Abstract
Electronic Health Record (EHR) sharing is essential for enhancing the quality of healthcare services, particularly in organ donation systems where timely access to patient data is crucial. However, centralized cloud-based EHR systems are susceptible to privacy breaches and unauthorized access. This paper presents the MedAccess Hybrid-Blockchain Privacy Framework (HBPF), a novel approach that combines the scalability of cloud storage with the security and immutability of blockchain technology. Our framework employs a hybrid blockchain architecture consisting of a Record Chain (RecChain) Blockchain for storing immutable transaction records and an Audit Chain (AuditChain) Blockchain for managing sensitive operations and overseeing the RecChain. The framework also incorporates a Three-Party Key Exchange Protocol (TPKE) protocol enabling fine-grained access control and ensuring that only authorized healthcare providers can access specific EHRs. Performance evaluation demonstrates that the MedAccess HBPF framework achieves significant improvements over existing models. Specifically, it reduces storage costs by 50% compared to BCAACPC, and maintains low computational costs, starting at 20 ms and only slightly increasing to about 25 ms, making it suitable for large-scale deployment. These results highlight the framework's effectiveness in maintaining high computational efficiency and low communication overhead, making it a viable solution for modern healthcare systems.
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Data Availability
The corresponding author can provide the dataset generated and analyzed during this study upon reasonable request.
References
Boniol M, Kunjumen T, Nair TS, Siyam A, Campbell J, Diallo K. The global health workforce stock and distribution in 2020 and 2030: a threat to equity and “universal” health coverage? BMJ Glob Health. 2022;7(6): e009316.
Li C, Dong M, Li J, Xu G, Chen X, Ota K. Healthchain: secure EMRs management and trading in distributed healthcare service system. IEEE Internet Things J. 2021;8(9):7192–202.
Chenthara S, Ahmed K, Wang H, Whittaker F. Security and privacy-preserving challenges of e-health solutions in cloud computing. IEEE Access. 2019;7:74361–82.
Qiu H, Qiu M, Liu M, Memmi G. Secure health data sharing for medical cyber-physical systems for the healthcare 4.0. IEEE J Biomed Health Inform. 2020;24(9):2499–505.
Wang Y, Zhang A, Zhang P, Wang H. Cloud-assisted EHR sharing with security and privacy preservation via consortium blockchain. IEEE Access. 2019;7:136704–19.
Zukaib U, Cui X, Hassan M, Harris S, Hadi HJ, Zheng C. Blockchain and machine learning in EHR security: a systematic review. IEEE Access. 2023;11:130230–56.
Jayabalan J, Jeyanthi N. Scalable blockchain model using off-chain IPFS storage for healthcare data security and privacy. J Parallel Distrib Comput. 2022;164:152–67.
Singh S, Rathore S, Alfarraj O, Tolba A, Yoon B. A framework for privacy-preservation of IoT healthcare data using Federated Learning and blockchain technology. Fut Gen Comput Syst. 2021;2:5.
Yu K, Tan L, Shang X, Huang J, Srivastava G, Chatterjee P. Efficient and privacy-preserving medical research support platform against COVID-19: a blockchain-based approach. IEEE Cons Electron Mag. 2021;10(2):111–20.
Edemacu K, Jang B, Kim JW. Collaborative ehealth privacy and security: an access control with attribute revocation based on OBDD access structure. IEEE J Biomed Health Inform. 2020;24(10):2960–72.
Sahai A, Waters B. Fuzzy identity-based encryption. In: Cramer R, editor. Advances in cryptology—EUROCRYPT 2005. EUROCRYPT 2005. Lecture notes in computer science, vol. 3494. Berlin: Springer; 2005.
Goyal V, Pandey O, Sahai A, Waters B. Attribute-based encryption for fine-grained access control of encrypted data. In Proceedings of the 13th ACM conference on Computer and communications security (CCS '06). Association for Computing Machinery, New York, 2006;89–98.
Lewko A, Waters AB. Decentralizing attribute-based encryption. In: Paterson KG, editor. Advances in cryptology—EUROCRYPT 2011. EUROCRYPT 2011. Lecture notes in computer science, vol. 6632. Berlin: Springer; 2011.
Miao Y, Ma J, Liu X, Li X, Jiang Q, Zhang J. Attribute-based keyword search over hierarchical data in cloud computing. IEEE Trans Serv Comput. 2020;13(6):985–98.
Michalas A. The lord of the shares: combining attribute-based encryption and searchable encryption for flexible data sharing. In Proceedings of the 34th ACM/SIGAPP Symposium on Applied Computing (SAC '19). Association for Computing Machinery, New York, 2019;146–155.
Goyal V, Pandey O, Sahai AW, Brent. Attribute-based encryption for fine-grained access control of encrypted data. Proc ACM Conf Comput Commun Secur. 2006;89–98:89–98. https://doi.org/10.1145/1180405.1180418.
Wang S, Zhou J, Liu JK, Yu J, Chen J, Xie W. An efficient file hierarchy attribute-based encryption scheme in cloud computing. IEEE Trans Inf Forensics Secur. 2016;11(6):1265–77.
Ge A, Zhang R, Chen C, Ma C, Zhang Z. Threshold ciphertext policy attribute-based encryption with constant size ciphertexts. In: Susilo W, Mu Y, Seberry J, editors. Information security and privacy. ACISP 2012. Lecture notes in computer science, vol. 7372. Berlin: Springer; 2012.
Rajput AR, Li Q, Ahvanooey MT, Masood I. EACMS: emergency access control management system for personal health record based on blockchain. IEEE Access. 2019;7:84304–17.
Abouali M, Sharma K, Ajayi O, Saadawi T. Performance evaluation of secured blockchain-based patient health records sharing framework. 2022 IEEE International IOT, Electronics and Mechatronics Conference (IEMTRONICS), Toronto, 2022;1–7.
Nguyen DC, Pathirana PN, Ding M, Seneviratne A. Blockchain for secure EHRs sharing of mobile cloud based e-health systems. IEEE Access. 2019;7:66792–806. https://doi.org/10.1109/ACCESS.2019.2917555.
Wang M, Guo Y, Zhang C, Wang C, Huang H, Jia X. MedShare: a privacy-preserving medical data sharing system by using blockchain. IEEE Trans Serv Comput. 2023;16(1):438–51.
Ghayvat H, et al. CP-BDHCA: blockchain-based confidentiality-privacy preserving big data scheme for healthcare clouds and applications. IEEE J Biomed Health Inform. 2022;26(5):1937–48.
Yao Y, Chang J, Zhang A. Efficient data sharing scheme with fine-grained access control and integrity auditing in terminal-edge-cloud network. IEEE Internet Things J. 2024;2:5.
Zhang Y, Xiong L, Ling L, Fagen N, Xianhua W, Hanzhou. A blockchain-based privacy-preserving auditable authentication scheme with hierarchical access control for mobile cloud computing. J Syst Architect. 2023;142: 102949.
Xiang X, Cao J, Fan W. Decentralized authentication and access control protocol for blockchain-based e-health systems. J Netw Comput Appl. 2022;207:5.
Liu S, Chen L, Yu H, Gao S, Fang H. BP-AKAA: blockchain-enforced privacy-preserving authentication and key agreement and access control for IIoT. J Inf Secur Appl. 2023;73:25.
Ma K, Song G, Zhou Y, Xu R, Yang B. An efficient identity authentication protocol with revocation, tracking and fine-grained access control for electronic medical system. Comput Stand Interfaces. 2024;88:2.
Zhang Y, Xiong L, Li F, Hao Y. Blockchain-based privacy-preserving authentication with hierarchical access control using polynomial commitment for mobile cloud computing. IEEE Internet Things J. 2024;2:1–1.
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The authors acknowledged the CMR University, Bengaluru, India for supporting the research work by providing the facilities.
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Duggegowda, D., Ramamoorthy, U. MedAccess HBPF: A Privacy-Preserving Hybrid-Blockchain Framework for Secure and Efficient Cloud-Based Electronic Health Record Sharing. SN COMPUT. SCI. 5, 1018 (2024). https://doi.org/10.1007/s42979-024-03343-w
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DOI: https://doi.org/10.1007/s42979-024-03343-w