Design and Evaluation of a Blockchain–IPFS Framework for Secure Electronic Health Records in IoT-Enabled Healthcare

Abstract

This study introduces a blockchain-based framework designed to strengthen the privacy, security, and verifiability of Electronic Health Records (EHRs) within Internet of Things (IoT)-driven healthcare environments. The proposed hybrid model combines blockchain for tamper-proof data logging, the InterPlanetary File System (IPFS) for scalable and efficient off-chain storage, and advanced cryptographic mechanisms such as smart contracts and Zero-Knowledge Proofs (ZKPs) to enable secure access management. Within this architecture, patients retain ownership and control of their encrypted medical data, while healthcare providers obtain permissioned access verified through ZKP-enabled smart contracts. Comparative evaluation reveals notable performance gains—92% enhancement in data integrity, 87% improvement in privacy protection, and a 30–35% reduction in unauthorized access—relative to conventional centralized EHR systems. Additionally, the framework demonstrates over 40% higher auditability and trust among healthcare entities. Remaining research challenges include achieving cross-platform interoperability, ensuring regulatory compliance, and integrating advanced privacy-preserving technologies such as federated learning and homomorphic encryption. Future work aims to optimize consensus mechanisms and align the framework with HL7 FHIR standards to facilitate scalability and real-world deployment.