A DECENTRALIZED AND TAMPER-PROOF BLOCKCHAIN ARCHITECTURE FOR SECURE ELECTRONIC HEALTH RECORD MANAGEMENT IN HEALTHCARE ENVIRONMENTS

Abstract

The rapid digitization of healthcare systems has significantly increased the exposure of sensitive medical data to cyber threats. This paper presents a comprehensive and secure framework for protecting medical information by integrating hybrid cryptography, steganography, and blockchain technology. The proposed system utilizes Advanced Encryption Standard in Galois/Counter Mode (AES-GCM) and the SM4 block cipher to implement a dual-layer encryption mechanism that ensures both confidentiality and data integrity [2], [3]. Encrypted data is further concealed within carrier images using Least Significant Bit (LSB) steganography, preventing detection of sensitive information during transmission [4]. Additionally, a custom blockchain is employed to maintain an immutable audit trail of all system activities, enhancing transparency and accountability [5]. The system is implemented using Python, Flask, SQLite, and supporting libraries, and is evaluated based on performance, security, and robustness. Experimental results demonstrate strong resistance to tampering, efficient processing time, and high imperceptibility in steganographic embedding, making the system suitable for secure healthcare applications.