Patient centric pre-transaction signature verification assisted smart contract based blockchain for electronic healthcare records

The last few years have witnessed exponential rise in online digital data for real-time communication, storage, and query-driven processing. It has broadened the horizon for decentralized and ad-hoc digital data used for swift decision making. Nowadays, Electronic healthcare (e-Healthcare) is one of the most demanding industries for telemedicine and Electronic Healthcare Record (EHR) communication purposes. However, ensuring data-security over uncertain channels has remained challenge. To alleviate data-security challenges and enable preserved and immutable data exchange, blockchain technology has been found potential. Despite such significances, most of the existing EHR -oriented blockchain frameworks are developed permissionless with hospital as central unit with almost all access rights. This as a result has demotivated patients due to private data breaches and fake-insurance claims. Considering this limitation developing a patient-centric secure blockchain framework was inevitable. Recently, securing EHR data is a hot research topic and the existing works used varied schemes to enhance the security and privacy of EHR with minimum cost. But the existing studies faces several critical issues like computational complexity, higher processing time, data leakage, sensitive to different attacks, scalability problem etc. The aforementioned issues in the existing studies leads the system as reduced confidentiality and data insecurity. Thus, to overcome such issues, this paper proposes a highly robust pre-transaction signature verification assisted patient-centric multi-stakeholder blockchain model. The proposed blockchain framework focused on multi-stakeholder scalability as well as interoperability aspects while guaranteeing attack-resilience. It was designed over Ethereum armored with blockchain manager (BCM) and smart contract components, where cloud-based interplanetary file system was developed to support decentralized data-storage. It employed a gateway component to perform user’s signature verification to thwart away intruders. Once verifying the signature, BCM triggers user’s request to the smart contract that verifies user details and allied role, right and access (RRA) policies. In sync with RRA policies for the requesting node, BCM allows user (patients and doctors) to perform data upload, view and sharing. To share the patient data, the proposed method triggers a signature request phase in which the doctor requests intended patient for signature and receiving the signature-acknowledgement it performs unabstracted data view and sharing and alleviates any probability of single-point-failure. The proposed blockchain framework provides a unified solution with improved flexibility, availability, decentralized access, identity management, user authentication, patient centric permissioned control and data security that makes it suitable for real-time purposes. © 2023, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.