# Blockchain-Enabled Privacy-Preserving Ecosystem for DNA Sequence Sharing
## 4 Evaluation
### Usability and Real-World Deployment Challenges  
Despite the technical capabilities of the proposed system, there are usability and adoption challenges that must be addressed for real-world success. Blockchain-based applications in healthcare face hurdles in user acceptance; non-expert users often have a low awareness of blockchain and may feel anxiety about using unfamiliar tools [22]. In our context, patients and clinicians might find managing Ethereum wallets or Fabric certificates daunting. We have taken initial steps to improve usability--for example, the web DApp consolidates all interactions in a single interface, and MetaMask is used, as it is a widely adopted wallet interface--but this still assumes a certain level of technical literacy. In practical deployment, a training or an abstraction layer might be necessary (for instance, hospital IT systems could handle the blockchain interactions so that end users only see a conventional web portal). Simplifying key management (perhaps through custodial wallets or integrating with national health IDs) is an important future direction to enhance user-friendliness.  
Another challenge is integration into existing healthcare workflows. Hospitals and research institutes have established processes and databases; adopting our system would require linking those databases to the blockchain infrastructure and ensuring compliance with healthcare data standards. We have designed the system to use standard formats (e.g., VCF for genomic data) and to require minimal on-chain data, which eases integration, but substantial effort in terms of IT support and interoperability will be needed. Moreover, regulatory compliance (beyond GDPR) such as HIPAA in the US must be considered when deploying across jurisdictions. Our design of storing only encrypted, consented pointers on-chain is intended to help with compliance, but a thorough legal review in each deployment scenario is necessary.  
The requirement of government authorities (e.g., Ministry of Health) to certify and participate in the network, while a security strength, could slow down adoption. In some regions, obtaining such institutional engagement might be difficult or time-consuming. This introduces a threat to validity in terms of generalizability: the success of our approach in practice relies on a supportive regulatory environment. We mitigate this risk by demonstrating the system in a context (Taiwan's healthcare system) where such government involvement is plausible, but broader adoption may require adapting the governance model (for instance, using a consortium of major genomic institutions as the trust anchors if government participation is unavailable).  
In summary, real-world deployment will require addressing human and organizational factors. We have highlighted the user-centric design elements of our system to improve trust (e.g., giving users full control over their data-sharing settings), which can motivate participation. Still, building sufficient trust will likely require pilot programs. We plan to conduct user studies in the future to gather feedback from both patients and researchers using the system interface, which will guide further refinements in usability. Additionally, incremental rollout in a controlled environment (such as a single hospital network) could help demonstrate the value of the system and catalyze wider adoption. By acknowledging these practical challenges early, we can adapt our approach to ensure that the technology delivers benefits in a real healthcare setting, not just in theory.