Jing Yang, Abdullah Ayub Khan, Xiaoteng Yang, Diva Kurnianingtyas, Muh Arif Rahman, Por Lip Yee, Thippa Reddy Gadekallu
Blockchain technology has emerged as a foundational enabler for trusted data management, offering infrastructural security and integrity across industries. In e-healthcare, however, reliability, scalability, privacy, and cross-domain interoperability remain persistent challenges. Fragmented data silos, security vulnerabilities, and the absence of standardized processes hinder seamless operations and affect both consumers and providers. Motivated by the toward 6G networks and zero-touch operation, this paper presents a standardized blockchain-enabled framework for e-healthcare interoperability built on Hyperledger Sawtooth. The framework preserves both patient-centric and provider-centric data integrity through a hierarchical model and protects privacy using cryptographic hashing and access control policies together with consensus-backed validation. It integrates NuCypher Threshold Hash Re-Encryption for policy-based key management, the InterPlanetary File System (IPFS) for large medical objects, and a customized Proof of Elapsed Time (PoET) consensus for efficient transaction validation. The standardized interfaces of the proposed framework adhere to the HL7 FHIR specification for healthcare data exchange and the IEEE P2418.1 guideline for blockchain interoperability, ensuring syntactic and semantic consistency across heterogeneous systems. In experiments, the framework connected 30 nodes with a data transmission time of 2.5 seconds per node and enabled 150 nodes to complete transmission within 41 seconds. Compared with existing Hyperledger-based implementations, it reduced latency from 1.87% to 3.83% and increased throughput from 1.77% to 3.09% while lowering computational power consumption from 1.43% to 3.36%. The customized PoET achieved 267 protocol runs over 40,000 seconds, supporting efficient block validation. Security evaluation shows that NuCypher Threshold Hash Re-Encryption protected 261 transactions over the same period, reinforcing data privacy and integrity. These results indicate that the framework enhances e-healthcare interoperability while reducing computational overhead and ensuring secure and scalable data exchange. The approach contributes to reliable services that can operate with minimal manual intervention under zero-touch principles. By emphasizing standardized interfaces compliant with HL7 FHIR, IEEE P2418.1, and privacy regulations such as HIPAA and GDPR, the framework is positioned for 6G-ready healthcare ecosystems that demand accessibility, security, and interoperability. © 2017 IEEE.
Universiti Malaya, Center of Research for Cyber Security and Network (CSNET), Faculty of Computer Science and Information Technology, Kuala Lumpur, 50603, Malaysia; Bahria University, Karachi Campus, Department of Computer Science, Karachi, 75260, Pakistan; Xidian University, School of Telecommunications Engineering, Xi’an, 710071, China; Universitas Brawijaya, Faculty of Computer Science, Department of Informatics Engineering, Malang, 65145, Indonesia; Zhejiang AF University, College of Mathematics and Computer Science, Hangzhou, 311300, China; Lovely Professional University, Division of Research and Development, Phagwara, 144001, India
