Enhancing health data integrity through on-chain verification and cryptographic proofs

Abstract

The integration of blockchain technology in healthcare has gained significant attention due to its potential to address critical challenges such as data privacy, interoperability, and health record integrity. Although electronic health record (EHR) standards such as health level 7 fast healthcare interoperability resources (HL7 FHIR) and OpenEHR provide frameworks for data consistency and interoperability, concerns persist regarding the privacy and security of sensitive patient information, particularly in compliance with regulations. Existing solutions often store only hashed representations of data on blockchain nodes, making direct on-chain validation impossible and increasing the risk of invalid or malicious data entering the system. This paper introduces maximize, encrypt, prove, comply and adapt (MEPCA), a novel blockchain-based framework designed to enhance on-chain EHR data processing using cryptographic techniques. The model incorporates an innovative method to generate cryptographic proofs of data validity, enabling direct on-chain verification of hash digests. We present practical use case implementations and perform a technical evaluation of a fully on-chain MEPCA approach within the HL7 FHIR ecosystem. Our analysis examines the processing time of the hash proof algorithm, comparing it with existing methods based on transactions per second (TPS), latency, and computational efficiency in a multi-host network environment. The experimental results show that the MEPCA framework achieves a maximum of 83.2 TPS, with a latency below 1.5 s and the hash-proof computation taking 1.6 ms. Our primary contribution is to demonstrate viable healthcare scenarios for a fully on-chain approach, providing strategic guidance for the adoption of decentralized solutions in healthcare through technical evaluation and real-world applications.