Background: Blockchain is an emerging technology that enables secure and decentralized approaches to reduce technical risks
and governance challenges associated with sharing data. Although blockchain-based solutions have been suggested for sharing
health information, it is still unclear whether a suitable incentive mechanism (intrinsic or extrinsic) can be identified to encourage
individuals to share their sensitive data for research purposes.
Objective: This study aimed to investigate how important extrinsic incentives are and what type of incentive is the best option
in blockchain-based platforms designed for sharing sensitive health information.
Methods: In this study, we conducted 3 experiments with 493 individuals to investigate the role of extrinsic incentives (ie,
cryptocurrency, money, and recognition) in data sharing with research organizations.
Results: The findings highlight that offering different incentives is insufficient to encourage individuals to use blockchain
technology or to change their perceptions about the technology’s premise for sharing sensitive health data. The results demonstrate
that individuals still attribute serious risks to blockchain-based platforms. Privacy and security concerns, trust issues, lack of
knowledge about the technology, lack of public acceptance, and lack of regulations are reported as top risks. In terms of attracting
people to use blockchain-based platforms for data sharing in health care, we show that the effects of extrinsic motivations
(cryptoincentives, money, and status) are significantly overshadowed by inhibitors to technology use.
Conclusions: We suggest that before emphasizing the use of various types of extrinsic incentives, the users must be educated
about the capabilities and benefits offered by this technology. Thus, an essential first step for shifting from an institution-based
data exchange to a patient-centric data exchange (using blockchain) is addressing technology inhibitors to promote patient-driven
data access control. This study shows that extrinsic incentives alone are inadequate to change users’ perceptions, increase their
trust, or encourage them to use technology for sharing health data.