HealthChain: A Privacy-Preserving and Verifiable Healthcare Record Management System Using Permissioned Blockchain
Keywords:
Access control, Electronic health records, Healthcare privacy, Hyperledger Fabric, Off-chain storage, Patient consent, Permissioned blockchainAbstract
The digitization of healthcare records has introduced significant challenges regarding data privacy, security, and interoperability. Centralized Electronic Health Record (EHR) systems are prone to single points of failure, insider manipulation, and unauthorized access, leaving patients with negligible control over their sensitive medical information. This article proposes HealthChain, a decentralized healthcare record management system built on a permissioned blockchain (Hyperledger Fabric). HealthChain utilizes a dual-tier storage strategy where sensitive Protected Health Information (PHI) is stored off-chain in an encrypted PostgreSQL database, while only cryptographic hashes and provenance metadata are anchored to the immutable ledger. The study introduces a dynamic patient-controlled consent protocol that enables fine-grained access control, allowing patients to grant or revoke access to specific medical records for defined temporal windows. Furthermore, the system incorporates a mandatory human-in-the-loop verification process for healthcare providers to ensure clinical accountability before key issuance. Experimental performance evaluations demonstrate that HealthChain maintains low transaction latency, linear scalability under multi-user concurrency, and absolute mathematical verifiability against internal and external data tampering.
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