Emerging Technologies

Blockchain Platforms, Networks and Other Distributed Ledger Technologies

A variety of platforms and networks comprise today’s blockchain landscape. Some are fully developed while others are emerging. Some adhere strictly to the blockchain standard while others deviate from the standard and are considered blockchain alternatives. Several other platforms employ distributed ledgers without the use of blockchain.

As a result, not all blockchains are created equal. Based on the capabilities built into a given blockchain platform, a variety of network types can be provisioned. These blockchain network types can be defined as public, private, consortium, federated, hybrid or semi-private. Definitions for each network type can be found in the Terminology section.

The current blockchain landscape includes the blockchain/DLT platforms listed in this section. Each listing includes a brief description of the platform, its primary focus, and any applications or networks currently available or in development. Links to other sources have been provided for more detailed information.

To date, the following platforms are most commonly leveraged and “enterprise-ready” for use in the healthcare industry.


Ethereum is an open-source, blockchain application platform developed by the Ethereum Foundation. See also the Enterprise Ethereum Alliance, focused on the use of Ethereum in enterprise applications across multiple industries including healthcare. It is a decentralized platform that runs smart contracts, which are applications that run exactly as programmed without any possibility of downtime, censorship, fraud or third-party interference. Ethereum blockchains can either be public or private. Ethereum blockchain nodes can also run in cloud environments.


IBM’s Hyperledger platform provides a variety of open-source frameworks, which guide the development of blockchain networks and applications. Hyperledger frameworks include Burrow, Fabric, Indy, Iroha and Sawtooth. Hyperledger tools include Caliper, Cello, Composer, Explorer and Quilt. [1]

The Hyperledger organization oversees several open-source blockchain platform projects. One of the most popular frameworks is described below.

  • Hyperledger Fabric, initially contributed by Digital Asset and IBM, is an open-source blockchain framework implementation and one of the Hyperledger projects hosted by The Linux Foundation. The Linux Foundation includes leaders in finance, banking, IoT, supply chain, manufacturing and technology. Intended as a foundation for developing applications or solutions with a modular architecture, Hyperledger Fabric enables components, such as consensus and membership services, to be plug-and-play.


R3 Corda is a blockchain for business enterprise application. Initially focused on financial services, it now supports business enterprise applications across multiple industries including healthcare. On December 6, 2017, Amazon Web Services (AWS) announced a partnership with R3 to allow the company's Corda platform to become one of the first ever distributed ledger technology solutions on the AWS. Corda allows users to deploy DApps onto the AWS platform and to create new apps directly. Corda also runs on other cloud environments.

R3’s Corda open-source platform is defined by corda.com as a blockchain platform. However, other references refer to Corda as a distributed ledger that is seeking to improve upon the bitcoin deficiencies related to performance scalability and privacy. [2]

The networks and applications that are developing on the Corda platform include healthcare and finance. The Corda Healthcare Community is one example. [3]

For further questions or content suggestions, please email blockchain@himss.org.

Additional platforms, applications and networks also exist that are gaining traction in the healthcare space. Included below are additional efforts currently underway listed in alphabetical order.

Azure Blockchain Workbench

Microsoft’s Azure Blockchain Workbench, is a blockchain application development platform. It provides the capability to construct bridges needed to facilitate connections between blockchain networks and other infrastructures. It currently utilizes the Ethereum Proof of Authority consensus protocol. [4]


Cardano is a technological platform that will be capable of running financial applications currently used everyday by individuals, organizations and governments all around the world. The platform is being constructed in layers, which gives the system the flexibility to be more easily maintained and allow for upgrades by way of soft forks. After the settlement layer that will run Ada is complete, a separate computing layer will be built to handle smart contracts, the digital legal agreements that will underpin future commerce and business. Cardano will also run decentralized applications, or dApps, which are services not controlled by any single party but instead operate on a blockchain. [5].


Coco Framework (short for “Confidential Consoritum” [6]) is an Azure cloud based blockchain platform created by Microsoft in collaboration with several partners including Intel. Streamlined for enterprise use across confidential (private) consortiums, Coco Framework has high throughput and strong security.


EOSIO is software, being built by Block.One, which introduces a blockchain architecture designed to enable vertical and horizontal scaling of decentralized applications. The software provides accounts, authentication, databases, asynchronous communication and the scheduling of applications across multiple CPU cores and/or clusters. The resulting technology is a blockchain architecture that has the potential to scale to millions of transactions per second, eliminates user fees and allows for quick and easy deployment of decentralized applications. EOSIO Software can be used to create both private and public blockchains.


Kaleido, a startup nurtured by ConsenSys, is the first full-stack platform which brings together distributed technologies to power new trust systems. ConsenSys has partnered with Amazon Web Services and the Enterprise Ethereum Alliance to create an environment for simplified onboarding, built-in governance tools and automated workflows.


JP Morgan’s Quorum is an enterprise-ready distributed ledger and smart contract platform. Quorum is well-suited for financial applications through its Ethereum-based enterprise platform, which delivers a permissioned, secure architecture. [7]


Ripple is a payment settling, currency exchange and remittance system intended for banks and payment networks. Ripple doesn't use blockchain but uses a distributed consensus ledger using a network of validating servers and cryptocurrency called XRP (sometimes referred to as Ripples); a token which is used on the Ripple network to facilitate transfers of money between different currencies.[8]

SAP Cloud Platform Blockchain Service

The SAP Cloud Platform Blockchain Service allows SAP clients to leverage blockchain platforms. SAP business solutions have the capability to access SAP’s blockchain-as-a-service (BaaS) layer, in beta, in order to create blockchain nodes via SAP’s BaaS Cloud solution called MultiChain or chain codes developed through Hyperledger Fabric. [9, 10]


Stellar is an international, cryptically secure payments protocol introduced April 2015. [11] Stellar utilizes the Stellar Consensus Protocol (SCP); a construction for federated Byzantine agreement featuring decentralized control, flexible trust, low latency and asymptotic security. [12]


Stratis is a Blockchain-as-a-Service provider, built on an Ethereum-based blockchain created with C# programming language. It allows enterprises to build their own private blockchains, which can be integrated with the main Stratis blockchain. [13]/p>


Strato, a blockchain by BLOCKAPPS, who coined the term “Blockchain-as-a-Service”, utilizes the Ethereum Virtual Machine to deploy private blockchains. It is available on AWS, Azure, and Google Cloud and includes management of smart contracts.