Blockchain-Enabled Electronic Health Record Model for Managing Patients Vital Data and Medical Reports
DOI:
https://doi.org/10.30953/bhty.v9.455Keywords:
Blockchain, electronic health record, Hyperledger Fabric, hyperledger Caliper, performance evaluation, remote patient monitoringAbstract
The evolution of IoT in healthcare has transformed patient care, with the Internet of Medical Things (IoMT) enabling remote patient monitoring (RPM) through body sensors that track vitals such as heart rate, oxygen saturation, and body temperature. These devices generate huge volumes of data, raising concerns about security, privacy, and scalability. Existing blockchain-based Electronic Health Record (EHR) solutions mostly focus on textual data and lack integration of high-dimensional medical images like X-rays, MRIs, and CT scans, which are vital for diagnosis and treatment. To overcome these limitations, this study proposes a blockchain-enabled secure storage and retrieval framework, including medical imaging. The system is built using Hyperledger Fabric in an IoT-enabled RPM environment. IoMT sensors collect patient vitals, and implement smart contracts using Node.js. The model adopts a multi-organization setup with two organizations, a single channel, and RAFT consensus to ensure data consistency and high performance. In testing, 1200 transactions were executed at different Transactions per second rates. Results showed that throughput remained close to the send rate up to 90 TPS, peaking at 117.04 TPS when configured at 150 TPS, after which it declined. Importantly, no transactions failed, demonstrating system reliability. Latency ranged between 0.21 and 2.24 seconds, while read operations consistently maintained 0.01 seconds across all rounds.
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References
1. Katoon PM, Turukmane AV. Interoperable blockchain network for
healthcare data using Fabric, Ethereum, and IPFS. Discov Artif
Intell. 2025;5(1):1–27. https://doi.org/10.1007/s44163-025-00564-7
2. Afzal I, Parah SA, Hurrah NN, Song OY. Secure patient data transmission
on resource constrained platform. Multimed Tools Appl.
2024;83(5):15001–26. https://doi.org/10.1007/s11042-020-09139-3
3. Shen Y, Yu J, Zhou J, Hu G. Twenty-five years of evolution and
hurdles in electronic health records and interoperability in medical
research. J Med Internet Res. 2025;27(1):59024–49. https://doi.
org/10.2196/59024
4. Tertulino R, Antunes N, Morais H. Privacy in electronic health
records: a systematic mapping study. J Public Health. 2024;32(3):
435–54. https://doi.org/10.1007/s10389-022-01795-z
5. Alomar D, Almashmoum M, Eleftheriou I, The impact of patient
access to electronic health records on health care engagement: systematic
review. J Med Internet Res. 2024;26:473–88. https://doi.
org/10.2196/56473
6. Carlos Ferreira J, Elvas LB, Correia R, Mascarenhas M. Enhancing
EHR interoperability and security through distributed ledger technology.
Healthcare (Basel). 2024;12:1967–87. https://doi.org/10.3390/
healthcare12191967
7. Kasa PSP. A distributed and scalable system for remote patient monitoring
using cloud-based architecture. IJIRCCE. 2024;12(8):10706–17.
8. Hathaliya J, Sharma P, Tanwar S. Blockchain-based remote patient
monitoring in healthcare 4.0. In 9th international conference on
advanced computing (IACC). IEEE; 2019. p. 87–91.
9. 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.
10. Kayikci S, Khoshgoftaar TM. Blockchain meets machine learning:
a survey. J Big Data. 2024;11(1):9. https://doi.org/10.1186/
s40537-023-00852-y
11. Charles WM, Delgado BM. Health datasets as assets: blockchain-
based valuation and transaction methods. Blockchain Healthc
Today. 2022;5(10):953–66. https://doi.org/10.30953/bhty.v5.222
12. Cheikhrouhou O, Mershad K, Jamil F, Mahmud R, Koubaa A, Moosavi
SR. A lightweight blockchain and fog-enabled secure remote
patient monitoring system. Internet of Things. 2023;22:100691.
https://doi.org/10.1016/j.iot.2023.100691
13. Husnain G, Ullah Z, Mohmand MI, Qadir M, Alzahrani KJ, Ghadi
YY, et al. HealthChain: a blockchain-based framework for secure
and interoperable electronic health records (EHRs). IET Commun.
2024;18(19):1451–73.
14. Dobre D, Vasilățeanu A. Electronic health record authentication and
authorization using Blockchain and QR codes. Procedia Comput Sci.
2024;239(4):1784–91. https://doi.org/10.1016/j.procs.2024.06.358
15. Carter G, White D, Nalla A, Shahriar H, Sneha S. Toward application
of blockchain for improved health records management and
patient care. Blockchain Healthc Today. 2019;2(7):240–52. https://doi.
org/10.30953/bhty.v2.37
16. Upadrista V, Nazir S, Tianfield H. Secure data sharing with blockchain
for remote health monitoring applications: a review. J
Reliab Intell Environ. 2023;9(3):349–68. https://doi.org/10.1007/
s40860-023-00204-w
17. Garg S, Kaushal RK, Kumar N. A novel design and performance assessment
of a blockchain-powered remote patient monitoring system. SN
Comput Sci. 2024;5(7):849. https://doi.org/10.1007/s42979-024-03151-2
18. Carter G, Shahriar H, Sneha S. Blockchain-based interoperable electronic
health record sharing framework. In IEEE Annual Computer
Software and Applications Conference 2019. p. 452–60.
19. Kaushal RK, Kumar N, Kukreja V, Boonchieng E. Hyperledger
fabric-based remote patient monitoring solution and performance
evaluation. Peer-to-Peer Netw Appl. 2025;18(3):105. https://doi.
org/10.1007/s12083-025-01921-0
20. Tahir NUA, Rashid U, Hadi HJ, Ahmad N, Cao Y, Alshara MA,
et al. Blockchain-based healthcare records management framework:
enhancing security, privacy, and interoperability. Technologies. 2024;
12(9):168. https://doi.org/10.3390/technologies12090168
21. Ullah A, Ullah Z, Rizvi SS, Gul L, Kwon SJ. Toward blockchain-
based electronic health record management with fine-grained
attribute-based encryption and decentralized storage mechanisms. Sci
Rep. 2025;15(1):542–67. https://doi.org/10.1038/s41598-025-17875-5
22. Hasnain M, Albogamy FR, Alamri SS, Ghani I, Mehboob B. The
Hyperledger fabric as a Blockchain framework, preserves the security
of electronic health records. Front Public Health. 2023;11(4):787–99.
https://doi.org/10.3389/fpubh.2023.1272787
23. Salleh MIM, Abdullah R, Zakaria N. Evaluating the effects of
electronic health records system adoption on the performance of
Malaysian health care providers. BMC Med Inform Decis Mak.
2021;21:1–13. https://doi.org/10.1186/s12911-021-01447-4
24. Carter G, Chevellereau B, Shahriar H, Sneha S. Openpharma blockchain
on FHIR: an interoperable solution for read-only health records
exchange through blockchain and biometrics. Blockchain Healthc
Today. 2020;3:1–11. https://doi.org/10.30953/bhty.v3.120
25. Çodur S, Erkayman B. Blockchain technology from the supply chain
perspective: a systematic literature review. Spectr Decis Mak Appl.
2025;2(1):268–85. https://doi.org/10.31181/sdmap21202520
26. Kaushal RK, Kumar N. Exploring hyperledger caliper benchmarking
tool to measure the performance of blockchain based solutions. In:
2024 11th international conference on reliability, infocom technologies
and optimization IEEE; 2024. p. 1–6.
27. Bigini G, Lattanzi E. Toward the interplanetary health layer for the
internet of medical things with distributed ledgers and storage. IEEE
Access. 2022;10:82883–95.
28. Schweitzer M, Flórez K, Steger B, Baumgarten D, Romano V, Augustin
M. Integrating a novel eye imaging system into clinical practice:
an open-source DICOM simulation platform. Stud Health Technol
Inform. 2023;301:198–203. https://doi.org/10.3233/SHTI230039
[AQ15]
[AQ16]
[AQ17]
12 Citation: Blockchain in Healthcare Today 2026, 8: 455 - https://doi.org/10.30953/bhty.v8.455
(page number not for citation purpose)
A. Sharma et al.
29. Kumar R, Marchang N, Tripathi R. Distributed off-chain storage of
patient diagnostic reports in healthcare system using IPFS and blockchain
COMSNETS. IEEE, 2020. p. 1–5.
30. Jayadev V, Moradpoor N, Petrovski A. Assessing the performance of
ethereum and hyperledger fabric under DDoS attacks for cyber-physical
systems. In: Proceedings of the 19th international conference on
availability, reliability and security. 2024. p. 1–6.
31. Battisti JHF, Batista VE, Koslovski GP, Pillon MA, Miers CC,
Marques MA, et al. Performance analysis of the Raft consensus algorithm
on Hyperledger Fabric and Ethereum on the cloud. In: 2023
IEEE. 2023. p. 155–60.
32. Pradhan NR, Singh AP, Verma S, Kavita, Kaur N, Roy DS, et al.
A novel blockchain-based healthcare system design and performance
benchmarking on a multi-hosted testbed. Sensors. 2022;22(9):
3449–69. https://doi.org/10.3390/s22093449
33. Capocasale V, Gotta D, Perboli G. Comparative analysis of permissioned
blockchain frameworks for industrial applications. Blockchain
Res Appl. 2023;4(1). https://doi.org/10.1016/j.bcra.2022.100113
34. Khan MM, Khan FS, Nadeem M, Khan TH. Scalability and efficiency
analysis of hyperledger fabric and private ethereum in smart
contract execution. Computers. 2025;14(4):132–66. https://doi.org/
10.3390/computers14040132
35. Yuan F, Huang X, Zheng L, Wang L, Wang Y. The evolution and
optimization strategies of a PBFT consensus algorithm for consortium
blockchains. Information. 2025;16(4):268–309. https://doi.
org/10.3390/info16040268
36. Ucbas Y, Eleyan A, Hammoudeh M, Alohaly M. Performance and
scalability analysis of ethereum and Hyperledger Fabric. IEEE Access.
2023;11(3):67156–67. https://doi.org/10.1109/ACCESS.2023.3291618
37. Díaz Á, Kaschel H. Scalable electronic health record management
system using a dual-channel blockchain hyperledger fabric. Systems.
2023;11(7):346–69. https://doi.org/10.3390/systems11070346
38. Kumar Kaushal R, Kumar N, Flammini F. Enhancing data integrity
in higher education: a blockchain-based student complaint system using Hyperledger fabric. Int J Comput Digit Syst. 2024;16(1):
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