This study aims to explore the application of blockchain technology in smart healthcare, establish a hierarchical theoretical framework of smart healthcare, reveal the impact of blockchain on smart healthcare, and finally, construct a development application system of smart healthcare under the blockchain based on stakeholder theory. However, such a hierarchical theoretical framework should consider not only the necessary attributes and the interrelationship among various aspects and attributes but also the role of multiple stakeholders. Therefore, the paper uses fuzzy set theory to filter unnecessary attributes, proposes a decision-making and experimental evaluation laboratory (DEMATEL) to manage the complex interrelationships between various aspects and attributes, and uses Interpretive Structure Modeling (ISM) to divide the hierarchy and construct a hierarchical theoretical framework. The results show that (1) the top-level design, the medical record management, and the doctor management are the root causes of system. (2) The specific application of blockchain in the field of smart healthcare is mainly carried out around the intelligent contract, which relies on the medical record management and is constrained by the system, and optimization of application is the key to system upgrading. (3) The internal and external regulation, the medical insurance, and the environmental governance play a guaranteed role for the development of the system and effectively safeguard the interests of stakeholders. (4) The application system of smart healthcare under the blockchain needs to be built based on three layers: the transaction layer, information layer, and stakeholder layer. The theoretical hierarchical framework is intended to guide smart healthcare towards blockchain applications, and stakeholders are suggested to participate in the development application systems.
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