Decentralized Electronic Health Record Management with Semantic-Aware Hierarchical Encryption

Firdaus Putra Kurniyanto; Bagus Jati Santoso

doi:10.59395/ijadis.v6i2.1413

Authors

Firdaus Putra Kurniyanto Department of Informatics, Institut Teknologi Sepuluh Nopember, Surabaya, Indonesia
Bagus Jati Santoso Department of Informatics, Institut Teknologi Sepuluh Nopember, Surabaya, Indonesia

DOI:

https://doi.org/10.59395/ijadis.v6i2.1413

Keywords:

blockchain, electronic health record, hierarchical encryption, medical data security, semantic encryption

Abstract

The rising incidence of cyberattacks targeting electronic health records (EHR) in Indonesia necessitates a robust and context-aware data protection scheme. This paper proposes a decentralised EHR management system that leverages blockchain, IPFS, and a novel Semantic-Aware Hierarchical Encryption (SAHE) algorithm. SAHE enables multi-level access control based on data sensitivity semantics, ensuring privacy while maintaining usability for medical professionals. The system was implemented in a prototype environment and evaluated through stress testing with up to 200 users, achieving an average CPU usage of 55% and a memory consumption of 80.2 MB. Differential cryptanalysis demonstrated a strong avalanche effect (~50%), with no vulnerabilities found via OWASP ZAP scanning. This architecture offers a promising solution for privacy-preserving, patient-controlled EHR systems, particularly in regions with limited infrastructure.

1142 686

Downloads

Download data is not yet available.

References

[1] R. Sendelj and I. Ognjanovic, “Cybersecurity Challenges in Healthcare,” in Studies in Health Technology and Informatics, IOS Press BV, Oct. 2022, pp. 190–202. doi: 10.3233/SHTI220951. DOI: https://doi.org/10.3233/SHTI220951

[2] I. C. A. Pilares, S. Azam, S. Akbulut, M. Jonkman, and B. Shanmugam, “Addressing the Challenges of Electronic Health Records Using Blockchain and IPFS,” Sensors, vol. 22, no. 11, Jun. 2022, doi: 10.3390/s22114032. DOI: https://doi.org/10.3390/s22114032

[3] Gaganjeet Singh Reen, Manasi Mohandas, and S. Venkatesan, “Decentralized Patient Centric e- Health Record Management System using Blockchain and IPFS,” IEEE, 2019. doi: 10.1109/CICT48419.2019.9066212. DOI: https://doi.org/10.1109/CICT48419.2019.9066212

[4] X. Qu, Z. Yang, Z. Chen, and G. Sun, “A consent-aware electronic medical records sharing method based on blockchain,” Comput Stand Interfaces, vol. 92, Mar. 2025, doi: 10.1016/j.csi.2024.103902. DOI: https://doi.org/10.1016/j.csi.2024.103902

[5] R. P. Puneeth and G. Parthasarathy, “A cross-chain-based approach for secure data sharing and interoperability in electronic health records using blockchain technology,” Computers and Electrical Engineering, vol. 120, Dec. 2024, doi: 10.1016/j.compeleceng.2024.109676. DOI: https://doi.org/10.1016/j.compeleceng.2024.109676

[6] H. Arshad, C. Johansen, O. Owe, P. Picazo-Sanchez, and G. Schneider, “Semantic Attribute-Based Encryption: A framework for combining ABE schemes with semantic technologies,” Inf Sci (N Y), vol. 616, pp. 558–576, Nov. 2022, doi: 10.1016/j.ins.2022.10.132. DOI: https://doi.org/10.1016/j.ins.2022.10.132

[7] S. Ding, C. Li, and H. Li, “A Novel Efficient Pairing-Free CP-ABE Based on Elliptic Curve Cryptography for IoT,” IEEE Access, vol. 6, pp. 27336–27345, May 2018, doi: 10.1109/ACCESS.2018.2836350. DOI: https://doi.org/10.1109/ACCESS.2018.2836350

[8] Y. F. Yao, H. Y. Chen, Y. Gao, K. Wang, and H. Y. Yu, “A decentralized multi-authority CP-ABE scheme from LWE,” Journal of Information Security and Applications, vol. 82, May 2024, doi: 10.1016/j.jisa.2024.103752. DOI: https://doi.org/10.1016/j.jisa.2024.103752

[9] S. Liu, J. Yu, L. Chen, and B. Chai, “Blockchain-Assisted Comprehensive Key Management in CP-ABE for Cloud-Stored Data,” IEEE Transactions on Network and Service Management, vol. 20, no. 2, pp. 1745–1758, Jun. 2023, doi: 10.1109/TNSM.2022.3185237. DOI: https://doi.org/10.1109/TNSM.2022.3185237

[10] M. Xiao, H. Li, Q. Huang, S. Yu, and W. Susilo, “Attribute-Based Hierarchical Access Control With Extendable Policy,” IEEE Transactions on Information Forensics and Security, vol. 17, pp. 1868–1883, 2022, doi: 10.1109/TIFS.2022.3173412. DOI: https://doi.org/10.1109/TIFS.2022.3173412

[11] X. Yang and Y. Tao, “FUR-HABE:A Hierarchical CP-ABE Scheme with Traceable Fine-grained User Revocation for Cloud Storage,” May 22, 2024. doi: 10.21203/rs.3.rs-4410803/v1. DOI: https://doi.org/10.21203/rs.3.rs-4410803/v1

[12] G. Yang, Peixuan Li, Y. Xin, Y. He, C. Wang, and X. Chen, “An efficient hierarchical attribute-based encryption scheme with cross-domain data sharing,” Computer Networks, vol. 255, Dec. 2024, doi: 10.1016/j.comnet.2024.110863. DOI: https://doi.org/10.1016/j.comnet.2024.110863

[13] N. A. Van Nguyen and M. T. T. Pham, “Quantum-safe Anonymous Hierarchical Identity-Based Encryption with Traceable Identities,” Comput Stand Interfaces, vol. 84, Mar. 2023, doi: 10.1016/j.csi.2022.103695. DOI: https://doi.org/10.1016/j.csi.2022.103695

[14] K. Emura, A. Takayasu, and Y. Watanabe, “Efficient identity-based encryption with Hierarchical key-insulation from HIBE,” Des Codes Cryptogr, vol. 89, no. 10, pp. 2397–2431, Oct. 2021, doi: 10.1007/s10623-021-00926-z. DOI: https://doi.org/10.1007/s10623-021-00926-z

[15] Z. Y. Liu, M. Mambo, R. Tso, and Y. F. Tseng, “Anonymous hierarchical identity-based encryption with delegated traceability for cloud-based data sharing systems,” Comput Stand Interfaces, vol. 89, Apr. 2024, doi: 10.1016/j.csi.2023.103817. DOI: https://doi.org/10.1016/j.csi.2023.103817

[16] Z. Ying, M. Liu, S. Kong, S. Xu, and J. Xiong, “Anonymous Hierarchical Identity-based Encryption EHR Sharing Mechanism Based on SM9,” in Proceedings - 2022 IEEE 21st International Conference on Ubiquitous Computing and Communications, IUCC-CIT-DSCI-SmartCNS 2022, Institute of Electrical and Electronics Engineers Inc., 2022, pp. 17–22. doi: 10.1109/IUCC-CIT-DSCI-SmartCNS57392.2022.00017. DOI: https://doi.org/10.1109/IUCC-CIT-DSCI-SmartCNS57392.2022.00017

[17] C. Li et al., “Hierarchical and non-monotonic key-policy attribute-based encryption and its application,” Inf Sci (N Y), vol. 611, pp. 591–627, Sep. 2022, doi: 10.1016/j.ins.2022.08.014. DOI: https://doi.org/10.1016/j.ins.2022.08.014

[18] K. Lee, “Revocable hierarchical identity-based encryption with adaptive security,” Theor Comput Sci, vol. 880, pp. 37–68, Aug. 2021, doi: 10.1016/j.tcs.2021.05.034. DOI: https://doi.org/10.1016/j.tcs.2021.05.034

[19] Q. Qin et al., “Securing Semantic Communications with Physical-Layer Semantic Encryption and Obfuscation,” in IEEE International Conference on Communications, Institute of Electrical and Electronics Engineers Inc., 2023, pp. 5608–5613. doi: 10.1109/ICC45041.2023.10279807. DOI: https://doi.org/10.1109/ICC45041.2023.10279807

[20] G. Liu, G. Yang, S. Bai, Q. Zhou, and H. Dai, “FSSE: An Effective Fuzzy Semantic Searchable Encryption Scheme over Encrypted Cloud Data,” IEEE Access, vol. 8, pp. 71893–71906, 2020, doi: 10.1109/ACCESS.2020.2966367. DOI: https://doi.org/10.1109/ACCESS.2020.2966367

[21] M. I. Khalid et al., “A Comprehensive Survey on Blockchain-Based Decentralized Storage Networks,” IEEE Access, vol. 11, pp. 10995–11015, 2023, doi: 10.1109/ACCESS.2023.3240237. DOI: https://doi.org/10.1109/ACCESS.2023.3240237

[22] I. Vakilinia, W. Wang, and J. Xin, “An Incentive-Compatible Mechanism for Decentralized Storage Network,” IEEE Trans Netw Sci Eng, vol. 10, no. 4, pp. 2294–2306, Jul. 2023, doi: 10.1109/TNSE.2023.3245326. DOI: https://doi.org/10.1109/TNSE.2023.3245326

[23] L. Meng and B. Sun, “Research on Decentralized Storage Based on a Blockchain,” Sustainability (Switzerland), vol. 14, no. 20, Oct. 2022, doi: 10.3390/su142013060. DOI: https://doi.org/10.3390/su142013060

[24] M. Kuliha and S. Verma, “Secure internet of medical things based electronic health records scheme in trust decentralized loop federated learning consensus blockchain,” International Journal of Intelligent Networks, vol. 5, pp. 161–174, Jan. 2024, doi: 10.1016/j.ijin.2024.03.001. DOI: https://doi.org/10.1016/j.ijin.2024.03.001

[25] A. Kumari, S. Bhaskar, S. Patil, and K. Parmar, “Decentralized and Multi-Authority based Public Key Infrastructure for Sharing Electronic Health Records,” in Procedia Computer Science, Elsevier B.V., 2023, pp. 44–54. doi: 10.1016/j.procs.2023.12.059. DOI: https://doi.org/10.1016/j.procs.2023.12.059

[26] K. Shuaib, J. Abdella, F. Sallabi, and M. A. Serhani, “Secure decentralized electronic health records sharing system based on blockchains,” Journal of King Saud University - Computer and Information Sciences, vol. 34, no. 8, pp. 5045–5058, Sep. 2022, doi: 10.1016/j.jksuci.2021.05.002. DOI: https://doi.org/10.1016/j.jksuci.2021.05.002

[27] S. Ballal, Y. Chandre, R. Pise, B. Sonare, and S. Patil, “Blockchain-Based Decentralized Platform for Electronic Health Records Management,” in 2023 IEEE International Conference on Blockchain and Distributed Systems Security, ICBDS 2023, Institute of Electrical and Electronics Engineers Inc., 2023. doi: 10.1109/ICBDS58040.2023.10346392. DOI: https://doi.org/10.1109/ICBDS58040.2023.10346392

[28] S. Singh, S. Gupta, and Indu, “MedEHR-Electronic health Record using Blockchain,” in 2023 International Conference on Computational Intelligence, Communication Technology and Networking, CICTN 2023, Institute of Electrical and Electronics Engineers Inc., 2023, pp. 58–62. doi: 10.1109/CICTN57981.2023.10141053. DOI: https://doi.org/10.1109/CICTN57981.2023.10141053

[29] D. Sentausa and D. Habsara Hareva, “Decentralize Application for Storing Personal Health Record using Ethereum Blockchain and Interplanetary File System,” in Proceedings - 2022 1st International Conference on Technology Innovation and Its Applications, ICTIIA 2022, Institute of Electrical and Electronics Engineers Inc., 2022. doi: 10.1109/ICTIIA54654.2022.9935996. DOI: https://doi.org/10.1109/ICTIIA54654.2022.9935996

[30] H. Guo, W. Li, C. Meese, and M. Nejad, “Decentralized Electronic Health Records Management via Redactable Blockchain and Revocable IPFS,” in Proceedings - 2024 IEEE/ACM Conference on Connected Health: Applications, Systems and Engineering Technologies, CHASE 2024, Institute of Electrical and Electronics Engineers Inc., 2024, pp. 167–171. doi: 10.1109/CHASE60773.2024.00028. DOI: https://doi.org/10.1109/CHASE60773.2024.00028

[31] P. Shukla, S. Thakur, S. Arora, and A. Wadhwa, “Nature-Inspired Algorithms Analysis on various Benchmark Functions using Python and Golang,” in Proceedings of 2022 1st International Conference on Informatics, ICI 2022, Institute of Electrical and Electronics Engineers Inc., 2022, pp. 226–228. doi: 10.1109/ICI53355.2022.9786911. DOI: https://doi.org/10.1109/ICI53355.2022.9786911

[32] B. Gupta, “Understanding Blockchain Technology: How It Works and What It Can Do,” Metaverse Basic and Applied Research, vol. 1, p. 18, Dec. 2022, doi: 10.56294/mr202218. DOI: https://doi.org/10.56294/mr202218

[33] P. Schwenteck, S. Zimmermann, C. Von Lengerke, J. A. Cabrera, and F. H. P. Fitzek, “Revisiting MARS: Storing Coded Packets In-Advance for IPFS,” in IEEE International Conference on Communications, Institute of Electrical and Electronics Engineers Inc., 2024, pp. 4692–4697. doi: 10.1109/ICC51166.2024.10622257. DOI: https://doi.org/10.1109/ICC51166.2024.10622257

[34] Baydaa Jaffer Al-Khafaji and Abdul Monem S Rahma, “Proposed new modification of AES algorithm for data security,” Global Journal of Engineering and Technology Advances, vol. 12, no. 3, pp. 117–122, Sep. 2022, doi: 10.30574/gjeta.2022.12.3.0165. DOI: https://doi.org/10.30574/gjeta.2022.12.3.0165

[35] William. Stallings, Cryptography and network security : principles and practice. Pearson Education Limited, 2017.

[36] W. K. Lee, H. J. Seo, S. C. Seo, and S. O. Hwang, “Efficient Implementation of AES-CTR and AES-ECB on GPUs With Applications for High-Speed FrodoKEM and Exhaustive Key Search,” IEEE Transactions on Circuits and Systems II: Express Briefs, vol. 69, no. 6, pp. 2962–2966, Jun. 2022, doi: 10.1109/TCSII.2022.3164089. DOI: https://doi.org/10.1109/TCSII.2022.3164089

[37] F. Weissbaum and T. Lugrin, “Symmetric cryptography,” in Trends in Data Protection and Encryption Technologies, Springer Nature, 2023, pp. 7–10. doi: 10.1007/978-3-031-33386-6_2. DOI: https://doi.org/10.1007/978-3-031-33386-6_2

[38] S. Wade, “Description of Image encryption Using AES-256 bits,” Int J Res Appl Sci Eng Technol, vol. 11, no. 5, pp. 7167–7171, May 2023, doi: 10.22214/ijraset.2023.53365. DOI: https://doi.org/10.22214/ijraset.2023.53365

[39] V. Mulder, A. Mermoud, V. Lenders, and B. Tellenbach, Trends in data protection and encryption technologies. Springer Nature, 2023. doi: 10.1007/978-3-031-33386-6. DOI: https://doi.org/10.1007/978-3-031-33386-6

[40] P. James, S. Laschet, S. Ramacher, and L. Torresetti, “Key Management Systems for Large-Scale Quantum Key Distribution Networks,” in ACM International Conference Proceeding Series, Association for Computing Machinery, Aug. 2023. doi: 10.1145/3600160.3605050. DOI: https://doi.org/10.1145/3600160.3605050

[41] S. Rana, F. K. Parast, B. Kelly, Y. Wang, and K. B. Kent, “A comprehensive survey of cryptography key management systems,” Journal of Information Security and Applications, vol. 78, Nov. 2023, doi: 10.1016/j.jisa.2023.103607. DOI: https://doi.org/10.1016/j.jisa.2023.103607

[42] P. C. Y. Sheu and A. Ghafoor, “Guest Editorial: Introduction to the Special Issue on Advances in Semantic Computing,” Jun. 01, 2015, IEEE Computer Society. doi: 10.1109/TETC.2015.2432332. DOI: https://doi.org/10.1109/TETC.2015.2432332

[43] Y. Y. Chan, C. Y. Khor, B. T. Khoo, J. Sen Teh, W. J. Teng, and N. Jamil, “On the resistance of new lightweight block ciphers against differential cryptanalysis,” Heliyon, vol. 9, no. 4, Apr. 2023, doi: 10.1016/j.heliyon.2023.e15257. DOI: https://doi.org/10.1016/j.heliyon.2023.e15257

[44] Z. Xu, H. Xu, L. Tan, and W. Qi, “Linear cryptanalysis of SPECK and SPARX,” Journal of Information Security and Applications, vol. 83, Jun. 2024, doi: 10.1016/j.jisa.2024.103773. DOI: https://doi.org/10.1016/j.jisa.2024.103773

[45] K. Mohamed, M. N. M. Pauzi, F. H. H. M. Ali, and S. Ariffin, “Analyse On Avalanche Effect In Cryptography Algorithm,” in Proceedings of the International Conference on Sustainable Practices, Development and Urbanisation (IConsPADU 2021), 16 November 2021, Universiti Selangor (UNISEL), Malaysia, European Publisher, Oct. 2022, pp. 610–618. doi: 10.15405/epms.2022.10.57. DOI: https://doi.org/10.15405/epms.2022.10.57