This research proposes a blockchain-centered framework designed to address ongoing challenges related to data security, privacy, and interoperability in Electronic Healthcare Records (EHRs). As the healthcare sector increasingly relies on digitalized records, centralized EHR systems face significant risks, including data breaches, privacy violations, and limited compatibility across platforms. This study introduces a decentralized blockchain-based framework, built on Hyperledger Fabric, that leverages cryptographic methods, smart contracts, and distributed ledger technology to ensure secure data sharing, enhanced privacy, and structured access control. The research focuses on the theoretical development and practical evaluation of this framework. Using a design-based approach, the study incorporates a comprehensive literature review, framework development, and empirical testing to assess the framework’s effectiveness. Key performance indicators include data integrity, security, system efficiency, and interoperability across diverse healthcare platforms. In conclusion, this framework offers a promising solution for securely managing healthcare data and ensuring interoperability, with potential applications extending beyond the healthcare sector.
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A Blockchain Technology Framework to Enhance
Security and Interoperability of Electronic
Healthcare Records
Deng Zilong
1,3
, Mustafa Muwafak Alobaedy
2
, Mohd Nurul Hafiz
Bin Ibrahim
4
, Xiaocun Huang
5
1,2,4
City Graduate School, City University, Malaysia,
3
Anqing Vocational & Technical
College,China,
5
Cangzhou Normal University,China,
Email: mustafa.theab@city.edu.my, mohd.nurul.hafiz@city.edu.my,
huangxiaocun@caztc.edu.cn
Coressponding Author Email: dzlong@aqvtc.edu.cn
Abstract
This research proposes a blockchain-centered framework designed to address ongoing
challenges related to data security, privacy, and interoperability in Electronic Healthcare
Records (EHRs). As the healthcare sector increasingly relies on digitalized records, centralized
EHR systems face significant risks, including data breaches, privacy violations, and limited
compatibility across platforms. This study introduces a decentralized blockchain-based
framework, built on Hyperledger Fabric, that leverages cryptographic methods, smart
contracts, and distributed ledger technology to ensure secure data sharing, enhanced privacy,
and structured access control. The research focuses on the theoretical development and
practical evaluation of this framework. Using a design-based approach, the study incorporates
a comprehensive literature review, framework development, and empirical testing to assess
the framework’s effectiveness. Key performance indicators include data integrity, security,
system efficiency, and interoperability across diverse healthcare platforms. In conclusion, this
framework offers a promising solution for securely managing healthcare data and ensuring
interoperability, with potential applications extending beyond the healthcare sector.
Keywords: Blockchain, Healthcare, Electronic Health Record, Data Security, Interoperability,
Framework
Introduction
The healthcare sector is undergoing a digital transformation, with Electronic Health Records
(EHRs) becoming the standard for storing patient information, including medical histories and
treatment plans. While EHRs improve care coordination, reduce errors, and enhance patient
outcomes (Puneeth & Parthasarathy, 2023), centralized EHR systems introduce significant
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To Link this Article: http://dx.doi.org/10.6007/IJARBSS/v15-i4/25319 DOI:10.6007/IJARBSS/v15-i4/25319
Published Date: 22 April 2025
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risks in terms of data security, privacy, and interoperability, making them susceptible to
cyberattacks (Sharma & Balamurugan, 2020). To address these challenges, this research
proposes a decentralized, blockchain-enabled framework that leverages Hyperledger Fabric
and smart contracts to provide secure, interoperable data management. Unlike centralized
systems, which struggle with interoperability and hinder data sharing across platforms,
especially during critical situations (Liu et al., 2023), the proposed blockchain framework
improves EHR sharing, strengthens security, and grants patients greater control over their
data (Kim et al., 2023). By incorporating cryptographic methods and decentralized
governance, this framework enhances data integrity and security, offering a robust solution
to the current challenges in healthcare data management (Lee et al., 2023).
Research Methodology
This study employs a design-based research methodology to develop and evaluate a novel
blockchain framework focused on enhancing the security and interoperability of Electronic
Health Records (EHRs). The research integrates conceptual framework and empirical
validation to identify challenges and deliver a tailored solution for managing healthcare data.
The methodology includes an extensive literature review, analysis of existing blockchain
frameworks, and qualitative data collection through interviews with industry experts such as
blockchain developers, cybersecurity specialists, and healthcare IT professionals.
The study’s primary objective is to explore how blockchain technology can improve data
security and privacy in healthcare while ensuring regulatory compliance and addressing the
integration challenges posed by current healthcare IT systems. The research objectives are
directly connected to real-world healthcare applications, particularly in refining algorithmic
frameworks for more secure and efficient data management. The analysis is grounded in a
comprehensive review of databases like PubMed, IEEE Xplore, and Google Scholar, ensuring
the credibility and relevance of the sources used.
In addition to the literature review, the qualitative data is analyzed using thematic analysis to
identify patterns and gaps in blockchain usage within healthcare. Initially, 200 articles were
identified using keywords such as “blockchain in healthcare,” “data security,” “privacy,” and
“interoperability.” After a thorough screening process, 115 articles were selected for an indepth review, categorized based on their focus on blockchain architecture, consensus
mechanisms, encryption techniques, and the challenges of implementation in healthcare.
By examining both the theoretical and practical aspects of blockchain adoption, the study
aims to address existing knowledge gaps and suggest future development directions. This
systematic approach provides a comprehensive understanding of blockchain technology’s
potential to resolve key challenges related to data security and interoperability in healthcare.
Figure 1 shows the flow of research design, methods used, input and output in this study.
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Figure 1: Research Flow
The research methodology consists of five phases, each contributing towards the systematic
development of a blockchain-based EHR framework. The literature review sets the foundation
by analyzing existing studies, while the framework analysis identifies gaps. Qualitative data
collection through expert interviews adds practical insights, and thematic analysis extracts
core themes to be addressed. Finally, the framework is developed, integrating all findings to
ensure an innovative, secure, and interoperable solution for healthcare data management.
This approach ensures that the final blockchain framework is comprehensive, addressing both
theoretical and practical needs in healthcare data security and interoperability.
Thematic Analysis
This thematic analysis investigates the potential of blockchain technology to enhance the
security and interoperability of Electronic Health Records (EHRs) in healthcare. The review
identified three key themes: architectural designs and frameworks, consensus mechanisms,
and encryption techniques. These themes are critical in understanding how blockchain-based
frameworks can address current challenges in healthcare data management and provide
more secure, efficient, and interoperable EHR systems.
Architectural Designs and Frameworks
The literature underscores the significance of permissioned blockchain systems in healthcare
due to the sensitive nature of medical data, offering controlled access and enhanced privacy.
However, scalability challenges emerge as healthcare generates vast amounts of data, with
proposed solutions such as off-chain storage and sharding to manage these volumes (Tanwar
et al., 2020). Key security features, including immutability and smart contracts, are essential
to preventing unauthorized access (Attaran, 2020). Interoperability also remains a critical
concern, with blockchain frameworks specifically designed to facilitate seamless data
exchange across diverse healthcare platforms (Reegu et al., 2023).
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Consensus Mechanisms
Several consensus mechanisms have been explored to enhance the reliability and efficiency
of blockchain frameworks in healthcare. Proof of Stake (PoS) is favored over Proof of Work
(PoW) due to its energy efficiency and faster transaction rates, making it more suitable for
healthcare applications (Kashyap, 2024). Practical Byzantine Fault Tolerance (PBFT) is also
gaining popularity for its ability to manage malicious nodes, ensuring system reliability
(Simonoski & Bogatinoska, 2024). Research is ongoing into AI-enhanced consensus
mechanisms to improve flexibility, security, and scalability in healthcare environments (Han
et al., 2022). Hybrid mechanisms that combine PoS and PBFT are considered promising
solutions, balancing security, speed, and energy efficiency in healthcare settings (Desai &
Ambali, 2024).
Encryption Techniques and Data Security
Combining advanced encryption techniques with blockchain enhances data security and
privacy within healthcare frameworks. Identity-Based Encryption (IBE) provides privacy
without the need for complex key management, while AES and DES are effective for
encrypting large datasets (Maddela, 2025). Homomorphic encryption allows secure data
processing without exposing sensitive information, which is crucial for applications like
medical research. Attribute-Based Encryption (CP-ABE) enables precise access control,
ensuring that only authorized users can access specific patient information (Hu et al., 2023).
Chaotic maps, which are highly resilient against attacks, have proven effective for encrypting
medical images (Lipsa et al., 2022).
In conclusion, while blockchain frameworks demonstrate significant potential for improving
data security and interoperability in healthcare, challenges related to scalability,
computational overhead, and key management persist. Future research should focus on
developing more scalable encryption algorithms, improving key management processes, and
exploring AI-enhanced encryption methods. The successful integration of blockchain in
healthcare will depend on overcoming these challenges to ensure efficient, secure, and
patient-centered data management.
Proposed Framework
The blockchain-based framework enhances healthcare data management by improving the
security, privacy, and interoperability of Electronic Health Records (EHRs). It combines
advanced cryptographic techniques with blockchain’s decentralized architecture to ensure
secure data sharing and efficient handling of patient information, particularly in cloud
environments. By leveraging the Interplanetary File System (IPFS) for decentralized storage,
smart contracts for automating processes, and the transparency and immutability of
blockchain, this framework addresses key challenges in traditional data management. It offers
a robust solution for securely managing confidential healthcare data while enhancing system
efficiency and regulatory compliance.
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Figure 2: Proposed Blockchain-based Healthcare Framework
The Interplanetary File System (IPFS) forms the foundation of a decentralized storage
framework aimed at enhancing the security, privacy, and interoperability of healthcare data,
particularly Electronic Health Records (EHRs). Unlike traditional centralized systems, IPFS
distributes data across multiple nodes in a peer-to-peer network, reducing the risk of
breaches and ensuring data availability, even during periods of high traffic. This decentralized
architecture is ideal for managing large volumes of sensitive healthcare data, as it eliminates
single points of failure and increases system resilience.
The Data Owner (DO) plays a crucial role in maintaining data confidentiality and integrity by
encrypting the data before uploading it to IPFS. This encryption ensures that even if a node is
compromised, unauthorized users cannot access the data without the appropriate decryption
key. This approach is particularly important in decentralized systems like IPFS, where data is
stored across multiple locations, making it essential to protect sensitive healthcare
information.
The Data User (DU) retrieves and accesses the encrypted data stored on IPFS but must possess
the correct decryption key to unlock it. This access control mechanism ensures that only
authorized individuals—such as doctors, nurses, or healthcare professionals—can access
sensitive patient information. By ensuring that only authorized personnel can work with
confidential data, this layer of security prevents unauthorized access while maintaining
operational efficiency.
Encryption and decryption are at the core of the framework's security. Encryption converts
readable data (plaintext) into unreadable ciphertext, which can only be decrypted by
individuals with the correct key. This guarantees the confidentiality of data during both
storage and transmission. Decryption reverses the process, transforming ciphertext back into
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readable data but only for authorized individuals. The security of this process is supported by
strong cryptographic algorithms and key management strategies, ensuring that sensitive
healthcare information remains secure throughout its lifecycle.
The Control Setup governs data access by integrating a Smart Agreement (smart contract) and
a Transactional Blockchain. This setup automates access control, ensuring that only
individuals who meet predefined conditions can access data. Automation reduces human
error, improves security, and ensures compliance with regulatory standards when accessing
sensitive information.
The Smart Agreement is a self-executing contract stored on the blockchain that manages the
interaction between the Data Owner and the Data User. It enforces policies on who can access
specific data, ensuring that only authorized users can retrieve particular records. For example,
in healthcare, the contract may permit only licensed medical professionals to access certain
patient data. Additionally, the smart contract handles the issuance and validation of tokens,
which act as digital credentials to authenticate access requests.
The Transactional Blockchain serves as an immutable ledger that records all transactions
related to data access and management. Each interaction, whether retrieving, decrypting, or
validating data, is permanently logged, creating a transparent audit trail. In healthcare, this
transparency is essential for regulatory compliance, as it ensures a verifiable record of who
accessed patient data and when. The immutability of blockchain technology guarantees that
the transaction history cannot be altered, providing a secure method for tracking data usage.
Tokens are digital credentials generated by the Smart Agreement to authenticate data access.
The system validates these tokens to ensure that only users with the correct permissions can
access the encrypted data. This multi-layered authentication process enhances security by
ensuring that only authorized individuals can decrypt and retrieve sensitive healthcare
information.
User Registration is critical for managing identities and access rights within the system. Before
accessing data, users must complete a registration process that verifies their identity and
assigns permissions based on their role. For instance, in a healthcare setting, a doctor may
have full access to patient records, while a nurse may have more limited access. This rolebased access control ensures that sensitive data is accessible only to those who require it, in
compliance with regulations such as HIPAA (Health Insurance Portability and Accountability
Act) in the United States.
This blockchain-based framework, which leverages IPFS, smart contracts, and transactional
blockchain, offers a secure and efficient system for managing healthcare data. By
decentralizing storage and automating access control, the system reduces vulnerabilities and
ensures that sensitive information is protected while remaining accessible to authorized users.
The integration of encryption, authentication, and transparent logging provides a robust
solution for handling EHRs, addressing key concerns around security, privacy, and regulatory
compliance. This approach represents a promising advancement in healthcare data
management, enabling secure and seamless data sharing in a decentralized environment.
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Workflow Overview
The blockchain-based framework for data management utilizes decentralized storage via the
Interplanetary File System (IPFS), smart contracts, and transactional blockchain to enhance
the security, privacy, and efficiency of managing sensitive data, such as Electronic Health
Records (EHRs). The process begins with the Data Owner encrypting the data before
uploading it to IPFS, ensuring secure storage. Metadata is recorded on the blockchain, while
smart contracts automate the data access requests. When a Data User requests access, their
credentials are validated through a token system, allowing them to retrieve and decrypt the
data using a private key.
Key innovations of this framework include decentralized storage, which minimizes
vulnerabilities found in centralized systems, enhances data redundancy, and improves
reliability—particularly critical in healthcare. Smart contracts automate rule enforcement for
data access, reducing administrative errors and improving efficiency. The transactional
blockchain logs all interactions in an immutable ledger, ensuring data integrity and providing
a transparent audit trail, which is crucial for regulatory compliance in industries such as
healthcare.
The framework integrates multi-layered security measures, including encryption, token
validation, and decentralized storage, ensuring that data remains secure throughout its entire
lifecycle. It also enhances operational efficiency by automating processes that traditionally
required manual oversight. This is particularly beneficial in healthcare, where strict
regulations such as HIPAA mandate secure data handling and transparency. Overall, this
system offers a secure, efficient, and scalable solution for managing sensitive data, with
potential applications beyond healthcare in other fields requiring stringent data security and
privacy protections.
Results and Discussion
The blockchain-based framework proposed in this study is designed to address critical
challenges related to the security, privacy, and interoperability of Electronic Healthcare
Records (EHRs). Given the sensitivity of healthcare data and the strict regulatory oversight
required, the framework integrates decentralized storage, cryptographic encryption
techniques, and smart contracts to provide secure and efficient healthcare data management.
This study explores how the innovative framework enhances the handling of EHRs and
provides a robust solution to long-standing data management challenges in healthcare.
The primary objective of this study was to validate the effectiveness of the proposed
blockchain framework in securing EHRs while ensuring seamless interoperability across
various healthcare systems. The empirical validation highlighted key aspects of the
framework's performance, particularly in terms of data integrity, data access, and overall
system efficiency. One of the main findings concerns data integrity: the decentralized nature
of the Interplanetary File System (IPFS), which supports the framework's storage mechanism,
ensures that EHR data remains tamper-proof across different storage locations. Even in the
event of network downtime or failure, access to patient data is maintained, showcasing the
system’s resilience and its ability to secure data from potential breaches or interruptions.
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In terms of data access, the use of smart contracts to automate access control has proven
highly effective in reducing the risk of unauthorized access. Every access request is validated
through a token-based system, ensuring that only authorized personnel can retrieve or
modify the data. This tokenization process strengthens data access security and creates a
verifiable trail of interactions with EHR data, crucial for auditability and regulatory compliance,
such as with HIPAA. Additionally, the use of smart contracts has significantly improved system
efficiency by automating the management of data-sharing rules, reducing administrative
overhead, and ensuring consistent execution without the risk of human error. The framework
can handle a substantial volume of data transactions without significant latency, which is
critical in healthcare environments where timely access to patient data is essential.
The results of this study can be organized around three central themes: data security, privacy,
and interoperability. For data security, the integration of cryptographic techniques, such as
the Advanced Encryption Standard (AES) and public-private key encryption, ensures that data
is securely stored and transmitted across the network. AES provides high-speed protection
for large datasets, while asymmetric encryption ensures that only authorized users with valid
decryption keys can access the encrypted data. This layered encryption approach enhances
the overall security of the framework, protecting against unauthorized access or tampering.
In terms of data privacy, the framework utilizes Ciphertext-Policy Attribute-Based Encryption
(CP-ABE), a fine-grained access control mechanism that enforces data-sharing rules based on
user attributes. This ensures that only authorized personnel can access specific segments of
patient records, preserving the privacy of sensitive healthcare data. CP-ABE adds an additional
layer of privacy protection by allowing the system to define complex rules regarding who can
access certain types of data and under what conditions. This is especially important in
healthcare, where different stakeholders (e.g., doctors, nurses, insurers) require varying
levels of access to patient information.
One of the most significant contributions of the framework is in the area of interoperability.
The blockchain-based system significantly improves EHR interoperability by using
standardized data formats and integrating a restful API. This setup enables seamless data
exchange across healthcare providers using different platforms without compromising data
integrity or security. Additionally, the introduction of data synchronization mechanisms
ensures that patient records are consistently updated across all platforms, preventing the use
of outdated or inconsistent information in medical decisions. The ability to synchronize data
across disparate systems in real time represents a significant advancement over traditional
EHR systems, which often struggle with interoperability due to differing data formats and
siloed storage practices.
To evaluate the framework’s performance, a series of statistical analyses were conducted
during the testing phase. Table 1 shows the results.
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Table 1
Performance Metric Results
Performance Metric Blockchain-based EHR Traditional EHR
Throughput (transactions/sec) 500 100
Latency (seconds) 1 3
Encryption Overhead (milliseconds) 0.2 1
Failure Rate (%) 0.1 1
The comparison between blockchain-based Electronic Health Records (EHR) systems and
traditional EHR systems reveals significant differences in performance metrics that highlight
the potential of blockchain technology in modernizing healthcare data management. By
examining throughput, latency, encryption overhead, and failure rates, we can understand
why blockchain offers an effective solution to current healthcare challenges.
Throughput, measured by the number of transactions processed per second, is a key indicator
of a system’s capacity to handle data. The blockchain-based EHR system demonstrates a
throughput of 500 transactions per second, which is five times greater than the 100
transactions per second seen in traditional systems. This high throughput shows the
blockchain's enhanced ability to manage large volumes of concurrent data requests, an
essential feature in healthcare environments where multiple users are accessing and updating
records simultaneously. This increased capacity can be attributed to blockchain's
decentralized network structure, which processes transactions across numerous nodes rather
than depending on a single central server. Moreover, blockchain utilizes smart contracts to
automate many processes, eliminating manual interventions and thereby speeding up
transaction handling. In contrast, traditional systems often rely on centralized servers that
can easily become overwhelmed during peak usage, leading to bottlenecks and reduced
performance. Figure 3 shows the comparison of throughput between blockchain-based
Electronic Health Records (EHR) systems and traditional EHR systems.
Figure 3: Comparison of throughput between blockchain-based Electronic Health Records
(EHR) systems and traditional EHR systems
Latency, defined as the time taken for a transaction to be completed and confirmed, is also a
crucial factor, especially in healthcare where timely access to patient data is often critical. The
blockchain-based EHR system has a latency of just one second compared to three seconds for
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traditional EHR systems. This significantly lower latency allows healthcare professionals to
access patient information more promptly, which is vital during emergencies. The
blockchain’s low latency is partly due to its ability to retrieve data from multiple nodes
concurrently, ensuring faster access. Additionally, blockchain employs efficient consensus
mechanisms like Proof of Stake (PoS) and Practical Byzantine Fault Tolerance (PBFT), which
reduce the time required to verify transactions. In traditional EHR systems, centralized
databases create bottlenecks under high demand, resulting in longer waiting times. The need
for multiple security checks in traditional systems also contributes to the increased latency.
Blockchain’s distributed nature allows for a more dynamic and balanced retrieval of data, thus
minimizing latency and improving the overall user experience for healthcare providers. Figure
4 shows the comparison of latency between blockchain-based Electronic Health Records (EHR)
systems and traditional EHR systems.
Figure 4: Comparison of latency between blockchain-based Electronic Health Records (EHR)
systems and traditional EHR systems
Encryption overhead is another significant metric, reflecting the additional processing time
required for encrypting data to ensure security. In blockchain-based EHR systems, the
encryption overhead is 0.2 milliseconds, far lower than the one millisecond overhead seen in
traditional EHR systems. This difference highlights the efficiency of blockchain in managing
secure data. Blockchain systems often leverage advanced encryption methods, such as the
Advanced Encryption Standard (AES), combined with Identity-Based Encryption (IBE) or
Attribute-Based Encryption (ABE). These optimized encryption techniques provide robust
data protection without significantly impacting processing time. Traditional systems, on the
other hand, frequently use older and less efficient encryption protocols that contribute to
greater processing delays. Moreover, key management in centralized systems can be
cumbersome, which adds to the overhead during encryption and decryption processes. The
lower encryption overhead in blockchain-based systems ensures that security measures do
not hinder the system's performance, thereby maintaining a balance between data safety and
system efficiency. Figure 5 shows the comparison of encryption overhead between
blockchain-based Electronic Health Records (EHR) systems and traditional EHR systems.
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Figure 5: Comparison of encryption overhead between blockchain-based Electronic Health
Records (EHR) systems and traditional EHR systems
The failure rate, which indicates the percentage of transactions that fail to complete
successfully, is an essential measure of reliability in EHR systems. The blockchain-based EHR
system has a remarkably low failure rate of 0.1%, compared to a 1% failure rate in traditional
EHR systems. This tenfold reduction in the failure rate demonstrates blockchain’s reliability in
maintaining healthcare records. Blockchain achieves this reliability through its distributed
ledger technology, where each node maintains a complete copy of the entire blockchain. This
redundancy ensures that data can still be accessed even if a node fails, thereby greatly
reducing the likelihood of data loss or system failure. Furthermore, the immutability of
blockchain records prevents data corruption, a common cause of failure in traditional systems.
In contrast, traditional EHR systems are vulnerable to server downtimes, hardware failures,
or systemic issues due to their centralized nature. If the central server in a traditional EHR
system fails, the entire system can become inaccessible, leading to a higher failure rate.
Additionally, centralized databases are prone to cyberattacks or accidental data corruption,
which further increases the failure rate and compromises data integrity. Figure 6 shows the
comparison of failure ratebetween blockchain-based Electronic Health Records (EHR) systems
and traditional EHR systems.
Figure 6: Comparison of failure rate between blockchain-based Electronic Health Records
(EHR) systems and traditional EHR systems
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Overall, blockchain-based EHR systems outperform traditional EHR systems across all
performance metrics, offering clear advantages in terms of efficiency, scalability, and
reliability. The higher throughput in blockchain systems allows them to meet the high demand
inherent in healthcare environments, ensuring that numerous transactions can be processed
concurrently without performance degradation. The lower latency in blockchain systems
ensures that patient information can be accessed quickly, a factor that is crucial in emergency
scenarios where every second counts. The minimal encryption overhead highlights that
blockchain-based EHR systems can maintain high levels of data security without sacrificing
usability. Finally, the significantly lower failure rate underscores the reliability of blockchain
technology, ensuring that healthcare providers have consistent access to accurate and
untampered data.
However, while blockchain presents many advantages over traditional systems, the realworld implementation of blockchain-based EHRs must take into consideration challenges like
regulatory compliance, integration with existing healthcare IT infrastructure, and managing
the complexity of blockchain technology for non-specialist users. Despite these challenges,
the potential of blockchain to enhance data security, privacy, and interoperability makes it a
promising solution for modernizing healthcare data management. The improvements in
throughput, latency, encryption efficiency, and reliability position blockchain as a viable tool
for overcoming the limitations of traditional EHR systems and advancing healthcare delivery
in the digital age.
The study highlights that the proposed blockchain-based framework effectively addresses the
limitations of traditional EHR systems by decentralizing data storage through IPFS and
leveraging advanced cryptographic techniques. It ensures data security even when a node is
compromised, while smart contracts automate access control, reducing the risk of human
error. The introduction of Ciphertext-Policy Attribute-Based Encryption (CP-ABE) further
enhances granular access control, significantly improving data privacy and security. These
results align with existing research, demonstrating improved privacy, security, and scalability
for handling large data volumes without performance loss. Beyond healthcare, the framework
offers secure data management solutions applicable to other industries such as finance, legal
services, and supply chains, all while ensuring compliance with regulatory standards through
blockchain’s immutability and auditability.
While the proposed blockchain framework enhances EHR security, privacy, and
interoperability, it still faces challenges related to encryption overhead and integration with
legacy systems. Future research should focus on optimizing encryption algorithms and
improving scalability for managing large data volumes, as well as enhancing compatibility with
legacy systems, offering a promising solution for healthcare data management.
Conclusion
This study advances the theoretical and practical discourse in healthcare information systems.
Theoretically, it introduces a blockchain-based framework that extends current models by
integrating decentralized architecture, layered cryptographic mechanisms, and smart
contract functionality, thereby proposing an innovative approach to safeguarding Electronic
Health Records (EHRs). By employing a hybrid model that combines IPFS (InterPlanetary File
System) for decentralized storage with smart agreements, this research establishes a secure,
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scalable, and privacy-preserving methodology for healthcare data exchange. These
contributions enrich the expanding body of knowledge on blockchain’s transformative
potential in healthcare.
From a practical standpoint, this work addresses critical challenges encountered by
healthcare providers, particularly in contexts where data breaches, systemic inefficiencies,
and interoperability limitations are prevalent. The proposed framework emphasizes granular
access control, immutable audit trails, and real-time data synchronization, rendering it
applicable across diverse healthcare settings—from advanced digital infrastructures to
resource-constrained environments. Furthermore, its alignment with global regulatory
standards such as HIPAA and GDPR ensures that healthcare institutions can adopt this
solution to modernize their data management practices while maintaining compliance.
The blockchain-driven framework developed in this study enhances healthcare data
management by reinforcing security, privacy, and interoperability. Leveraging IPFS for
distributed storage, cryptographic encryption for data integrity, and smart contracts for
automated governance, the system ensures that only authorized entities can access sensitive
records while optimizing operational workflows. Consequently, it not only improves
administrative efficiency but also facilitates seamless care coordination across heterogeneous
healthcare platforms.
Future research should explore the scalability of this framework within larger, multiinstitutional healthcare networks and investigate its adaptability to other data-sensitive
sectors, such as finance and legal services. As digital healthcare ecosystems continue to
evolve, this study underscores the broader applicability of blockchain technology in enabling
secure, transparent, and efficient data-sharing paradigms beyond the medical domain.
Acknowledgements
The authors express their gratitude to City University for their valuable insights and technical
support.This research was funded by Anhui Province Young and Middle aged Backbone
Teachers Overseas Study Visit Project (JY000267).
Authors contribution
Deng Zilong conceptualized the study and led the research design. Mustafa Muwafak
Alobaedy and Mohd Nurul Hafiz Bin Ibrahim contributed to the methodology and data
analysis. Xiaocun Huang reviewed and edited the manuscript, providing critical insights into
blockchain applications. All authors reviewed and approved the final manuscript.
Conflict of interests
The authors declare no conflicts of interest. The funders had no role in the study's design,
data collection, analysis, manuscript preparation, or publication decisions.
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