Blockchain-Based Healthcare Data Interoperability Platform

Abstract

The rapid proliferation of digital health records has accentuated critical challenges in secure, scalable, and interoperable medical data exchange across heterogeneous healthcare institutions. Conventional centralized architectures exhibit fundamental vulnerabilities including single points of failure, susceptibility to data breaches, unauthorized access, and irreversible data tampering — all of which critically undermine patient privacy and clinical data integrity. This paper proposes a novel, decentralized blockchain-based healthcare data interoperability platform that synergistically integrates the InterPlanetary File System (IPFS) with Ethereum smart contracts to establish a robust, patient-centric ecosystem for secure medical data management. The framework incorporates Health Level Seven (HL7) standards, specifically Fast Healthcare Interoperability Resources (FHIR) R4, to ensure standardized exchange of Electronic Health Records (EHRs). Patient records are encrypted using AES-256-GCM prior to IPFS storage, while cryptographic hash values anchored on the Ethereum blockchain ensure data integrity and immutability. Role-based smart contracts enforce patient-centric access control with real-time grant and revocation. Experimental evaluations demonstrate superior transparency, integrity, and interoperability relative to conventional centralized healthcare systems across all measured performance dimensions.

Introduction

This text describes a blockchain-based healthcare data interoperability system designed to solve major problems in modern digital healthcare.

Healthcare systems today rely heavily on Electronic Health Records (EHRs), telemedicine, and AI tools, but they suffer from serious issues such as poor interoperability between hospitals, fragmented patient records, and weak data sharing across institutions. Centralized storage systems also create major security risks, as shown by large-scale data breaches and ransomware attacks. In addition, patients often lack control or visibility over who accesses their medical data, raising concerns about privacy and consent.

To address these challenges, the paper proposes a decentralized healthcare platform using blockchain technology combined with IPFS storage, Ethereum smart contracts, and HL7 FHIR R4 standards. The system aims to make medical data secure, interoperable, patient-controlled, and tamper-proof.

Key components include:

• Client-side AES-256 encryption to secure patient data before storage
• IPFS for decentralized, distributed file storage
• Ethereum smart contracts for access control, identity management, and audit logs
• HL7 FHIR APIs to ensure standardized communication between healthcare systems
• React-based frontend dashboards for patients, doctors, and administrators

The system architecture is layered, ensuring that each stage (encryption, storage, blockchain logging, and access control) is independent and secure. Patients authenticate using blockchain wallets (MetaMask), and all access to records is governed by smart contracts with time-limited permissions.

The main objectives are to improve interoperability between hospitals, protect patient privacy through encryption, enable patient-controlled access, maintain immutable audit trails for compliance, and support scalable nationwide deployment.

Conclusion

This paper presented a comprehensive, decentralized blockchain-based healthcare data interoperability platform that integrates IPFS off-chain storage, Ethereum smart contracts, AES-256-GCM client-side encryption, and HL7 FHIR R4 standards within a unified, production- oriented architecture. The proposed system fundamentally addresses the four critical limitations of conventional centralized healthcare architectures identified in the problem statement: interoperability deficit, data siloing, security vulnerabilities, and patient agency erosion. By combining cryptographic immutability from blockchain technology with the storage scalability of IPFS, the programmability of Ethereum smart contracts, and the clinical interoperability of HL7 FHIR R4, the platform achieves a level of security, transparency, and patient empowerment that no existing single-technology solution can match. Experimental evaluation on a representative 4.2 GB multi-institutional synthetic dataset confirmed the platform\'s strong performance profile: 100% tamper detection, 99.97% access control accuracy, 98.6% FHIR R4 compliance, 3.2-second average transaction confirmation, 1.8-second average IPFS retrieval latency, and 99.8% system uptime over a 30-day evaluation period. These metrics collectively confirm the clinical viability of the proposed approach and establish a rigorous baseline for future development. Future work will pursue three primary research directions: (1) Layer-2 Ethereum integration to reduce transaction gas costs and confirmation latency, enabling economically viable per-record on-chain anchoring at national healthcare scale; (2) Federated machine learning integration for AI-assisted disease prediction and clinical decision support without compromising patient data privacy through differential privacy and secure aggregation techniques; and (3) Cross-chain interoperability protocols to enable seamless connectivity across blockchain networks operated by different national healthcare authorities, supporting global health information exchange in the era of increasing healthcare globalization.

References

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Copyright

Copyright © 2026 Mrs. P. Nithya, Kiruthika M, Janani T, Ashwini S, Charumathi M. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.