TrustHealth: Enhancing eHealth Security with Blockchain and Trusted Execution Environments

Abstract

The rapid growth of electronic health (eHealth) systems has led to serious security and privacy challenges, highlighting the critical importance of protecting sensitive healthcare data. Although researchers have employed blockchain to tackle data management and sharing within eHealth systems, substantial privacy concerns persist as a primary challenge. In this paper, we introduce TrustHealth, a secure data sharing system that leverages trusted execution environment (TEE) and blockchain technology. TrustHealth leverages blockchain to design smart contracts to offer robust hashing protection for patients’ healthcare data. We provide a secure execution environment for SQLCipher, isolating all sensitive operations of healthcare data from the untrusted environment to ensure the confidentiality and integrity of the data. Additionally, we design a TEE-empowered session key generation protocol that enables secure authentication and key sharing for both parties involved in data sharing. Finally, we implement TrustHealth using Hyperledger Fabric and ARM TrustZone. Through security and performance evaluation, TrustHealth is shown to securely process massive encrypted data flows at a rate of 5000 records per second, affirming the feasibility of our proposed scheme. We believe that TrustHealth offers valuable guidelines for the design and implementation of similar systems, providing a valuable contribution to ensuring the privacy and security of eHealth systems.