Beyond Trial and Error: Strategic Assessment of Decentralized Identity in US Healthcare

The US healthcare system relies on trustworthy and effective data exchange. Yet its data flows are impaired by pervasive conflicting interests and incentives and the lack of authentic data, leading to persistent inefficiencies. By ensuring authentic data, decentralized identity (ID) presents a potential solution. However, information systems (ISs) have historically shown high rates of unsuccessful deployment in healthcare. Since formative use case evaluation frameworks can enhance deployment success rates, this paper conducted a participatory action research study to develop and test an evidence-based, theory-informed, and practical framework for assessing healthcare use cases' amenability to decentralized ID. The framework serves healthcare organizations as a decision-support tool in choosing suitable use cases for decentralized ID and planning corresponding initiatives. For researchers, the socio-technical factors that determine use cases' amenability to decentralized ID enhance their understanding of this novel IS and the socio-technical change it brings about.