Zero-knowledge proofs for anonymous authentication of patients on public and private blockchains

Abstract

In recent years, the healthcare sector has been increasingly challenged in securing patient identities and medical records on blockchain due to rising privacy demands and strict regulatory requirements. Although advanced techniques like self-sovereign identity and zero-knowledge proofs (ZKPs) show promise, these solutions fail to limit unwarranted patient data disclosure effectively. In this paper, we propose a ZKP-based solution that combines STARKs and anonymous credentials to enable anonymous authentication and enhance privacy across both public and private blockchains. Leveraging transparent ZKP schemes and anonymous credentials, our approach ensures unlinkability by preventing the correlation of multiple patient interactions. We present sequence diagrams of real-world interactions, detailed algorithms for on- and off-chain computations, and implement the system on Ethereum and Starknet blockchains. We present a rigorous evaluation of the proposed solution, encompassing smart contract testing on Starknet networks, transaction cost analysis, performance benchmarking, scalability assessment, and static security auditing. The results demonstrate consistent and economically viable transaction costs, millisecond-level execution times for credential issuance, presentation generation, and verification, linear scalability with increasing claim count and size. We compare our solution with state-of-the-art ZKP-based identity systems to demonstrate its superiority. We further discuss its broader applicability beyond healthcare, including domains such as finance, education, and supply chain management. We make the smart contract codes publicly available on GitHub.