ENHANCING E-HEALTHCARE SECURITY WITH BLOCKCHAIN-BASED ACCESS CONTROL: A DECENTRALIZED APPROACH TO DATA PRIVACY AND INTEGRITY

Abstract

The extensive use of cloud-based Electronic Health Records (EHRs) has sparked serious worries about privacy, security, and access management. The necessity for a decentralized and secure solution is highlighted by the vulnerability of traditional centralized access control techniques to data breaches, unwanted access, and single points of failure. Because blockchain technology guarantees immutability, transparency, and decentralization for improved EHR security, it presents a possible substitute. This paper presents a blockchain-based access control architecture that enhances data integrity, authentication, and privacy by utilizing Smart Contracts, Proxy Re-Encryption (PRE), Attribute-Based Encryption (ABE), and Zero- Knowledge Proofs (ZKPs). Access policies are dynamically enforced by smart contracts, and fine-grained access control is guaranteed by ABE. PRE enables safe decryption rights delegation, and ZKPs allow secure authentication without disclosing private user data. To reduce blockchain storage overhead and improve scalability, off-chain storage is also incorporated. In terms of access control effectiveness, authentication success rate, privacy preservation, and scalability enhancement, performance studies reveal that the suggested model performs noticeably better than current blockchain-based EHR security approaches. With a higher authentication success rate (99.1%) and data integrity (99.5%), the framework ensures
secure data access while lowering storage overhead. For safe EHR management, this study offers a solid, scalable, and privacy-preserving system. Upcoming studies will concentrate on improving real-time performance, scalability of the blockchain, and incorporating AI-driven analytics for astute security monitoring.