Purpose
Blockchain technology (BCT) has multiple benefits across industries in varied contexts, but limited organizations have adopted such disruptive innovative technologies in the healthcare industry in India. The research on advancing the understanding of blockchain adoption (BCA) determinants in India's healthcare industry is limited. Thus, the study aims to identify the BCA determinants in the healthcare sector in India. Further, the impact of BCA was examined on organizational performance (OP).

Design/methodology/approach
The study utilizes Technology, Organization, and Environment (TOE) framework to investigate the determinants of BCA in the healthcare sector in India. The data were gathered using a seven-point Likert seven-point ranging from “strongly agree” to “strongly disagree” from 272 respondents working in the healthcare industry in India. The relationship within the framework was investigated using structural equation modeling.

Findings
The results demonstrate the positive impact of top management support, organizational size, organizational readiness, competitive pressure and government support on BCA in the healthcare sector. On the other hand, compatibility, security and privacy issues do not affect BCA. The results emphasize and validate blockchain’s importance in improving OP in the healthcare sector. Further, the results indicate that non-technological factors are paramount to improving BCA within the healthcare sector. Organizations should invest in employee training and development to ensure their staff have the necessary knowledge and skills to effectively manage BCT.

Research limitations/implications
The model was developed for BCA in the healthcare sector in the Indian context; however, the model applies to other countries with the same business environment. Hence, the model can be further examined in diverse countries to generalize the findings.

Practical implications
The study offers valuable insights into the factors that influence BCA and OP in the healthcare sector. The results of this research can be used to inform policy decisions and guide practitioners toward promoting and facilitating the use of BCT in healthcare organizations.

Originality/value
To the best of the author’s knowledge, the present study is the first of its kind to examine the TOE framework in BCA within the healthcare sector and its implications on OP.