Hyperledger Fabric-Based Blockchain Framework for Secure and Interoperable Healthcare Record Management

Abstract

Patient mobility and specialized healthcare services have increased the issues associated with managing a distributed electronic health record. Traditional electronic health records systems lack the robustness for confidentiality, integrity, or data interoperability even with the support of standards like Fast Healthcare Interoperability Resources and Health Level 7. Most data- sharing methods nowadays are push, pull, and view, which normally give poor security and standard audit trails that may offer potential dangers of data shattering or unauthorized access. This paper introduces a decentralized healthcare record solution utilizing Hyperledger Fabric, a permissioned blockchain framework, to address those issues. The proposed system would leverage the secure and non-modifiable storage of the blockchain while enhancing interoperability among healthcare providers as well as protecting patient anonymity through the use of smart contracts and controlled access. Hyperledger Fabric\'s architecture, built on the idea of trust among network members, does not require centralized surveillance but instead is supported through Certificate Authorities and Membership Service Providers. This decentralization decreases the cost of the resources and ensures integrity, giving patients more control of their medical information

Introduction

The healthcare sector faces increasing complexity in managing and sharing Electronic Health Records (EHRs) due to patient mobility and specialized services. Current EHR systems rely on centralized databases and standards like FHIR and HL7, which inadequately address data security, privacy, and interoperability. These traditional systems are vulnerable to unauthorized access, weak audit trails, and data fragmentation.

Blockchain technology, particularly Hyperledger Fabric (HLF), offers a promising solution by providing a secure, decentralized, and permissioned framework that enhances trust, data integrity, privacy, and interoperability among healthcare providers. HLF uses Certificate Authorities (CAs) and Membership Service Providers (MSPs) to control access, ensuring that only authorized users can access sensitive medical data. It supports immutable transaction ledgers and smart contracts (chaincode) to enforce fine-grained access controls and automate data sharing policies.

The proposed system models hospitals as organizations within the HLF network, treating patient data as digital assets stored on the blockchain while maintaining references in external databases for scalability. It uses modular components like Fabric SDK, CAs, MSPs, and smart contracts to manage identities, permissions, and secure data exchange.

Security is reinforced through encryption, private data collections, and role-based access controls, allowing patients to grant or revoke access to their records. The system supports interoperability, enabling efficient and secure information exchange across multiple hospitals.

The methodology includes network configuration with Docker containers, an application layer with RESTful APIs, and detailed workflows for patient, doctor, and admin roles. The architecture leverages CouchDB for flexible data storage and MongoDB for credential management, ensuring a secure, transparent, and interoperable healthcare record system based on Hyperledger Fabric.

Conclusion

This work shows the robustness of Hyperledger Fabric (HLF) for managing Electronic Health Records (EHR) on blockchain in a decentralized healthcare ecosystem. With HLF features including customizable policies, smart contracts (chaincode), and secure identity management through Certificate Authorities (CAs) and Membership Service Providers (MSPs), it is assuredly and meticulously secured the patient records. HLF provides hospitals’ facilities with transparency and seamless interoperability among various hospital organizations without the need for any central oversight. By creating this interoperability, healthcare providers can easily access comprehensive patient histories improving decision making and improving patient care outcomes. In addition, not having to keep physical medical records saves patients from having to physically carry around records. Based on this, we can argue that Hyperledger Fabric comes with an efficient and secure solution to managing medical records on the downside of traditional EHR systems in terms of security, privacy and interoperation. This research shows the potential of HLF to replace current practices for healthcare record management with an improved, more efficient, more secure system, enabling a more patient centric healthcare environment.

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Copyright

Copyright © 2025 Aniket Deo, Utkarsh Roy, Sharukhali Syed, Akhilesh Singh. 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.