A Secure And Interoperable Blockchain-Based Electronic Health Record System With Ai-Driven Analytics For Healthcare 4.0
Keywords:
Blockchain, Electronic Health Records, Healthcare 4.0, Hyperledger Fabric, Smart Contracts, HL7 FHIR, IoMT, Differential Privacy, Federated LearningAbstract
The transition to healthcare 4.0 characterised by cyber-physical integration, Internet of Medical Things (IoMT), and AI-augmented clinical decision support demands an electronic health record (EHR) infrastructure that is simultaneously secure, interoperable, patient-centric, and auditable. Existing centralised EHR systems suffer from data silos, single-point-of-failure vulnerabilities, and inadequate patient consent management, collectively undermining trust and regulatory compliance. This paper presents a Blockchain-Based EHR System (BC-EHR-H4) that integrates Hyperledger Fabric 2.5 with an AI analytics layer, HL7 FHIR R4 interoperability standards, and IPFS-based encrypted off-chain storage. The proposed system achieved 97.3% unauthorised access blocking, 1,240 transactions per second (TPS), and a record retrieval latency of 0.18 seconds—improvements of 54.3%, 226.3%, and 95.3% respectively over legacy EHR baselines. Five smart contract types were deployed and validated across 4,640 test cases with a composite pass rate of 99.1%. The AI clinical NLP layer demonstrated 91.7% entity extraction accuracy on de-identified clinical notes. Statistical significance was confirmed across all primary metrics (p < 0.001, n = 50,000 simulated transactions). The framework establishes a deployable blueprint for national-scale Healthcare 4.0 EHR infrastructure.
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