impacts Trust in technology Attitudes and beliefs Risk acceptance Moral attitudes Collaboration and participation Social values and norms Transparency and accountability Justice and equality Getting support through social media The role of social networks in acceptance Engaging stakeholders through social media Initial cost management Cost management Managing operating costs Cost reduction Achieving economic advantage Increase income Payment-for-service models Improving payment models Subscription models Token-based models The impact of blockchain technology on healthcare providers Positive impact on various stakeholders The impact of blockchain technology on patients The impact of blockchain technology on insurance companies The impact of blockchain technology on government Improving the quality of healthcare After completing the axial coding phase, the researcher entered the selective coding phase. Selective coding is the third level of coding. It enables the researcher to select and integrate categories of organized data from axial coding in cohesive and meaning-filled expressions. “Selective coding continues the axial coding at a higher level of abstraction [through] actions that lead to an elaboration or formulation of the story of the case”. [ix] The results of this phase are reported in the Table 5. Table 5 Results from selective coding of interviews Axial coding Selective coding Management support Organizational factors (One of the key dimensions in the acceptance of blockchain technology in healthcare facilities. These factors include factors related to how the organization operates and its readiness to implement and use this new technology.) Organizational culture Organizational structure Human Resources Technology infrastructure Technological Factors (Technological factors are a key dimension in the acceptance of blockchain technology in healthcare settings. These factors include factors related to the capabilities and technical performance of the technology and its suitability for the specific needs of the healthcare sector) Technology standards Practical and technological solutions Technical expertise Awareness and understanding Social Factors (Social factors are a key dimension in the acceptance of blockchain technology in healthcare settings. These factors include factors related to the attitudes, beliefs, and values of various stakeholders related to this technology, as well as how they interact and collaborate with each other in the process of its acceptance and use.) Attitudes and beliefs Social values and norms The role of social networks in acceptance Cost management Economic Factors (Economic factors are a key dimension in the acceptance of blockchain technology in healthcare. These factors include factors related to the costs, benefits, and overall economic value of implementing and using this technology in the healthcare sector.) Achieving economic advantage Improving payment models Positive impact on various stakeholders According to the results of the qualitative research, in the present study, interviews and the grounded theory method were used to collect data and information for the qualitative analysis. After the interviews were conducted, the interviews were coded at two levels: primary and axial coding. The coding in the first stage is considered primary coding due to its generality and openness. In the stage after this type of coding, secondary or axial coding was performed, in which the primary codes were converted into a conceptual code or subcategory due to the large number of similar categories or secondary codes, and then the main categories were determined in the selective coding stage. Accordingly, during open coding, 61 items were extracted as evidence from the interview text, which were categorized into 50 primary codes, then 16 subcategories, and four main categories. According to the results of the present qualitative research, the pattern of blockchain technology acceptance in health centers is presented in Figure 1. According to Figure 1, the acceptance of blockchain technology in healthcare is influenced by four key factors, including organizational factors, technological factors, social factors, and economic factors. Each of these factors, in turn, influences the acceptance and application process of this technology and plays an important role in shaping its success. 1. Research Limitations While this study focused on health centers in the country, it faced certain limitations that may impact the generalizability of the results. These limitations include: - Scope of the Sample: The research community comprised IT managers, cybersecurity experts, senior health center managers, and specialists in new technology. However, findings may not be applicable to other sectors or institutions due to variations in organizational structure, culture, and management practices. 2. Practical Recommendations Based on the research findings, the following practical suggestions are provided for the successful acceptance of blockchain technology in health centers: 2.1 Management Support: Senior managers should actively support blockchain acceptance by establishing committees that include representatives from different departments. These committees will help identify organizational needs and manage challenges effectively. 2.2 Organizational Culture: Health centers should foster a culture of innovation by organizing educational programs and workshops. These initiatives can raise awareness about the benefits of blockchain technology and encourage staff participation. 2.3 Organizational Structure : To enhance flexibility in adopting new technologies, health centers should consider creating dedicated innovation and technology units within their structure. 2.4 Human Resources : Training programs focusing on blockchain technology and IT skills are essential for maximizing the potential of blockchain. Attracting experts in these fields can also strengthen the workforce's capabilities. Conclusion The results of this research emphasize the importance of accurate documentation and clear explanation to ensure trust and confidence within the research community. This transparency allows for the identification of shortcomings and facilitates comprehensive planning to address them. In particular, the final stages of research—accurate data analysis and drawing correct conclusions—are critical, as they serve as the foundation for future planning in the research community. This study aimed to design and present a model for the acceptance of blockchain technology in health centers. Blockchain, a ground-breaking technology, has shown significant potential in enhancing security, transparency, and efficiency across various sectors, including healthcare. With its unique features, such as data immutability and the elimination of intermediaries, blockchain can address many current challenges in health information management and contribute to cost reductions. The primary objective of this research was to identify key factors influencing blockchain acceptance in health centers and develop an appropriate model for its implementation. - Suggestions for Future Research Building on the limitations and findings of this study, the following directions are suggested for future research: a. Broader Sample Sizes: Future studies should aim to include a wider range of health centers across different regions and types (private, government, non-profit) to enhance the generalizability of the findings and explore variations in blockchain acceptance across sectors. b. Social and Cultural Dimensions : Further research could investigate the social, cultural, and economic factors influencing blockchain acceptance. This would provide a more comprehensive understanding of user behavior, cultural barriers, and social influences. c. Empirical Studies: Research evaluating the real-world performance of blockchain technology in healthcare facilities would be valuable. Comparing empirical data with theoretical models can help identify the strengths and weaknesses of blockchain in practice. Abbreviations EHR Electronic health record Declarations Consent to participate and publish was obtained. Competing interests and Funding declaration: The authors declare that they have no competing interests in relation to this study. This work was not supported by any external funding; all efforts and resources were self-sustained, with no grants, funding, or support received from any organization. Conflict of interests and Data Availability All authors collectively declare that there are no conflicts of interest in this article. Qualitative data from this study consists of interview transcripts and coding schemes. For data sharing inquiries, including requests for interview transcripts or other data, please contact Seyed Mohsen Khademian at https://orcid.org/0009-0005-5783-2849. Note: Data sharing is contingent upon ensuring participant anonymity and compliance with ethical guidelines. Author Contribution Author Contributions StatementAuthor 1: Conceived the study, designed the interviews, analyzed the data, and performed the statistical analyses.Author 2: Contributed to the study's conception, supervised the project, and provided critical revisions for important intellectual content.Author 3: Served as an advisor and provided critical revisions for important intellectual content."All authors have approved the final version of the manuscript and agree to be accountable for all aspects of the work. References Crosby, M., Pattanayak, P., Verma, S., & Kalyanaraman, V. (2016). Blockchain technology: Beyond bitcoin. Applied innovation, 2(6-10), 71. 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An Introduction to Qualitative Research: Sage Publications. P 310 Additional Declarations No competing interests reported. Cite Share Download PDF Status: Published Journal Publication published 25 Nov, 2025 Read the published version in International Journal of Healthcare Information Systems and Informatics → Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. 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The rapid uptake of digitization in healthcare has led to the generation of massive electronic records about patients. Such growth poses unprecedented demands for healthcare data protection while in use and exchange.[\u003ca class=\"FNLink\" href=\"#Fn3\" id=\"#FNLinkFn3\"\u003e\u003c/a\u003e] Blockchain, as is, currently lacks a number of elements needed to make it successful as a national record keeping framework to replace our current system. Many of these barriers are monetarily driven, such as the incentives to create this very large network of connected blocks of data. The current EHR market is valued at tens of billions of dollars, and very recently, many academic universities and other large health systems have poured millions of dollars into new vendor-led commercial health record systems in large part incentivized by the federal government.[\u003ca class=\"FNLink\" href=\"#Fn4\" id=\"#FNLinkFn4\"\u003e\u003c/a\u003e] Emerging technological breakthroughs in blockchain and smart contracts are expected to provide promising solutions to secure patient data despite being shared and accessed through EHR.[\u003ca class=\"FNLink\" href=\"#Fn5\" id=\"#FNLinkFn5\"\u003e\u003c/a\u003e] Healthcare records or medical records have proven their importance to patients because of the valuable asset recorded in consonance with their point of view. Although sharing patient information amongst various healthcare providers through EHR may boost diagnostic accuracy, the health information repository may become a single point of failure and may be targeted by attackers resulting in ransomware attacks or denial of services.[\u003ca class=\"FNLink\" href=\"#Fn6\" id=\"#FNLinkFn6\"\u003e\u003c/a\u003e] Medical data is now accessible through a large number of smart devices, which may result in accidental or malicious leakage.[\u003ca class=\"FNLink\" href=\"#Fn7\" id=\"#FNLinkFn7\"\u003e\u003c/a\u003e] Blockchain technologies are a promising solution that can address security and privacy issues associated to mobile devices and mobile applications. Through its chain of records, the blockchain can offer a secure, immutable and verifiable health data storage system and mechanisms.[\u003ca class=\"FNLink\" href=\"#Fn8\" id=\"#FNLinkFn8\"\u003e\u003c/a\u003e]Considering the challenges and requirements related to the adoption of blockchain technology in healthcare, this paper seeks to present key findings that support the development of a comprehensive framework for effectively implementing blockchain in healthcare.\u003c/p\u003e"},{"header":"Methodology","content":"\u003cp\u003eData collection methods in this study were divided into two categories: library and field methods. Both approaches were utilized to obtain necessary data from the following sources:\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e- Library Resources:\u003c/strong\u003e This included websites, English articles, and existing documents, reports, and writings.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e-\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eSemi-Structured Interviews\u003c/strong\u003e\u003csup\u003e\u003csup\u003e[i]\u003c/sup\u003e\u003c/sup\u003e: Expert interviews were conducted to identify components of the research model.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e1. Research Community\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe research community comprised experts and specialists who met the necessary criteria to ensure the validity of the interviews. Participants included information technology managers, cybersecurity experts, senior health center managers, specialists in new technologies, and university professors in health-related fields, all involved in management processes and the implementation of digital technologies in health centers.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2. Sampling and Participant Selection Method\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA purposeful snowball sampling\u003csup\u003e\u003csup\u003e[ii]\u003c/sup\u003e\u003c/sup\u003e method was employed to select participants for the grounded theory\u003csup\u003e\u003csup\u003e[iii]\u003c/sup\u003e\u003c/sup\u003e analysis, allowing the sample size to expand until theoretical saturation was reached. Initial interviews were conducted with qualified experts, who were then asked to identify additional individuals in the field.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3. Criteria for Selecting Participants\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.1 Expertise and Experience\u003c/strong\u003e: Specialized knowledge in blockchain technology and health centers, along with practical management experience.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.2 Professional Position\u003c/strong\u003e: Key management or decision-making roles in health-related organizations, ensuring comprehensive knowledge of new technology implementation.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.3 Familiarity with Blockchain\u003c/strong\u003e: At least a basic understanding of blockchain technology and its applications in health systems.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.4 Publication Record\u003c/strong\u003e: Preference for participants with published research in information technology, blockchain, and health.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.5 Collaborative Project Experience\u003c/strong\u003e: Involvement in innovative projects related to new technology in health centers, providing practical insights.\u003c/p\u003e\n\u003cp\u003e- A total of 15 participants were included in the study, determined through theoretical saturation.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e4. Reliability of Interviews\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTo ensure the trustworthiness of the interviews, standards were maintained throughout the process, from question design to transcription. Following 13 interviews, data saturation was indicated by the repetition of main and secondary factors. Two additional interviews confirmed the saturation, resulting in a final sample size of 15 participants. Open and axial coding\u003csup\u003e\u003csup\u003e[iv]\u003c/sup\u003e\u003c/sup\u003e, along with research results, were shared with select interviewees for feedback, leading to revisions and confirmations of the findings.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Analysis:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe demographic profile of the participants in the qualitative interviews (Table 1 ) demonstrates significant diversity in terms of educational backgrounds, fields of activity, locations of activity, and work experience. This balanced gender distribution aids in understanding the various opinions and experiences regarding the acceptance of blockchain technology in health and wellness centers.\u003c/p\u003e\n\u003cp\u003eIn terms of education, the majority of participants hold advanced degrees, with 9 possessing a master\u0026rsquo;s degree and 6 holding a doctorate. This high level of education underscores the participants\u0026rsquo; expertise and deep knowledge in fields related to information technology and health. Such diversity enriches the qualitative data and opens up new opportunities for detailed and practical analysis of the results.\u003c/p\u003e\n\u003cp\u003eAdditionally, the participants\u0026apos; work experience averages between 10 and 35 years, which significantly enhances the validity of the research findings.\u003c/p\u003e\n\u003cp\u003eTable 1 Cognitive characteristics of experts\u003c/p\u003e\n\u003ctable dir=\"rtl\" border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"99%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 16px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eWork Experience (Years)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003esex\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eLevel of education\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eField of activity\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003ePlace of activity\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 16px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e15\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp dir=\"LTR\"\u003efemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp dir=\"LTR\"\u003eMaster\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24px;\"\u003e\n \u003cp dir=\"LTR\"\u003eInformation Technology\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25px;\"\u003e\n \u003cp dir=\"LTR\"\u003eTehran University\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5px;\"\u003e\n \u003cp dir=\"LTR\"\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 16px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e30\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp dir=\"LTR\"\u003efemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp dir=\"LTR\"\u003eMaster\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24px;\"\u003e\n \u003cp dir=\"LTR\"\u003eInformation Technology\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25px;\"\u003e\n \u003cp dir=\"LTR\"\u003eMinistry of Petroleum\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5px;\"\u003e\n \u003cp dir=\"LTR\"\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 16px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e18\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp dir=\"LTR\"\u003emale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp dir=\"LTR\"\u003eMaster\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24px;\"\u003e\n \u003cp dir=\"LTR\"\u003eInformation Technology\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25px;\"\u003e\n \u003cp dir=\"LTR\"\u003eMinistry of Health\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5px;\"\u003e\n \u003cp dir=\"LTR\"\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 16px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e20\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp dir=\"LTR\"\u003emale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp dir=\"LTR\"\u003ePh. D\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24px;\"\u003e\n \u003cp dir=\"LTR\"\u003eComputer Science\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25px;\"\u003e\n \u003cp dir=\"LTR\"\u003eAllameh Tabatabaei University\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5px;\"\u003e\n \u003cp dir=\"LTR\"\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 16px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e35\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp dir=\"LTR\"\u003emale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp dir=\"LTR\"\u003ePh. D\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24px;\"\u003e\n \u003cp dir=\"LTR\"\u003eComputer Science\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25px;\"\u003e\n \u003cp dir=\"LTR\"\u003eAllameh Tabatabaei University\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5px;\"\u003e\n \u003cp dir=\"LTR\"\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 16px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e25\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp dir=\"LTR\"\u003emale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp dir=\"LTR\"\u003ePh. D\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24px;\"\u003e\n \u003cp dir=\"LTR\"\u003ePhysician\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25px;\"\u003e\n \u003cp dir=\"LTR\"\u003eMinistry of Health\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5px;\"\u003e\n \u003cp dir=\"LTR\"\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 16px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e10\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp dir=\"LTR\"\u003emale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp dir=\"LTR\"\u003eMaster\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24px;\"\u003e\n \u003cp dir=\"LTR\"\u003eNursing\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25px;\"\u003e\n \u003cp dir=\"LTR\"\u003eMinistry of Health\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5px;\"\u003e\n \u003cp dir=\"LTR\"\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 16px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e15\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp dir=\"LTR\"\u003efemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp dir=\"LTR\"\u003eBachelor\u0026apos;s degree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24px;\"\u003e\n \u003cp dir=\"LTR\"\u003eComputer software\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25px;\"\u003e\n \u003cp dir=\"LTR\"\u003eMinistry of Health\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5px;\"\u003e\n \u003cp dir=\"LTR\"\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 16px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e11\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp dir=\"LTR\"\u003emale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp dir=\"LTR\"\u003eBachelor\u0026apos;s degree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24px;\"\u003e\n \u003cp dir=\"LTR\"\u003eComputer software\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25px;\"\u003e\n \u003cp dir=\"LTR\"\u003eMinistry of Health\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5px;\"\u003e\n \u003cp dir=\"LTR\"\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 16px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e22\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp dir=\"LTR\"\u003emale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp dir=\"LTR\"\u003ePh. D\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24px;\"\u003e\n \u003cp dir=\"LTR\"\u003eComputer Science\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25px;\"\u003e\n \u003cp dir=\"LTR\"\u003eMinistry of Communications\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5px;\"\u003e\n \u003cp dir=\"LTR\"\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 16px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e20\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp dir=\"LTR\"\u003emale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp dir=\"LTR\"\u003ePh. D\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24px;\"\u003e\n \u003cp dir=\"LTR\"\u003eInformation Technology Management\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25px;\"\u003e\n \u003cp dir=\"LTR\"\u003ePrivate company\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5px;\"\u003e\n \u003cp dir=\"LTR\"\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 16px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e11\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp dir=\"LTR\"\u003efemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp dir=\"LTR\"\u003eBachelor\u0026apos;s degree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24px;\"\u003e\n \u003cp dir=\"LTR\"\u003eElectricity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25px;\"\u003e\n \u003cp dir=\"LTR\"\u003ePrivate company\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5px;\"\u003e\n \u003cp dir=\"LTR\"\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 16px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e30\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp dir=\"LTR\"\u003emale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp dir=\"LTR\"\u003ePh. D\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24px;\"\u003e\n \u003cp dir=\"LTR\"\u003eElectricity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25px;\"\u003e\n \u003cp dir=\"LTR\"\u003ePrivate company\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5px;\"\u003e\n \u003cp dir=\"LTR\"\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 16px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e18\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp dir=\"LTR\"\u003emale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp dir=\"LTR\"\u003eMaster\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24px;\"\u003e\n \u003cp dir=\"LTR\"\u003eInformation Technology Management\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25px;\"\u003e\n \u003cp dir=\"LTR\"\u003eBank\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5px;\"\u003e\n \u003cp dir=\"LTR\"\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 16px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e11\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp dir=\"LTR\"\u003emale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp dir=\"LTR\"\u003eBachelor\u0026apos;s degree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24px;\"\u003e\n \u003cp dir=\"LTR\"\u003eInformation Technology Management\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25px;\"\u003e\n \u003cp dir=\"LTR\"\u003ePrivate company\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5px;\"\u003e\n \u003cp dir=\"LTR\"\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eFollowing the implementation of interviews, open coding was conducted. Open coding is the first level of coding. In open coding, the researcher is identifying distinct concepts and themes for categorization. The first level of data is organized by creating initial broad thematic domains for data assemblage. \u0026ldquo;The first step [open coding] aims at expressing data and phenomena in the form of concepts. Units of meaning classifying expressions (single words, short sequences of words) in order to attach annotations and \u0026quot;concepts\u0026rdquo;.\u003csup\u003e\u003csup\u003e[v]\u003c/sup\u003e\u003c/sup\u003e In open coding, this process was termed the concept-indicator model. In brief, the concept-indicator model used constant comparison of [textual] indicators and focused on comparing regularly occurring textual material. This approach was accompanied by the ongoing coding of themes as an indicator of a concept, always comparing it to previous indicators that had been similarly coded\u003csup\u003e\u003csup\u003e[vi]\u003c/sup\u003e\u003c/sup\u003e.\u003c/p\u003e\n\u003cp\u003eIn practice, the researcher needs to sift through informant\u0026rsquo;s responses and organize similar words and phrases, concept-indicators, in broad initial thematic domains.\u003csup\u003e\u003csup\u003e[vii]\u003c/sup\u003e\u003c/sup\u003e\u003c/p\u003e\n\u003cp\u003eExamples of open coding (labeling and categorization) from the interview texts are presented for clarity. One participant shared their journey into blockchain, highlighting its potential in healthcare, including secure storage and sharing of medical records, improved coordination, and reduced errors. They acknowledged challenges such as complexity and regulatory ambiguity but emphasized blockchain\u0026apos;s transformative potential in healthcare.\u003c/p\u003e\n\u003cp\u003eBelow (Table 2) are some examples of open coding (labeling and concept determination), based on important points identified from the above interview.\u003c/p\u003e\n\u003cp\u003eTable 2 Open coding example including quote identification, open coding, and category determination\u003c/p\u003e\n\u003ctable dir=\"rtl\" border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"97%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eSpeech Evidence (Meaningful Unit)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 29px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eOpen coding\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eM4: Blockchain can facilitate information sharing between patients, doctors, and researchers.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 29px;\"\u003e\n \u003cp dir=\"LTR\"\u003eInteroperability\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e\u003cspan dir=\"RTL\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 29px;\"\u003e\n \u003cp dir=\"LTR\"\u003eIdentity management\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eM4:Blockchain can help protect sensitive patient information from hacking.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 29px;\"\u003e\n \u003cp dir=\"LTR\"\u003eSecurity\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eM4: The best way to increase awareness and facilitate understanding among various stakeholders is to hold seminars, workshops, and information sessions.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 29px;\"\u003e\n \u003cp dir=\"LTR\"\u003eExistence of a management strategy for adopting blockchain technology\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eM4: Blockchain can help track medicines and medical devices from the point of production to the point of consumption.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 29px;\"\u003e\n \u003cp dir=\"LTR\"\u003eSupply chain management\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eM4: Managers should be aware of the benefits and capabilities of this technology and support the budget and resources necessary for its implementation.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 29px;\"\u003e\n \u003cp dir=\"LTR\"\u003eSenior management commitment to blockchain technology\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eM4: Staff should also receive the necessary training to familiarize themselves with its benefits and uses, and patients should be able to use this technology to improve their care and maintain privacy.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 29px;\"\u003e\n \u003cp dir=\"LTR\"\u003eEncouraging employee cooperation and participation in the implementation process\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eM4: Providing financial and non-financial incentives to health centers can increase their motivation to implement blockchain solutions.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 29px;\"\u003e\n \u003cp dir=\"LTR\"\u003eAllocation of financial and human resources by the manager to implement blockchain technology\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eM4: Investment in research and development can also help develop new and innovative applications of blockchain in the healthcare sector.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 29px;\"\u003e\n \u003cp dir=\"LTR\"\u003eEncouraging a culture of innovation and risk-taking\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eM4: Establishing clear standards and guidelines is also essential for the use of this technology.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 29px;\"\u003e\n \u003cp dir=\"LTR\"\u003eWillingness to change and embrace new technology\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eM4: Encouraging collaboration between healthcare providers, technology companies, and other stakeholders to develop and implement blockchain solutions, and addressing legal and regulatory challenges associated with the use of this technology, are other measures that can help promote blockchain acceptance in healthcare.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 29px;\"\u003e\n \u003cp dir=\"LTR\"\u003eThe existence of values that support innovation and efficiency in an organization\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eAccordingly, during open coding, 61 items were obtained as verbal evidence (labelling) from the interview transcripts.\u003c/p\u003e\n\u003cp\u003eNext, during open coding, 50 initial concepts were extracted from the available speech evidence. Some results are presented in Table 3.\u003c/p\u003e\n\u003cp\u003eTable 3 Examples of results from open coding of interviews\u003c/p\u003e\n\u003ctable dir=\"rtl\" border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"114%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eSpeech evidence (meaningful unit)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 36px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eOpen coding\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eM1: \u0026quot;Management commitment is not just talk, it must be demonstrated by tangible actions such as allocating resources, encouraging innovation, and supporting the implementation process.\u0026quot;\u003c/strong\u003e\u003c/p\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eM4: Managers must be aware of the benefits and capabilities of this technology and support the budget and resources necessary for its implementation.\u0026quot;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 36px;\"\u003e\n \u003cp dir=\"LTR\"\u003eSenior management commitment to blockchain technology\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eM2: \u0026quot;Employees must be willing to change their ways of working and learn new skills to use this technology.\u0026quot;\u003c/strong\u003e\u003c/p\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eM4: Establishing clear standards and guidelines for using this technology is also essential.\u0026quot;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 36px;\"\u003e\n \u003cp dir=\"LTR\"\u003eWillingness to change and embrace new technology\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eM5: \u0026quot;All parts of the organization, such as IT, clinical care, finance, and management, must work together to successfully implement this technology.\u0026quot;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 36px;\"\u003e\n \u003cp dir=\"LTR\"\u003eCoordination between different parts of the organization\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eM8: \u0026quot;To work with this new technology, we need experts and trained in the field of blockchain and health and wellness.\u0026quot;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 36px;\"\u003e\n \u003cp dir=\"LTR\"\u003eThe existence of skilled and trained human resources to implement and use technology\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eM4: Blockchain can help protect sensitive patient information from hacking\u0026quot;\u003c/strong\u003e\u003c/p\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eM10: \u0026quot;Blockchain should protect the privacy and security of our patients\u0026apos; information, such as medical information, hospital records, and financial data. Otherwise, patient information will be leaked and there will be a lot of trouble.\u0026quot;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 36px;\"\u003e\n \u003cp dir=\"LTR\"\u003eSecurity\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eM4: Blockchain can help track medicines and medical equipment from the point of production to the point of consumption\u0026quot;\u003c/strong\u003e\u003c/p\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eM12: \u0026quot;Medicines and medical equipment can be tracked through all stages of the supply chain, from production to distribution, with blockchain to prevent them from being counterfeited and of poor quality. This way, we can rest assured that the medicines and equipment are genuine and of high quality.\u0026quot;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 36px;\"\u003e\n \u003cp dir=\"LTR\"\u003eSupply chain management\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eM9: \u0026quot;Patients can access their medical information more securely and conveniently using this new technology, easily share their information with different doctors, and make more informed decisions about their own health.\u0026quot;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 36px;\"\u003e\n \u003cp dir=\"LTR\"\u003eThe impact of blockchain technology on patients\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eM10: \u0026quot;Insurance companies can use this new technology to reduce fraud, increase payment accuracy, and offer new services to customers, such as health data-based insurance.\u0026quot;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 36px;\"\u003e\n \u003cp dir=\"LTR\"\u003eThe impact of blockchain technology on insurance companies\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eAxial coding is the second level of coding. In contrast to open coding, which focuses on identifying emergent themes, axial coding further refines, aligns, and categorizes the themes. With the completion of open coding and transition to axial coding, collected data can be sifted, refined, and categorized with the goal of creating distinct thematic categories in preparation for selective coding. \u0026ldquo;Axial coding identifies relationships between open codes, for the purpose of developing core codes. Major (core) codes emerge as aggregates of the most closely interrelated (or overlapping) open codes for which supporting evidence is strong\u0026rdquo;.\u003csup\u003e\u003csup\u003e[viii]\u003c/sup\u003e\u003c/sup\u003e\u003c/p\u003e\n\u003cp\u003eNext, and according to the grounded theory; after determining the initial codes (previous section), axial coding and assigning the initial codes to subcategories were carried out. At this stage, the researcher\u0026apos;s effort was to examine and organize the relationships between the codes identified in the open coding stage. The main goal of this stage was to identify the relationships between scattered concepts and organize them around subcategories, in such a way that the relationship structure between these categories becomes clear. At this stage, the researcher sought to place the scattered concepts and codes in a more organized framework and, by categorizing them into subcategories, create a coherent structure for analyzing the phenomenon under study. This structure facilitated the identification of relationships among various categories, enabling each category to aid in understanding the overall phenomenon within a broader context. The results are reported in Table 4.\u003c/p\u003e\n\u003cp\u003eTable 4 Results from axial coding of interviews\u003c/p\u003e\n\u003ctable dir=\"rtl\" border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"98%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eOpen coding\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 40px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eAxial coding\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eSenior management commitment to blockchain technology\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" style=\"width: 40px;\"\u003e\n \u003cp dir=\"LTR\"\u003eManagement support\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eAllocation of financial and human resources by the manager to implement blockchain technology\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eExistence of a management strategy for acceptance blockchain technology\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eEncouraging a culture of innovation and risk-taking\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eEmployee awareness and understanding of blockchain technology\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" style=\"width: 40px;\"\u003e\n \u003cp dir=\"LTR\"\u003eOrganizational culture\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eWillingness to change and embrace new technology\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eThe existence of values that support innovation and efficiency in an organization\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eEncouraging employee cooperation and participation in the implementation process\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eThe existence of appropriate decision-making processes for technology implementation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" style=\"width: 40px;\"\u003e\n \u003cp dir=\"LTR\"\u003eOrganizational structure\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eThe existence of an agile and flexible organizational structure\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eCoordination between different parts of the organization\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eExistence of change management processes to facilitate the acceptance process\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eThe existence of skilled and trained human resources to implement and use technology\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 40px;\"\u003e\n \u003cp dir=\"LTR\"\u003eHuman Resources\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eExistence of human resources development programs to improve employee skills\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eIncentives and rewards for employees involved in the admissions process\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eInteroperability\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" style=\"width: 40px;\"\u003e\n \u003cp dir=\"LTR\"\u003eTechnology infrastructure\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eSecurity\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eScalability\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eReliability\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eData standards\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 40px;\"\u003e\n \u003cp dir=\"LTR\"\u003eTechnology standards\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eSecurity standards\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003ePrivacy standards\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eIdentity management\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" style=\"width: 40px;\"\u003e\n \u003cp dir=\"LTR\"\u003ePractical and technological solutions\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eSupply chain management\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eData sharing\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eRecords management\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eAvailability of skilled staff\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 40px;\"\u003e\n \u003cp dir=\"LTR\"\u003eTechnical expertise\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eTraining and development\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eAwareness of blockchain technology\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 40px;\"\u003e\n \u003cp dir=\"LTR\"\u003eAwareness and understanding\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eUnderstanding social impacts\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eTrust in technology\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 40px;\"\u003e\n \u003cp dir=\"LTR\"\u003eAttitudes and beliefs\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eRisk acceptance\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eMoral attitudes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eCollaboration and participation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 40px;\"\u003e\n \u003cp dir=\"LTR\"\u003eSocial values and norms\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eTransparency and accountability\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eJustice and equality\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eGetting support through social media\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 40px;\"\u003e\n \u003cp dir=\"LTR\"\u003eThe role of social networks in acceptance\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eEngaging stakeholders through social media\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eInitial cost management\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 40px;\"\u003e\n \u003cp dir=\"LTR\"\u003eCost management\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eManaging operating costs\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eCost reduction\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 40px;\"\u003e\n \u003cp dir=\"LTR\"\u003eAchieving economic advantage\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eIncrease income\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003ePayment-for-service models\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 40px;\"\u003e\n \u003cp dir=\"LTR\"\u003eImproving payment models\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eSubscription models\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eToken-based models\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eThe impact of blockchain technology on healthcare providers\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"5\" style=\"width: 40px;\"\u003e\n \u003cp dir=\"LTR\"\u003ePositive impact on various stakeholders\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eThe impact of blockchain technology on patients\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eThe impact of blockchain technology on insurance companies\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eThe impact of blockchain technology on government\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eImproving the quality of healthcare\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eAfter completing the axial coding phase, the researcher entered the selective coding phase. Selective coding is the third level of coding. It enables the researcher to select and integrate categories of organized data from axial coding in cohesive and meaning-filled expressions. \u0026ldquo;Selective coding continues the axial coding at a higher level of abstraction [through] actions that lead to an elaboration or formulation of the story of the case\u0026rdquo;. \u003csup\u003e\u003csup\u003e[ix]\u003c/sup\u003e\u003c/sup\u003eThe results of this phase are reported in the Table 5.\u003c/p\u003e\n\u003cp\u003eTable 5 Results from selective coding of interviews\u003c/p\u003e\n\u003ctable dir=\"rtl\" border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"102%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eAxial coding\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 50px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eSelective coding\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp dir=\"RTL\"\u003e\u003cstrong\u003e\u003cspan dir=\"LTR\"\u003eManagement support\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" style=\"width: 50px;\"\u003e\n \u003cp dir=\"LTR\"\u003eOrganizational factors\u003c/p\u003e\n \u003cp dir=\"RTL\"\u003e(One of the key dimensions in the acceptance of blockchain technology in healthcare facilities. These factors include factors related to how the organization operates and its readiness to implement and use this new technology.)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp dir=\"RTL\"\u003e\u003cstrong\u003e\u003cspan dir=\"LTR\"\u003eOrganizational culture\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp dir=\"RTL\"\u003e\u003cstrong\u003e\u003cspan dir=\"LTR\"\u003eOrganizational structure\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp dir=\"RTL\"\u003e\u003cstrong\u003e\u003cspan dir=\"LTR\"\u003eHuman Resources\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp dir=\"RTL\"\u003e\u003cstrong\u003e\u003cspan dir=\"LTR\"\u003eTechnology infrastructure\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" style=\"width: 50px;\"\u003e\n \u003cp dir=\"LTR\"\u003eTechnological Factors\u003c/p\u003e\n \u003cp dir=\"LTR\"\u003e\u003cspan dir=\"RTL\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003cp dir=\"RTL\"\u003e(Technological factors are a key dimension in the acceptance of blockchain technology in healthcare settings. These factors include factors related to the capabilities and technical performance of the technology and its suitability for the specific needs of the healthcare sector)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp dir=\"RTL\"\u003e\u003cstrong\u003e\u003cspan dir=\"LTR\"\u003eTechnology standards\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp dir=\"RTL\"\u003e\u003cstrong\u003e\u003cspan dir=\"LTR\"\u003ePractical and technological solutions\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp dir=\"RTL\"\u003e\u003cstrong\u003e\u003cspan dir=\"LTR\"\u003eTechnical expertise\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp dir=\"RTL\"\u003e\u003cstrong\u003e\u003cspan dir=\"LTR\"\u003eAwareness and understanding\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" style=\"width: 50px;\"\u003e\n \u003cp dir=\"LTR\"\u003eSocial Factors\u003c/p\u003e\n \u003cp dir=\"RTL\"\u003e(Social factors are a key dimension in the acceptance of blockchain technology in healthcare settings. These factors include factors related to the attitudes, beliefs, and values of various stakeholders related to this technology, as well as how they interact and collaborate with each other in the process of its acceptance and use.)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp dir=\"RTL\"\u003e\u003cstrong\u003e\u003cspan dir=\"LTR\"\u003eAttitudes and beliefs\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp dir=\"RTL\"\u003e\u003cstrong\u003e\u003cspan dir=\"LTR\"\u003eSocial values and norms\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp dir=\"RTL\"\u003e\u003cstrong\u003e\u003cspan dir=\"LTR\"\u003eThe role of social networks in acceptance\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp dir=\"RTL\"\u003e\u003cstrong\u003e\u003cspan dir=\"LTR\"\u003eCost management\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" style=\"width: 50px;\"\u003e\n \u003cp dir=\"LTR\"\u003eEconomic Factors\u003c/p\u003e\n \u003cp dir=\"RTL\"\u003e(Economic factors are a key dimension in the acceptance of blockchain technology in healthcare. These factors include factors related to the costs, benefits, and overall economic value of implementing and using this technology in the healthcare sector.)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp dir=\"RTL\"\u003e\u003cstrong\u003e\u003cspan dir=\"LTR\"\u003eAchieving economic advantage\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp dir=\"RTL\"\u003e\u003cstrong\u003e\u003cspan dir=\"LTR\"\u003eImproving payment models\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp dir=\"RTL\"\u003e\u003cstrong\u003e\u003cspan dir=\"LTR\"\u003ePositive impact on various stakeholders\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eAccording to the results of the qualitative research, in the present study, interviews and the grounded theory method were used to collect data and information for the qualitative analysis. After the interviews were conducted, the interviews were coded at two levels: primary and axial coding. The coding in the first stage is considered primary coding due to its generality and openness. In the stage after this type of coding, secondary or axial coding was performed, in which the primary codes were converted into a conceptual code or subcategory due to the large number of similar categories or secondary codes, and then the main categories were determined in the selective coding stage. Accordingly, during open coding, 61 items were extracted as evidence from the interview text, which were categorized into 50 primary codes, then 16 subcategories, and four main categories. According to the results of the present qualitative research, the pattern of blockchain technology acceptance in health centers is presented in Figure 1.\u003c/p\u003e\n\u003cp\u003eAccording to Figure 1, the acceptance of blockchain technology in healthcare is influenced by four key factors, including organizational factors, technological factors, social factors, and economic factors. Each of these factors, in turn, influences the acceptance and application process of this technology and plays an important role in shaping its success.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e1. Research Limitations\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWhile this study focused on health centers in the country, it faced certain limitations that may impact the generalizability of the results. These limitations include:\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e- Scope of the Sample:\u003c/strong\u003e The research community comprised IT managers, cybersecurity experts, senior health center managers, and specialists in new technology. However, findings may not be applicable to other sectors or institutions due to variations in organizational structure, culture, and management practices.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2. Practical Recommendations\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eBased on the research findings, the following practical suggestions are provided for the successful acceptance of blockchain technology in health centers:\u003c/p\u003e\n\u003cp\u003e2.1 \u003cstrong\u003eManagement Support:\u003c/strong\u003e Senior managers should actively support blockchain acceptance by establishing committees that include representatives from different departments. These committees will help identify organizational needs and manage challenges effectively.\u003c/p\u003e\n\u003cp\u003e2.2 \u003cstrong\u003eOrganizational Culture:\u003c/strong\u003e Health centers should foster a culture of innovation by organizing educational programs and workshops. These initiatives can raise awareness about the benefits of blockchain technology and encourage staff participation.\u003c/p\u003e\n\u003cp\u003e2.3 \u003cstrong\u003eOrganizational Structure\u003c/strong\u003e: To enhance flexibility in adopting new technologies, health centers should consider creating dedicated innovation and technology units within their structure.\u003c/p\u003e\n\u003cp\u003e2.4 \u003cstrong\u003eHuman Resources\u003c/strong\u003e: Training programs focusing on blockchain technology and IT skills are essential for maximizing the potential of blockchain. Attracting experts in these fields can also strengthen the workforce\u0026apos;s capabilities.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe results of this research emphasize the importance of accurate documentation and clear explanation to ensure trust and confidence within the research community. This transparency allows for the identification of shortcomings and facilitates comprehensive planning to address them. In particular, the final stages of research—accurate data analysis and drawing correct conclusions—are critical, as they serve as the foundation for future planning in the research community.\u003c/p\u003e\n\u003cp\u003eThis study aimed to design and present a model for the acceptance of blockchain technology in health centers. Blockchain, a ground-breaking technology, has shown significant potential in enhancing security, transparency, and efficiency across various sectors, including healthcare. With its unique features, such as data immutability and the elimination of intermediaries, blockchain can address many current challenges in health information management and contribute to cost reductions. The primary objective of this research was to identify key factors influencing blockchain acceptance in health centers and develop an appropriate model for its implementation.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e-\u0026nbsp; \u0026nbsp;Suggestions for Future Research\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eBuilding on the limitations and findings of this study, the following directions are suggested for future research:\u003c/p\u003e\n\u003cp\u003ea. \u003cstrong\u003eBroader Sample Sizes:\u003c/strong\u003e Future studies should aim to include a wider range of health centers across different regions and types (private, government, non-profit) to enhance the generalizability of the findings and explore variations in blockchain acceptance across sectors.\u003c/p\u003e\n\u003cp\u003eb. \u003cstrong\u003eSocial and Cultural Dimensions\u003c/strong\u003e: Further research could investigate the social, cultural, and economic factors influencing blockchain acceptance. This would provide a more comprehensive understanding of user behavior, cultural barriers, and social influences.\u003c/p\u003e\n\u003cp\u003ec. \u003cstrong\u003eEmpirical Studies:\u003c/strong\u003e Research evaluating the real-world performance of blockchain technology in healthcare facilities would be valuable. Comparing empirical data with theoretical models can help identify the strengths and weaknesses of blockchain in practice.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eEHR Electronic health record\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003eConsent to participate and publish was obtained.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests and Funding declaration:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests in relation to this study. This work was not supported by any external funding; all efforts and resources were self-sustained, with no grants, funding, or support received from any organization.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflict of interests and Data Availability\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;All authors collectively declare that there are no conflicts of interest in this article.\u003c/p\u003e\n\u003cp\u003eQualitative data from this study consists of interview transcripts and coding schemes. For data sharing inquiries, including requests for interview transcripts or other data, please contact Seyed Mohsen Khademian at https://orcid.org/0009-0005-5783-2849.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eNote:\u0026nbsp;\u003c/strong\u003eData sharing is contingent upon ensuring participant anonymity and compliance with ethical guidelines.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor Contribution\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAuthor Contributions StatementAuthor 1: Conceived the study, designed the interviews, analyzed the data, and performed the statistical analyses.Author 2: Contributed to the study\u0026apos;s conception, supervised the project, and provided critical revisions for important intellectual content.Author 3: Served as an advisor and provided critical revisions for important intellectual content.\u0026quot;All authors have approved the final version of the manuscript and agree to be accountable for all aspects of the work.\u003c/p\u003e"},{"header":"References","content":"\u003col style=\"list-style-type: lower-roman;\"\u003e\n \u003cli\u003eCrosby, M., Pattanayak, P., Verma, S., \u0026amp; Kalyanaraman, V. (2016). Blockchain technology: Beyond bitcoin. Applied innovation, 2(6-10), 71.\u003c/li\u003e\n \u003cli\u003eRJ Krawiec, Dan Housman, Mark White, Mariya Filipova, Florian Quarre, Dan Barr, Allen Nesbitt, Kate Fedosova, Jason Killmeyer,Adam Israel, Lindsay Tsai. BBlockchain: Opportunities for Health Care^. https://www2.deloitte.com/content/dam/Deloitte/us/Documents/public-sector/us-blockchain-opportunities-for-healthcare.pdf. August 2016.\u003c/li\u003e\n \u003cli\u003eMichael, J.; Cohn, A.; Butcher, J.R. BlockChain Technology. 2018. Available online: https://www.steptoe.com/images/content/1/7/v3/171269/LIT-FebMar18-Feature-Blockchain.pdf (accessed on 20 March 2019). Du X et al (2021) Research on the application of blockchain in smart healthcare: constructing a hierarchical framework. J Healthcare Eng. https://www.hindawi.com/journals/jhe/2021/669 8122/. Accessed 10 June 2021\u003c/li\u003e\n \u003cli\u003eB8 Epic EHR implementations with the biggest price tags in 2015^. https://www.beckershospitalreview.com/healthcare-informationtechnology/ epic-ehr-implementations-with-the-biggest-price-tagsin-2015.html. July 1, 2015.\u003c/li\u003e\n \u003cli\u003eBMeaningful Use^. https://www.cdc.gov/ehrmeaningfuluse/introduction.html. Page last updated: January 18, 2017.\u003c/li\u003e\n \u003cli\u003eMohsin, A. H., Zaidan, A. A., Zaidan, B. B., Albahri, O. S., Albahri, A. S., Alsalem, M. A., \u0026amp; Mohammed, K. I. (2019). Blockchain authentication of network applications: Taxonomy, classification, capabilities, open challenges, motivations, recommendations and future directions. Computer Standards \u0026amp; Interfaces, 64, 41-60.\u003c/li\u003e\n \u003cli\u003eHussien, H.M., Yasin, S.M., Udzir, S.N.I. et al. A Systematic Review for Enabling of Develop a Blockchain Technology in Healthcare Application: Taxonomy, Substantially Analysis, Motivations, Challenges, Recommendations and Future Direction. J Med Syst \u003cstrong\u003e43\u003c/strong\u003e, 320 (2019).\u003c/li\u003e\n \u003cli\u003e\u003cspan dir=\"RTL\"\u003e\u0026nbsp;Luxton, D. D., Kayl, R. A., and Mishkind, M. C., mHealth data security: The need for HIPAA-compliant standardization. Telemed. e-Health. 18:284\u0026ndash;288, 2012. https://doi.org/10.1089/tmj.2011.0180.\u003c/span\u003e\u003cspan dir=\"RTL\"\u003ehttps://doi.org/10.1007/s10916-020-01680-w\u003c/span\u003e\u003c/li\u003e\n \u003cli\u003eKallio, H., Pietil\u0026auml;, A. M., Johnson, M., \u0026amp; Kangasniemi, M. (2016). Systematic methodological review: developing a framework for a qualitative semi‐structured interview guide. Journal of advanced nursing, 72(12), 2954-2965.\u003c/li\u003e\n \u003cli\u003eGoodman, L. A. (1961). Snowball sampling. The annals of mathematical statistics, 148-170.\u003c/li\u003e\n \u003cli\u003eGlaser, B., \u0026amp; Strauss, A. (2017). Discovery of grounded theory: Strategies for qualitative research. Routledge.\u003c/li\u003e\n \u003cli\u003eWilliams, M., \u0026amp; Moser, T. (2019). The art of coding and thematic exploration in qualitative research. International management review, 15(1), 45-55.\u003c/li\u003e\n \u003cli\u003eFlick, O., (2009). An Introduction to Qualitative Research: Sage Publications.p.307\u003c/li\u003e\n \u003cli\u003eSaldafia, J. (2009). The coding manual for qualitative researchers. London: Sage Publications.\u003c/li\u003e\n \u003cli\u003eWilliams, M., \u0026amp; Moser, T. (2019). The art of coding and thematic exploration in qualitative research. International management review, 15(1), 45-55.\u003c/li\u003e\n \u003cli\u003eStrauss, A. (1998). Qualitative analysis for social scientists. New York: Cambridge University Press.P.109\u003c/li\u003e\n \u003cli\u003eFlick, O., (2009). An Introduction to Qualitative Research: Sage Publications. P 310\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Blockchain technology, health and wellness centers, technology acceptance, grounded theory","lastPublishedDoi":"10.21203/rs.3.rs-5916940/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5916940/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eThis study presents a model for the acceptance of blockchain technology in health and wellness centers, aiming to enhance security, service quality, and transparency. The primary objective is to identify the key factors influencing the acceptance of blockchain within these centers.\u003c/p\u003e \u003cp\u003eWe conducted in-depth interviews with 15 professionals, including IT managers, cybersecurity experts, senior health center managers, technology specialists, and university professors in health-related fields. Data were collected using a snowball sampling method and analyzed through the Grounded Theory approach to identify the key influencing factors and components.\u003c/p\u003e \u003cp\u003eThe findings reveal that the acceptance of blockchain technology in health and wellness centers is influenced by four primary dimensions: 1. Organizational (management support, organizational culture, organizational structure, and human resources), 2. Technological (technology infrastructure, technology standards, practical and technological solutions, and technical expertise), 3. Social (awareness and understanding, attitudes and beliefs, social values and norms, and the role of social networks in adaption), and 4.Economic (cost management, achieving economic advantages, improving payment models and positive impacts on stakeholders). These dimensions form a comprehensive framework that can guide the successful implementation of blockchain technology in healthcare settings, with implications for improved efficiency and effectiveness in service delivery.\u003c/p\u003e","manuscriptTitle":"Exploring a Model for the Acceptance of Blockchain Technology in Health and Wellness Centers","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-02-06 06:55:40","doi":"10.21203/rs.3.rs-5916940/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"daa387ec-7384-43f8-9d23-f7280c218ee0","owner":[],"postedDate":"February 6th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-12-05T18:09:36+00:00","versionOfRecord":{"articleIdentity":"rs-5916940","link":"https://doi.org/10.4018/IJHISI.394255","journal":{"identity":"international-journal-of-healthcare-information-systems-and-informatics","isVorOnly":true,"title":"International Journal of Healthcare Information Systems and Informatics"},"publishedOn":"2025-11-26 00:00:00","publishedOnDateReadable":"November 26th, 2025"},"versionCreatedAt":"2025-02-06 06:55:40","video":"","vorDoi":"10.4018/IJHISI.394255","vorDoiUrl":"https://doi.org/10.4018/IJHISI.394255","workflowStages":[]},"version":"v1","identity":"rs-5916940","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5916940","identity":"rs-5916940","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}