Blockchain affordances in digital health: a systematic review and research agenda for personalized health-care

We aimed to systematically review Blockchain affordances in digital health and synthesize a framework and research agenda for personalized health-care. Following PRISMA guidance, we conducted a qualitative thematic synthesis of peer-reviewed studies (January 2020 – October 2025 search window; no meta-analysis). Blockchain technology is an emerging solution that can meet these needs. However, a nuanced application of Blockchain affordances in digital health is necessary to harness its full potential. This paper comprehensively reviews Blockchain affordances in digital health, aiming to identify perceived affordances and explore recent research in the field. We applied Preferred Reporting Items for Systematic Reviews, following the PRISMA guidelines and the lens of affordance theory to analyze about 5300 relevant papers, with 194 selected for deeper analysis. Our analysis identified 14 Blockchain affordances (access control, decentralization, interoperability, security, tamper-resistance, traceability, anonymity, data provenance, identity, immutability, integrity, privacy, transparency, and trust) that are perceived and realized in personalized health-care. Our study also discovered several constraints in Blockchain implementation, such as security and privacy, interoperability, scalability, and infrastructural support, that require further research attention. This study presents Blockchain research in the digital health domain and informs the design and development of computational medicine for personalized health-care.