Unlocking Blockchain Adoption in Healthcare: Transparency, Knowledge Application, and Behavioural Intention

Abstract

Blockchain technology has emerged as a transformative digital innovation with considerable potential to enhance transparency, data integrity, and trust across healthcare systems. Despite its recognised benefits, the mechanisms through which blockchain transparency influences healthcare professionals’ willingness to adopt the technology remain insufficiently understood. This study examines the effect of blockchain transparency on physicians’ behavioural intention to adopt blockchain technology while investigating the mediating role of knowledge application. A quantitative cross-sectional survey was conducted among physicians working in nine public hospitals in Mosul City, Iraq. Data were collected from 322 valid respondents using a structured questionnaire and analysed using SmartPLS and SPSS. The findings reveal that blockchain transparency has a positive and significant direct effect on both knowledge application and physicians’ behavioural intention to adopt blockchain technology. Knowledge application also exerts a significant positive influence on behavioural intention and partially mediates the relationship between blockchain transparency and blockchain adoption intention. These findings demonstrate that transparent, traceable, and tamper-resistant healthcare information enhances physicians’ ability to apply medical knowledge effectively, thereby increasing their confidence in blockchain technology and strengthening their intention to adopt it. The study contributes to the literature by extending current understanding of blockchain adoption through the integration of knowledge management and technology adoption perspectives and by identifying knowledge application as a key explanatory mechanism linking blockchain transparency to behavioural intention. The findings also provide practical guidance for healthcare policymakers and hospital administrators seeking to implement blockchain-based systems.