Blockchain-Enabled Electronic Health Records for Secure Data Sharing
Abstract
The digitization of the healthcare system has increased access to patient records significantly; nevertheless, it has triggered serious worries related to the security and privacy of data, as well as the lack of interoperability. Centralized electronic health record (EHR) systems are easy to breach, accessed illegally, and violated, making the trust of the patients jeopardized and decreasing the collaboration between the healthcare providers. This paper seeks to offer a remedy to such problems through a novel blockchain-based EHR platform that allows the advantages of transparency and immutability of a public blockchain (Ethereum) and privacy and access control of a private blockchain (Hyperledger Fabric). In this system, the sensitive information of patient data is reliably stored in the private chain but the information in the transaction and verification list is stored in the public chain to ensure integrity and not confidentiality. The incentivization of the patient using tokens ERC-20 standard digital, i.e. the patient will be offered to share his/her anonymized health information with research institutions or healthcare facilities in exchange of a certain number of ERC20 standard digital tokens; these tokens could be easily measured in the healthcare ecosystem, and they provide the patient with the active engagement and the power to make a difference with his/her data. It operates on the dynamic access control, which is based on smart contracts in order to grant access to data conditionally, temporarily, or in case of emergency according to privacy laws. The exchange of multihospitals simulated scenarios, emergency access requests, and research-oriented anonymized sharing demonstrated high data integrity (up to 92%), low access latency (approximately $30 \%$ lower) and high patient engagement through token rewards. On balance, the research confirms the capacity of the hybrid approach to blockchain to enhance security, transparency, and interoperability and motivate patients to engage, and this is a viable and realistic alternative to the traditional centralized EHR systems, which will build trusted and cooperative healthcare data-sharing ecosystem.