International Journal of Information Engineering and Electronic Business (IJIEEB)
IJIEEB Vol. 18, No. 3, 8 Jun. 2026
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Secure Electronic Health Records with Effective Data Management in Blockchain Framework Using FPOS
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Author(s)
Index Terms
Blockchain, Electronic Health Records (Ehrs), E-Governance, Healthcare Sector
Abstract
The widespread adoption of Electronic Health Records (EHRs) has remarkably transformed healthcare delivery through rapid retrieval of patient information and enhancement of internal clinical decision-making. The rapid adoption of digital health infrastructures and remote patient monitoring systems has further highlighted the need for data-driven care. Although digital health infrastructures and remote patient monitoring systems support real-time care and care planning, the majority of EHR systems remain susceptible to data breaches and privacy violations. Major EHR systems also continue to lack cross-institutional interoperability and sufficient protection against data breaches and cyber-attacks. While the majority of EHR systems remain vulnerable, the centralized architectures and cloud-based systems commonly employed to support them also fail to provide the necessary protections and assurances.
This work proposes a tailored management framework for EHR systems based on blockchain technology, incorporating automation through smart contracts. The framework employs a dual storage system in which sensitive clinical information is stored off-chain, while on-chain data pertains to access control logs, integrity proofs, and system control metadata.
The proposed system utilizes blockchain consensus mechanisms to confirm data immutability, smart contracts for role-based and policy-secured access control, and encryption algorithms for secure data storage. Data integrity is maintained through hashing, and the distributed ledgers allow interoperable healthcare network policies to be traced and kept unmodifiable.
Testing indicates that the proposed blockchain-based EHR system demonstrates enhanced data security, reduced access latency due to authorization, and improved resistance to cyber-attacks compared to traditional cloud-based EHR systems. The hybrid storage method effectively minimizes storage overhead while maintaining system efficiency. The system demonstrates a viable approach to integrating smart contract systems and blockchain technologies within EHR management systems.
Cite This Paper
Geetanjali Prashant Mohole, Shrinivas K. Sonkar, "Secure Electronic Health Records with Effective Data Management in Blockchain Framework Using FPOS", International Journal of Information Engineering and Electronic Business(IJIEEB), Vol.18, No.3, pp. 52-70, 2026. DOI:10.5815/ijieeb.2026.03.04
Reference
[1]Adlam, R. and Haskins, B. (2021) “Applying Blockchain Technology to Security-Related Aspects of Electronic Healthcare Record Infrastructure”, The African Journal of Information and Communication (AJIC) [Preprint], (28). doi:10.23962/10539/32211
[2]Häyrinen K, Saranto K, Nykänen P. Definition, structure, content, use and impacts of electronic health records: A review of the research literature. Int. J. Med. Inform 2008, 77, 291–304. https://doi.org/10.1016/j.ijmedinf.2007.09.001
[3]Shortliffe EH. The evolution of electronic medical records. Acad Med. 1999 Apr;74(4):414-419. doi: 10.1097/00001888-199904000-00038. PMID: 10219224.
[4]Khan FA, Muazzam AK, Suliman AA, Walid E, Mujeeb UR, Jawad A. An Immutable Framework for Smart Healthcare Using Blockchain Technology. Comput. Syst. Sci. Eng. 2023, 46, 165–179. http://dx.doi.org/10.32604/csse.2023.035066
[5]Yu T, Sekar V, Seshan S, Agarwal Y, Xu C. Handling a trillion (unfixable) flaws on a billion devices: Rethinking network security for the internet-of-things. In Proceedings of the 14th ACM Workshop on Hot Topics in Networks, Philadelphia, PA, USA, 16–17 November 2015; pp. 1–7. https://doi.org/10.1145/2834050.2834095
[6]Wang S, Yuan Y, Wang X, Li J, Qin R, Wang FY. An overview of smart contract: Architecture, applications, and future trends. In Proceedings of the 2018 IEEE Intelligent Vehicles Symposium (IV), Suzhou, China, 26–30 June 2018; pp. 108–113. doi: 10.1109/IVS.2018.8500488
[7]Li J, Wu J, Chen L. Block-secure: Blockchain based scheme for secure P2P cloud storage. Inf. Sci. 2018, 465, 219–231. https://doi.org/10.1016/j.ins.2018.06.071
[8]Zhang S, Lee JH. Analysis of the main consensus protocols of blockchain. ICT Express 2020, 6, 93–97. https://doi.org/10.1016/j.icte.2019.08.001
[9]Shahnaz A, Qamar U, Khalid A. Using blockchain for electronic health records. IEEE Access 2019, 7, 147782–147795. DOI: 10.1109/ACCESS.2019.2946373
[10]Bell KM. HHS National Alliance for Health Information Technology (NAHIT); Report to the Officer of the National Coordinator for Health Information Technology on Defining Key Health Information Technology Terms: DC, USA, 2008; pp. 1–40.
[11]Golosova J, Romanovs A. The advantages and disadvantages of the blockchain technology. In Proceedings of the 2018 IEEE 6th Workshop on Advances in Information, Electronic and Electrical Engineering (AIEEE), Vilnius, Lithuania, 8–10 November 2018; pp. 1–6. DOI:10.1109/AIEEE.2018.8592253
[12]Al-Breiki H, Rehman MHU, Salah K, Svetinovic D. Trustworthy blockchain oracles: Review, comparison, and open research challenges. IEEE Access 2020, 8, 85675–85685. DOI:10.1109/ACCESS.2020.2992698
[13]Ahram T, Sargolzaei A, Sargolzaei S, Daniels J, Amaba B. Blockchain technology innovations. In Proceedings of the 2017 IEEE Technology & Engineering Management Conference (TEMSCON), Evanston, IL, USA, 28 June–1 July 2017; pp. 137–141. DOI:10.1109/TEMSCON.2017.7998367.
[14]Breidenbach L, Cachin C, Chan B, Coventry A, Ellis S, Juels A, Koushanfar F, Miller A, Magauran B, Moroz D, Nazarov S, Topliceanu A, Tram`er F, Zhang F. Chainlink 2.0: Next steps in the evolution of decentralized oracle networks. Chainlink Labs. 2021.
[15]Hepp T, Sharinghousen M, Ehret P, Schoenhals A, Gipp B. On-chain vs. off-chain storage for supply-and blockchain integration. it-Inf. Technol. 2018, 60, 283–291. DOI:10.1515/itit-2018-0019
[16]Hillestad R, Bigelow J, Bower A, Girosi F, Meili R, Scoville R, Taylor R. Can electronic medical record systems transform health care? Potential health benefits, savings, and costs. Health Aff. 2005, 24, 1103–1117. DOI:10.1377/hlthaff.24.5.1103
[17]Watanabe H, Fujimura S, Nakadaira A, Miyazaki Y, Akutsu A, Kishigami J. Blockchain contract: Securing a blockchain applied to smart contracts. In Proceedings of the 2016 IEEE International Conference on Consumer Electronics (ICCE), Las Vegas, NV, USA, 7–11 January 2016; pp. 467–468. DOI:10.1109/ICCE.2016.7430693
[18]Zheng Z, Xie S, Dai HN, Chen W, Chen X, Weng J, Imran M. An overview on smart contracts: Challenges, advances and platforms. Future Gener. Comput. Syst. 2020, 105, 475–491. https://doi.org/10.1016/j.future.2019.12.019
[19]Hewa T, Ylianttila M, Liyanage M. Survey on blockchain based smart contracts: Applications, opportunities and challenges. J. Netw. Comput. Appl. 2021, 177, 102857. https://doi.org/10.1016/j.jnca.2020.102857
[20]Wang S, Ouyang L, Yuan Y, Ni X, Han X, Wang FY. Blockchain-enabled smart contracts: Architecture, applications, and future trends. IEEE Trans. Syst. Man Cybern. Syst. 2019, 49, 2266–2277. DOI:10.1109/TSMC.2019.2895123
[21]Cheikhrouhou O, Mershad K, Jamil F, Mahmud R, Koubaa A, Moosavi SR. A lightweight blockchain and fog-enabled secure remote patient monitoring system. Internet Things 2023, 22, 100691. https://doi.org/10.1016/j.iot.2023.100691
[22]Kumar R, Marchang N, Tripathi R. Distributed off-chain storage of patient diagnostic reports in healthcare system using IPFS and blockchain. In Proceedings of the 2020 IEEE International Conference on Communication Systems & Networks (COMSNETS), Bengaluru, India, 7–11 January 2020; pp. 1–5.DOI:10.1109/COMSNETS48256.2020.9027313
[23]Fernando E, Cassandra C. Medicine Information Record Based on Blockchain Technology. In Proceedings of the 2021 2nd IEEE International Conference on Innovative and Creative Information Technology (ICITech), Virtual, 23–25 September 2021; pp. 169–173. DOI:10.1109/ICITech50181.2021.9590133
[24]Ante L. Smart contracts on the blockchain–A bibliometric analysis and review. Telemat. Inform. 2021, 57, 101519. https://doi.org/10.1016/j.tele.2020.101519
[25]Ashfaq T, Khalid MI, Ali G, Affendi ME, Iqbal J, Hussain S, Ullah SS, Yahaya AS, Khalid R, Mateen A. An efficient and secure energy trading approach with machine learning technique and consortium blockchain. Sensors 2022, 22, 7263. https://doi.org/10.3390/s22197263
[26]Hadi HJ, Hayat U, Musthaq N, Hussain FB, Cao Y. Developing Realistic Distributed Denial of Service (DDoS) Dataset for Machine Learning-based Intrusion Detection System. In Proceedings of the 2022 9th IEEE International Conference on Internet of Things: Systems, Management and Security (IOTSMS), Milan, Italy, 29 November–1 December 2022; pp. 1–6. DOI:10.1109/IOTSMS58070.2022.10062034
[27]Hadi HJ, Cao Y, Li S, Xu L, Hu Y, Li M. Real-time fusion multi-tier DNN-based collaborative IDPS with complementary features for secure UAV-enabled 6G networks. Expert Syst. Appl. 2024, 252, 124215. https://doi.org/10.1016/j.eswa.2024.124215
[28]Ali G, Ahmad N, Cao Y, Ali QE, Azim F, Cruickshank H. BCON: Blockchain based access CONtrol across multiple conflict of interest domains. J. Netw. Comput. Appl. 2019, 147, 102440. https://doi.org/10.1016/j.jnca.2019.102440
[29]Sammeta N, Parthiban L. Data Ownership and Secure Medical Data Transmission using Optimal Multiple Key-Based Homomorphic Encryption with Hyperledger Blockchain. Int. J. Image Graph. 2021, 23, 2240003. https://doi.org/10.1142/S0219467822400034
[30]Saba T, Haseeb K, Rehman A, Jeon G. Blockchain-Enabled Intelligent IoT Protocol for High-Performance and Secured Big Financial Data Transaction. IEEE Trans. Comput. Soc. Syst. 2024, 11, 1667–1674. DOI:10.1109/TCSS.2023.3268592
[31]Fatima, N., Agarwal, P., Sohail, S.S. (2022). Security and Privacy Issues of Blockchain Technology in Health Care—A Review. In: Fong, S., Dey, N., Joshi, A. (eds) ICT Analysis and Applications. Lecture Notes in Networks and Systems, vol 314. Springer, Singapore. https://doi.org/10.1007/978-981-16-5655-2_18
[32]Babar M, Qureshi B, Koubaa A. Investigating the impact of data heterogeneity on the performance of federated learning algorithm using medical imaging. PLoS ONE 2024, 19, e0302539. https://doi.org/10.1371/journal.pone.0302539
[33]Butt AUR, Mahmood T, Saba T, Bahaj SAO, Alamri FS, Iqbal MW, Khan AR. An Optimized Role-Based Access Control Using Trust Mechanism in E-Health Cloud Environment. IEEE Access 2023, 11, 138813–138826. DOI:10.1109/ACCESS.2023.3335984
[34]Khan I, Qazi EA, Hadi HJ, Ahmad N, Ali G, Cao Y, Alshara MA. Securing Blockchain-Based Supply Chain Management: Textual Data Encryption and Access Control. Technologies 2024, 12, 110. https://doi.org/10.3390/technologies12070110
[35]Mohanta BK, Panda SS, Jena D. An overview of smart contract and use cases in blockchain technology. Proceedings of the 2018 9th IEEE International Conference on Computing, Communication and Networking Technologies (ICCCNT), Bengaluru, India, 10–12 July 2018; pp. 1–4. DOI: 10.1109/ICCCNT.2018.8494045
[36]Bodur H, Al Yaseen IF. An Improved blockchain-based secure medical record sharing scheme. Cluster Computing. 2024 Sep;27(6):7981-8000. https://doi.org/10.1007/s10586-024-04414-6
[37]Jia Q. Research on medical system based on blockchain technology. Medicine. 2021 Apr 23;100(16):e25625
[38]Cao B, Zhang Z, Feng D, Zhang S, Zhang L, Peng M, Li Y. Performance analysis and comparison of PoW, PoS and DAG based blockchains. Digital Communications and Networks. 2020 Nov 1;6(4):480-5.