Integrity of E-Health Record Ensured With Context-Based Merkle Tree Through Temporal Shadow in Blockchain

The patient's health record is sensitive and confidential information. The sharing of health information is a first venture to make health services more productive and improve the quality of healthcare services. Decentralized online ledgers with blockchain-based platforms were already proposed and in use to address the interoperability and privacy issues. However, other challenges remain, in particular, scalability, usability, and accessibility as core technical challenges. The paper focuses on ensuring the integrity of the health record with context-based Merkle tree (CBMT) through temporal shadow. In this system, two ledgers were used to ensure the integrity of eHealth records like general public ledger (GPL) and personalized micro ledger (PML). The context-based Merkle tree (CBMT) is used to aggregates all the transactions at a particular time. The context means it depends on time, location, and identity. This is ensured without the help of a third party.