{"ID":2838731,"CreatedAt":"2026-06-01T04:54:23.091178241Z","UpdatedAt":"2026-06-01T04:54:23.091178241Z","DeletedAt":null,"paper_url":"https://arxiv.org/abs/2511.17464","arxiv_id":"2511.17464","title":"A Patient-Centric Blockchain Framework for Secure Electronic Health Record Management: Decoupling Data Storage from Access Control","abstract":"We present a patient-centric architecture for electronic health record (EHR) sharing that separates content storage from authorization and audit. Encrypted FHIR resources are stored off-chain; a public blockchain records only cryptographic commitments and patient-signed, time-bounded permissions using EIP-712. Keys are distributed via public-key wrapping, enabling storage providers to remain honest-but-curious without risking confidentiality. We formalize security goals (confidentiality, integrity, cryptographically attributable authorization, and auditability of authorization events) and provide a Solidity reference implementation deployed as single-patient contracts. On-chain costs for permission grants average 78,000 gas (L1), and end-to-end access latency for 1 MB records is 0.7--1.4s (mean values for S3 and IPFS respectively), dominated by storage retrieval. Layer-2 deployment reduces gas usage by 10--13x, though data availability charges dominate actual costs. We discuss metadata privacy, key registry requirements, and regulatory considerations (HIPAA/GDPR), demonstrating a practical route to restoring patient control while preserving security properties required for sensitive clinical data.","short_abstract":"We present a patient-centric architecture for electronic health record (EHR) sharing that separates content storage from authorization and audit. Encrypted FHIR resources are stored off-chain; a public blockchain records only cryptographic commitments and patient-signed, time-bounded permissions using EIP-712. Keys are...","url_abs":"https://arxiv.org/abs/2511.17464","url_pdf":"https://arxiv.org/pdf/2511.17464v1","authors":"[\"Tanzim Hossain Romel\",\"Kawshik Kumar Paul\",\"Tanberul Islam Ruhan\",\"Maisha Rahman Mim\",\"Abu Sayed Md. Latiful Hoque\"]","published":"2025-11-21T18:09:25Z","proceeding":"cs.CR","tasks":"[\"cs.CR\",\"cs.SE\",\"eess.SY\"]","methods":"[]","has_code":false}