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<p>In recent years, blockchain technology has emerged as a promising solution for securing electronic health records (EHRs) while preserving patient privacy. Traditional e-health systems facilitate EHR sharing among healthcare providers but also introduce significant privacy risks, such as unauthorized access and data breaches. Blockchain, when integrated with privacy-preserving techniques, enhances transparency, integrity, and availability in EHR management. Smart contracts further strengthen security by enabling automated authentication and access control. This paper provides a comprehensive survey of blockchain-based access control frameworks in healthcare, categorizing them into permissioned and permissionless approaches. It also explores cryptographic privacy-preserving techniques designed to mitigate privacy risks. Additionally, blockchain platforms and consensus protocols commonly used in these frameworks are analyzed. The methodology follows a structured paper selection process, leading to the final inclusion of 45 research papers focusing on blockchain-based privacy preservation and access control in healthcare. Furthermore, it presents real-world case studies that illustrate the practical implementation of blockchain-based access control in healthcare settings, highlighting their strengths and challenges. Finally, it identifies privacy-related challenges, open research issues, and future directions to guide further research in this evolving domain.</p>

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Blockchain-based access control and privacy preservation in healthcare: a comprehensive survey

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年8月19日

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  • Ahmed M. Tawfik,
  • Ayman Al-Ahwal,
  • Adly S. Tag Eldien,
  • Hala H. Zayed

摘要

In recent years, blockchain technology has emerged as a promising solution for securing electronic health records (EHRs) while preserving patient privacy. Traditional e-health systems facilitate EHR sharing among healthcare providers but also introduce significant privacy risks, such as unauthorized access and data breaches. Blockchain, when integrated with privacy-preserving techniques, enhances transparency, integrity, and availability in EHR management. Smart contracts further strengthen security by enabling automated authentication and access control. This paper provides a comprehensive survey of blockchain-based access control frameworks in healthcare, categorizing them into permissioned and permissionless approaches. It also explores cryptographic privacy-preserving techniques designed to mitigate privacy risks. Additionally, blockchain platforms and consensus protocols commonly used in these frameworks are analyzed. The methodology follows a structured paper selection process, leading to the final inclusion of 45 research papers focusing on blockchain-based privacy preservation and access control in healthcare. Furthermore, it presents real-world case studies that illustrate the practical implementation of blockchain-based access control in healthcare settings, highlighting their strengths and challenges. Finally, it identifies privacy-related challenges, open research issues, and future directions to guide further research in this evolving domain.