A Patient-Centric Blockchain Framework for Secure Electronic Health Record Management: Decoupling Data Storage from Access Control
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arXiv
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| Autores principales: | , , , , |
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| Formato: | Preprint |
| Publicado: |
2025
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| _version_ | 1866912723228426240 |
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| author | Romel, Tanzim Hossain Paul, Kawshik Kumar Ruhan, Tanberul Islam Mim, Maisha Rahman Hoque, Abu Sayed Md. Latiful |
| author_facet | Romel, Tanzim Hossain Paul, Kawshik Kumar Ruhan, Tanberul Islam Mim, Maisha Rahman Hoque, Abu Sayed Md. Latiful |
| contents | We present a patient-centric architecture for electronic health record (EHR) sharing that separates content storage from authorization and audit. Encrypted FHIR resources are stored off-chain; a public blockchain records only cryptographic commitments and patient-signed, time-bounded permissions using EIP-712. Keys are distributed via public-key wrapping, enabling storage providers to remain honest-but-curious without risking confidentiality. We formalize security goals (confidentiality, integrity, cryptographically attributable authorization, and auditability of authorization events) and provide a Solidity reference implementation deployed as single-patient contracts. On-chain costs for permission grants average 78,000 gas (L1), and end-to-end access latency for 1 MB records is 0.7--1.4s (mean values for S3 and IPFS respectively), dominated by storage retrieval. Layer-2 deployment reduces gas usage by 10--13x, though data availability charges dominate actual costs. We discuss metadata privacy, key registry requirements, and regulatory considerations (HIPAA/GDPR), demonstrating a practical route to restoring patient control while preserving security properties required for sensitive clinical data. |
| format | Preprint |
| id |
arxiv_https___arxiv_org_abs_2511_17464 |
| institution | arXiv |
| publishDate | 2025 |
| record_format | arxiv |
| spellingShingle | A Patient-Centric Blockchain Framework for Secure Electronic Health Record Management: Decoupling Data Storage from Access Control Romel, Tanzim Hossain Paul, Kawshik Kumar Ruhan, Tanberul Islam Mim, Maisha Rahman Hoque, Abu Sayed Md. Latiful Cryptography and Security Software Engineering Systems and Control We present a patient-centric architecture for electronic health record (EHR) sharing that separates content storage from authorization and audit. Encrypted FHIR resources are stored off-chain; a public blockchain records only cryptographic commitments and patient-signed, time-bounded permissions using EIP-712. Keys are distributed via public-key wrapping, enabling storage providers to remain honest-but-curious without risking confidentiality. We formalize security goals (confidentiality, integrity, cryptographically attributable authorization, and auditability of authorization events) and provide a Solidity reference implementation deployed as single-patient contracts. On-chain costs for permission grants average 78,000 gas (L1), and end-to-end access latency for 1 MB records is 0.7--1.4s (mean values for S3 and IPFS respectively), dominated by storage retrieval. Layer-2 deployment reduces gas usage by 10--13x, though data availability charges dominate actual costs. We discuss metadata privacy, key registry requirements, and regulatory considerations (HIPAA/GDPR), demonstrating a practical route to restoring patient control while preserving security properties required for sensitive clinical data. |
| title | A Patient-Centric Blockchain Framework for Secure Electronic Health Record Management: Decoupling Data Storage from Access Control |
| topic | Cryptography and Security Software Engineering Systems and Control |
| url | https://arxiv.org/abs/2511.17464 |