Interoperable blockchain network for healthcare data using Fabric, Ethereum and IPFS

Abstract

Electronic Health Records (EHR) is the main core of modern healthcare, but interoperability across different blockchain platforms is a key challenge. This work proposes a cross-chain middleware architecture, which facilitates secure and real-time synchronization of EHR data between Hyperledger Fabric (private blockchain) and Ethereum Sepolia Testnet (public blockchain). The framework integrates AES-256 encryption and Inter Planetary File System (IPFS) as decentralized storage to enhance patient privacy. To facilitate interoperability across the blockchains the research introduces a smart middleware layer. This layer autonomously monitors the blockchain events, processes encrypted CIDs, enforces real time cross chain consistency and smart contract-based access control. The experimental evaluation shows that proposed framework achieves low synchronization times (< 195 ms), low gas and latency costs, small encryption overhead (< 4–5 KB), robust file storage and retrieval through IPFS. Such positive evaluations with scalable and real-time deployment, sets the foundation of patient centric interoperable healthcare ecosystems.