Requirements for Decentralized Consensus in E-Health Workflows: Towards Trustworthy Interorganizational Coordination

This paper explores conflict resolution in decentralized e-health prescription creation workflows, necessary for secure and efficient multi-stakeholder data sharing. Consensus mechanisms ensure consistency and enable trust across distributed systems. Decentralized Autonomous Organizations (DAOs) are adopted for decentralized decision-making in several domains but remain unexplored in e-healthcare. Current consensus mechanisms lack integration with governance models, limiting their adaptability to domain-specific requirements. Moreover, there is no existing consensus algorithm adapted for e-health, resulting in the lack of privacy, interoperability, and patient-centered data ownership. As a result, automatic conflict resolution in interorganizational e-health processes is com-plicated or almost impossible. To address this gap, we propose a domain-specific consensus algorithm adapted to the requirements of the e-health domain. The algorithm is embedded within a DAO-based governance framework, enabling transparency in decision-making among e-health stakeholders. Such integration enables auto-mated, privacy-preserving conflict resolution in interorganizational e-health workflows. Following the Design Science methodology, the consensus algorithm for e-health DAO is based on stakeholder-driven requirements and evaluated using Colored Petri Nets (CPN).The evaluation shows the solution improves conflict resolution enabling fair, efficient, and privacy-aware collaboration in decentralized e-health.