A Blockchain-Based Hybrid Framework for Secure and Scalable Electronic Health Record Management in In-Patient Follow-Up Tracking

As healthcare systems increasingly embrace digitalization, effective management of electronic health records (EHRs) has emerged as a critical priority, particularly in inpatient settings where data sensitivity and real-time access are paramount. Traditional EHR systems face significant challenges, including unauthorized access, data breaches, and inefficiencies in tracking follow-up appointments, which heighten the risk of misdiagnosis and medication errors. To address these issues, this research proposes a hybrid blockchain-based solution for securely managing EHRs, specifically designed as a framework for tracking inpatient follow-ups. By integrating QR code-enabled data access with a blockchain architecture, this innovative approach enhances privacy protection, data integrity, and auditing capabilities, while facilitating swift and real-time data retrieval. The architecture adheres to Role-Based Access Control (RBAC) principles and utilizes robust encryption techniques, including SHA-256 and AES-256-CBC, to secure sensitive information. A comprehensive threat model outlines trust boundaries and potential adversaries, complemented by a validated data transmission protocol. Experimental results demonstrate that the framework remains reliable in concurrent access scenarios, highlighting its efficiency and responsiveness in real-world applications. This study emphasizes the necessity for hybrid solutions in managing sensitive medical information and advocates for integrating blockchain technology and QR code innovations into contemporary healthcare systems.