Blockchain–Artificial Intelligence Synergy in Healthcare and Financial Systems: A Systematic Review and Future Research Agenda

Two ground-breaking technologies that are influencing contemporary infrastructures with durability, intelligence, and transparency are blockchain and artificial intelligence (AI). AI enables predictive analytics, anomaly detection, and decision support, while blockchain provides immutability, decentralization, and trust. For mission-critical fields like healthcare and finance, its convergence has drawn increasing scholarly attention. Fifty-three research papers published between 2018 and 2025 are compiled in this narrative review to assess the potential, challenges, and future directions of integrating blockchain technology with artificial intelligence. In order to guarantee methodological openness and analytical rigor, this study methodically synthesizes 53 peer-reviewed papers that were published between 2018 and 2025 using narrative synthesis principles inspired by PRISMA. Telemedicine, drug supply chain traceability, diagnostic support, and secure medical data transmission are important uses in the healthcare industry. The combination of blockchain and AI in financial systems enables the detection of fraud, innovation in digital banking, and the creation of digital currencies by central banks. Along with ethical concerns about explainability and justice, the analysis also finds enduring difficulties, including scalability, interoperability, privacy, and regulatory uncertainty. Explainable AI (XAI) for blockchain models, federated blockchain–AI frameworks, and cross-domain applications that connect healthcare and finance are areas where notable gaps are identified. This report provides a comprehensive synthesis, offering academics and industry professionals a comprehensive perspective on how the convergence of blockchain and AI will impact infrastructures in the future. In addition to mapping the applications of blockchain-AI convergence, this paper offers a comparative evaluation of approaches, points out unresolved issues with explainable models and federated architectures, and suggests a systematic research agenda for the future. This paper provides a cross-sector synthesis of healthcare and financial systems, exposing common design principles and governance implications in contrast to previous evaluations that concentrated on a single domain.