A Blockchain-Based Electronic Health Record (EHR) System for Edge Computing Enhancing Security and Cost Efficiency

Abstract

Blockchain technology offers unique features, such as transparency, the immutability of data, and the capacity to establish trust without a central authority. Such characteristics can be leveraged to support the collaboration among several different software systems operating within the healthcare ecosystem, while ensuring data integrity and make electronic health records (EHRs) more easily accessible. To provide a solution based on blockchain technology, this paper has evaluated the main issues that arise when large amounts of data are expected, i.e., mainly cost and performance. A balanced approach that maximizes the benefits and mitigates the constraints of the blockchain has been designed. The proposed decentralized application (dApp) architecture employs a hybrid storage strategy that involves storing medical records locally, on users’ devices, while utilizing blockchain to manage an index of these data. The dApp clients facilitate interactions among participants, leveraging a smart contract to enable patients to set authorization policies, thereby ensuring that only designated healthcare providers and authorized entities have access to specific medical records. The blockchain data-immutability property is used to validate data stored externally. This solution significantly reduces the costs related to the utilization of the blockchain, while retaining its advantages, and improves performance, since the majority of data are available off-chain.

TrustHealth: Enhancing eHealth Security with Blockchain and Trusted Execution Environments

“…Cao [3] centered their research on blockchain technology, proposing a robust cloud-assisted eHealth system designed to safeguard outsourced EHRs against unauthorized tampering. Mandarino et al [18] propose a hybrid storage strategy, where medical records are stored on users' devices, and blockchain merely manages the index of these data, thereby enhancing security and cost-effectiveness. Patients can set authorization policies through smart contracts, ensuring that only authorized entities can access their medical records.…”

“…While redundancy enhances fault tolerance and immutability, it also introduces significant storage overhead [17]. Moreover, storing plaintext data on the blockchain raises serious privacy concerns, especially for sensitive information like EHRs [18]. Fortunately, TEE focuses on runtime protection and secure storage of data [19].…”