Abstract

This study explores how privacy is understood and prioritised by patients, doctors, and nurses in blockchain based healthcare information systems. Using a constructive grounded theory approach, we conducted interviews with 2 participants, including core stakeholders and expert informants from technical, legal, and organisational domains. Analysis revealed three interdependent themes: privacy as a negotiated construct, fragility of trust in blockchain systems, and systemic misalignment across infrastructures, policies, and responsibilities. These findings show that privacy is not an inherent property of blockchain but an alignment problem shaped by technical affordances, regulatory obligations, and stakeholder practices. Synthesising these insights, we introduce the Stakeholder-Contingent Privacy Alignment (SCPA) framework, a theory-building contribution that conceptualises privacy as emerging from socio-technical alignment. The study advances information systems research by reframing blockchain privacy as stakeholder-contingent and context-sensitive, while offering practical guidance for regulators, developers, and healthcare organisations to align blockchain adoption with the Australian Privacy Principles.

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