Using Blockchain and Interplanetary File System

for Secure Medical Record Access Control

1st [Link] 2nd [Link] 3rd [Link]

Department of Information Technology Department of Information Technology Department of Information Technology
Vasavi College of Engineering(OU) Vasavi College of Engineering(OU) Vasavi College of Engineering(OU)
Hyderabad , India Hyderabad , India Hyderabad , India
email address abhirampattem1305@[Link] goudakash363@[Link]

Abstract—The increasing complexity of healthcare data man- Smart Contracts are indeed contracts that are self-executing
agement, the need for increased data security, and data interop- with a predefined rule and condition which has been pro-
erability issues require the development of sophisticated solutions grammed within the blockchain technology. In relation to
to ensure the integrity, privacy, and availability of the data
within the field. BlockDoc is a blockchain-based and decentral- BlockDoc, smart Contracts are employed to enable access
ized healthcare data-management application, designed for the control, authorize transactions between patients and healthcare
purposes of storing, sharing, and managing patient records. In providers and implement data-sharing policies. It becomes
this system, blockchain prevents the patient data from being unnecessary to engage intermediaries to execute health care
corrupted or altered, provides chances for secure data sharing, services, making the process faster, reliable, and cheaper.
and increases the transparency of the system. Additionally, the
intermediaries are not included in the process, which removes Decentralization in healthcare guarantees that no one has
the associated inefficiencies. Patient data is guaranteed to be complete control over the record of the patient. A typical
both immutable and transparent, yet the access to it is strictly healthcare system is a centralized one, and it is vulnerable
controlled. Smart contracts are used in this system to guarantee to hacking, unauthorized modifications, and inefficient admin-
the legality of the transactions between the patients, the doctors, istration. In the decentralized arrangement of BlockDoc, the
and the healthcare institutions. The design implementation, as
well as the benefits and prospects of this system, are described patient owns their medical record. He or she distributes access
and discussed below. to healthcare providers, giving power to the individual and
Index Terms—Blockchain, Healthcare, Smart Contracts, De- making healthcare safe and efficient.
centralization, SecureData Management Consequently, a hygienic system needs to ensure that the
data in use is secure. It is important to ensure that the medical
I. I NTRODUCTION data is confidential, accurate, and accessible to the right
individuals. BlockDoc uses cryptographic encryption, semi-
The blockchain is a distributed ledger technology which attribute-based access control, and blockchain for secure data
enables secure, transparent and tamper-proof record-keeping. management. The immutability of the blockchain reduces the
In the healthcare sector, the blockchain provides an immutable risk of unauthorized data access and data tampering.
way to store patient records which minimizes fraud, increases The design of the system is, therefore, reviewed in this
security, and interoperability between healthcare providers. paper together with its implementation and benefits. The
Blockchain is decentralized and hence no singular points of paper emphasizes the system’s potential to revolutionize the
failure which is a measure of making data more resilient to healthcare sector by enhancing the efficiency of the system of
cyber threats especially in the healthcare sector. operations, protecting the data of patients, and ensuring the
The healthcare industry is responsible for sensitive and interoperability of healthcare
confidential data, such as a patient’s medical history, the
II. R ELATED W ORK
prescriptions they take, and the treatments they undergo.
Presently, most healthcare systems are centralized, leading Several studies have been conducted on the security, in-
to data breaching, lack of interoperability, and inefficiencies teroperability, and decentralized data management applica-
in data access and sharing. When blockchain technology is tions of blockchain in the healthcare industry. Studies have
adopted in the healthcare industry, it can help improve the revealed that more than 50 million healthcare records were
integrity of data, patient privacy, and the ability to access lost to cyberattacks in 2022 alone, which highlights the
medical records across healthcare institutions. importance of security [11]. By view of research, there are
applications of smart contracts that automate processes in-
Identify applicable funding agency here. If none, delete this. volving administrative steps such as insurance claims as well
as patient consent management to ensure compliance with
laws such as HIPAA and GDPR [19][3]. Decentralization
is said to manage fragmented data silos within a healthcare
system so that seamless exchange of healthcare data between
the providers is done through blockchain networks [18][17].
Furthermore, various encryption and authentication mecha-
nisms are studied to improve secure data management and
patient privacy, including zero-knowledge proofs and multi-
signature authentication [10][3]. This work, therefore, extends
previous research by deploying a Hyperledger Fabric-based
permissioned blockchain for efficient patient data management
with an improvement in security, privacy, and interoperability
[14][11].

TABLE I
C OMPARISON OF B LOCKCHAIN T ECHNIQUES

Method Features Advantages Limitations Fig. 1. Architecture Diagram.

Blockchain Smart Enhances se- Scalability
for IoT contracts and curity, trans- issues; high
distributed parency, and energy
ledger for IoT automation consumption The third one is Access Control and Permissions. The
FHIRChain Blockchain Enhances Complex im- patients will give permissions to the people who can access
framework data plementation their records. This is done using smart contracts [19][16][3].
for clinical security and This will ensure that the records are private and can only
data exchange scalability
be accessed by the right person [12][7]. If an authorized
Auditable Blockchain Tamper-proof High compu-
Access for access access logs tational over- person requests the record, Record Retrieval and Verification
Control control head is performed. Here, the blockchain hash is validated to check
verification the permission, and if the permission is granted, the record
Reputation- Reputation- Scalable and Reputation is decrypted [10][8]. The last one is Audit and Transparency.
Based based resilient mechanisms Here, all the actions done by the user in the system are stored
Consensus transaction may be
validation gamed on the system [16][14]. This is to ensure that no unauthorized
Cloud- Cloud storage Scalable, re- Data security person can change or delete any action. This will ensure that
Based for health duces infras- risks the system is compliant with all the regulations [17][13][11
DBMS records tructure costs ].BlockDoc ensures that the trust, integrity, and access to the
IoMT Mis- Detects Enhances Requires medical records are improved by using blockchain.
behavior misbehavior security and significant
Detection in medical trust processing
IoT
IIoT-Based Blockchain Secure and Complex in-
EHR with decentralized tegration
Privacy federated
learning

III. M ETHODOLOGY
BlockDoc is an electronic medical record management sys-
tem that utilizes blockchain. The aim is to secure, transparent,
and efficient management of the healthcare data [18][14][11].
The system consists of the following subsystems. The first
one is User Registration and Authentication. Here, both the
patients and the healthcare providers are given a digital identity
[16][10][9]. The second is Record Creation and Encryption,
Fig. 2. Workflow of the system.
where the doctors create the EMRs. The created records are
then encrypted and a unique hash is given to them [17][10].
The hashed record is then stored on the Blockchain Storage 1) User Registration & Authentication
to ensure the immutability of the records [18][17]. The actual • User roles: patients, doctors, healthcare providers.
encrypted records will be stored in the Off-Chain Storage. It • Digital Identity: A user is provided a unique digital
can be by using IPFS or cloud solutions [5]. ID
 • Authentication Mechanism: Using Cryptographic
Keys for Secure Login
2) Access Control & Permissions
• Patient-Centric Model: Patients control medical
record access permissions
• Smart Contract Permissions:

– Access granted via blockchain verification

– Access revoked through smart contract triggers
3) Record Creation & Encryption
• Medical Record Entry (Initial): Physicians create
electronic medical records (EMRs)
• Encryption Process: Data is encrypted before stor-
age
Fig. 3. Patient’s access control over the medical record.
• Hash Generation: A unique hash is generated for
integrity verification
4) Blockchain Storage
• What is Stored: Only the hash of the encrypted
EMR
• Immutability: Data cannot be altered after being
saved
• Ethereum Smart Contracts: Handle interactions and
access control
5) Off-Chain Storage
• Why Off-Chain?: Blockchain storage is expensive
and limited
• Storage System: InterPlanetary File System (IPFS)
• Data Retrieval: Blockchain hash points to off-chain
location Fig. 4. Ganache Transactions
6) Record Retrieval & Verification
• Access Request: Doctors or hospitals request patient
data
• Verification: Blockchain hash verifies data integrity
• Decryption: Encrypted records are decrypted after
permission is granted
7) Audit & Transparency
• Access Logs: All the access made is logged on the
blockchain.
• Immutable Records: Changes made are tracked per-
manently
IV. I MPLEMENTATION
The figure 3 shows the interface in which the patient is
giving access to the doctor. This action sends a request to Fig. 5. Doctor creating the new EMR by analyzing the previous EMRs.
the patient MetaMask account. The patient has to approve the
request so that the doctor can access the EMRs.
V. R ESULTS A ND D ISCUSSION
The figure 5 shows the interface of the doctor after getting
the access from the patient, doctor submits the new record. BlockDoc was put through a series of rigorous tests that
This action sends a request to the doctor’s Metamask account included performance, security and scalability. The key results
through which he logged in. By approving the request the include :
access to the medical record will be revoked. • Security: Data immutability is guaranteed by the system
to prevent unauthorized changes.
Figure 5 shows all transactions that are being performed • Performance: Transactions are processed in seconds
and stored on the blockchain. which makes data access to be real time.
 • Scalability: The system can accommodate increasing data
volume without performance degradation.
• Interoperability: It can share information with other hos-
pitals and health institutions.
BlockDoc can allow smooth The benefits of using this
technology over the conventional healthcare databases, which
are centralized, include improved security and the fact that
patients in blockchain are the owners of their own data
which is not the case in traditional databases. Additionally,
blockchain is cost effective.
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