I recently finished a residency program in the U.S. (onto an informatics fellowship). I've actively tried to generate some interest in such matters but upmost problem is that doctors just want to practice. Most of doctors generate high enough salary to not bother being interested in improving workflow. Progress is sluggish. I was in program affiliated within the top 10 US hospital, but even getting the most routine data for quality assurance was like pulling teeth. We still use paper forms everywhere because it's easy and secure (yes storing data somewhere is insecure by default)

Added to that, there political battles between larger hospital organizations preventing usage of standardized protocols. The standards like HL7 exists but causes a big problem for clinicians because it ends up as a checklist of items - a logistical burden dumped onto clinical caregivers - it's not their domain. We are supposed to be as fine in terms of granularity as possible. Standards end up funneling our assessments into strict categories, hindering new areas of research. (i.e If a new subtype of thyroid cancer is discovered to be separate and behaves very well without chemotherapy, but based on standard checklist we have no way to backtrack these patients, because that entity does not exist because clinicians checked off the generic version of thyroid cancer based on the 'cancer checklist').

Secondly, EHR market has been monopolized by Epic to the point of a proprietary platform becoming the norm (they actively prevent other vendor machines from accessing their API). Medical field is not 'hot' like tech industry, where we're blessed with developers flocking to develop a new hot platform. Because of the complexities, security issues, we go with the safest choice: Epic. They are one of the most anti-open source EHR makers because they make money off custom module creation. I shouldn't be so harsh as they do have one of the best EHRs (akin to Windows of the OS market, gets bashed all the time but its a good OS if you think about adoption and usability).

These are some of the issues to be addressed and thought about prior to jumping in thinking blockchain in medicine. We are lightyears behind unfortunately. But I would also like to change that!