This paper explores the potential applications of Blockchain technology in the healthcare sector of Ecuador. It addresses the current challenges faced by Ecuador’s healthcare system and discusses how Blockchain can offer innovative solutions for patient identification, data interoperability, privacy, and drug traceability. The study also highlights ongoing initiatives and future research directions to integrate Blockchain into Ecuador’s healthcare infrastructure. To address this topic, challenges, actions, and open problems were mapped, and a framework for large-scale Electronic Health Record (EHR) was proposed. The integration of blockchain technology in healthcare presents significant opportunities for enhancing system trust, protecting patient privacy, and automating tasks. However, large-scale implementation requires substantial investments in infrastructure and system adaptation. In Ecuador, establishing a robust digital identity infrastructure is essential for effective health data management and compliance with data protection regulations. Research into advanced privacy models and decentralized systems, such as peer-to-peer networks and Health Wallets, is necessary. A major challenge remains achieving adequate workload capacity for blockchain-assisted EHRs. Future efforts will focus on digital identity solutions and interoperability to develop a more integrated healthcare system in Ecuador.