BCAS: blockchain-based secure access and sharing scheme for EHR data✩

Biao Jin; Xinhong Chen; Jinbo Xiong; Xuan Li; Li Lin; Zhiqiang Yao

doi:10.1016/j.dcan.2024.10.012

›› 2026, Vol. 12 ›› Issue (5) :765 -775. DOI: 10.1016/j.dcan.2024.10.012

Research Article

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BCAS: blockchain-based secure access and sharing scheme for EHR data^✩

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^a College of Computer and Cyber Security, Fujian Normal University , Fuzhou 350117, China

^b Industrial School of Joint Innovation, Quanzhou Vocational and Technical University , Quanzhou 362268, China

^c Fujian Provincial Key Laboratory of Network Security and Cryptology, Fujian Normal University , Fuzhou 350117, China

^* Corresponding author at: Fujian Provincial Key Laboratory of Network Security and Cryptology, Fujian Normal University, Fuzhou 350117, China. E-mail address: jbxiong@fjnu.edu.cn (J. Xiong).

Biao Jin received his Ph.D. degree in cartography and geographical information systems from Fujian Normal University, China, in 2019. He is currently an associate professor and Master’s supervisor with Fujian Normal University, Fuzhou, China. He has authored or coauthored more than 40 research papers. His current research interests include big data security and privacy-preserving. He is a member of IEEE and a senior member of CCF.

Xinhong Chen received the B.E. degree in electronic and information engineering from Fujian Agriculture and Forestry University, China, in June 2022. He is currently pursuing the M.S. degree with Fujian Normal University, China. His main research interests include blockchain and privacy protection.

Jinbo Xiong received the Ph.D. degree in computer system architecture from Xidian University, China, in 2013. He is currently the Full Professor with Industrial School of Joint Innovation, Quanzhou Vocational and Technical University, Quanzhou 362268, China, and also with Fujian Provincial Key Laboratory of Network Security and Cryptology, Fujian Normal University, and School of Computing and Data Science, Fujian University of Technology, Fuzhou 350118, China. He has published more than 100 papers in prestigious Conferences/Journals, such as IEEE TIFS, TDSC, TMC, TII, TITS, TCCN, and DCAN. His research interests include data security, privacy protection, blockchain and access control.

Xuan Li received the Ph.D. degree in computer science from South China University of Technology, Guangzhou, China, in 2012. She is currently an Associate Professor and Master’s supervisor at Fujian Normal University. Her research interests include data security and privacy protection.

Li Lin received his Ph.D. degree in computer science and engineering from Huazhong University of Science and Technology, Wuhan, China, in 2019. He received his B.E. and M.S. degrees in computer science and technology from Sichuan University, Chengdu, China, in 2005 and 2008, respectively. He was honored with the 2020 ACM Wuhan Computer Society Doctoral Dissertation Award. His research interests include edge computing, blockchain, and the Metaverse.

Zhiqiang Yao received the Ph.D. degree in computer system architecture from Xidian University, Xi’an, China, in 2014. He is currently a Full Professor with the College of Computer and Cyber Security, Fujian Normal University, and Fujian Engineering Research Center of Public Service Big Data Mining and Application, Fuzhou, China. He has authored or co-authored over 100 research articles and holds ten patents. His current research interests include big data security and privacy protection, multimedia security, and application security.

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Abstract

Sharing Electronic Health Record (EHR) data is critical for improving medical decision-making and emergency care. However, EHRs contain sensitive patient information, making data breaches and misuse a significant concern during sharing. To tackle this challenge, we propose the Blockchain-Based Secure Access and Sharing (BCAS) scheme, a patient-centered, secure, and efficient solution for large-scale EHR access and sharing that intelligently combines blockchain with proxy re-encryption. Four smart contracts are designed for the BCAS to achieve effective user identity registration, precise virtual identity verification, strict access control, and secure data management. The adoption of hybrid on-chain and off-chain storage structures, coupled with the four smart contracts, effectively optimizes the efficiency of the blockchain in BCAS. Proxy re-encryption further enhances data confidentiality and streamlines EHR sharing among authorized users. The security analysis indicates that BCAS can resist DDoS, spoofing, and man-in-the-middle attacks, ensuring the privacy and security of patient EHR data. The performance evaluation demonstrates that the CPU usage of smart contracts does not exceed 15%. The on-chain and off-chain storage structures require less than 30 s for uploading and downloading an 800 MB file. Additionally, the proxy re-encryption scheme can process a 10 MB file in less than 43 ms. These results indicate that BCAS offers efficient performance without compromising data security and privacy. Compared with existing blockchain-based EHR sharing systems, BCAS offers superior performance, a more comprehensive solution, and increased resistance to attacks.

Keywords

EHR / Identity verification / Blockchain / Access control / Proxy re-encryption

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Biao Jin, Xinhong Chen, Jinbo Xiong, Xuan Li, Li Lin, Zhiqiang Yao. BCAS: blockchain-based secure access and sharing scheme for EHR data^✩. , 2026, 12 (5) : 765-775 DOI:10.1016/j.dcan.2024.10.012

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CRediT authorship contribution statement

Biao Jin: Writing – original draft. Xinhong Chen: Methodology. Jinbo Xiong: Methodology, Formal analysis. Xuan Li: Resources. Li Lin: Resources. Zhiqiang Yao: Project administration.

Declaration of competing interest

None declared.

Acknowledgements

This work was supported by the National Natural Science Foundation of China under Grant Nos. 62272102, 62272103, the Key Project of Natural Science Foundation of Fujian Province under Grant No. 2023J02014, and the Natural Science Foundation of Fujian Province under Grant Nos. 2023J01531, 2023J01295, and 2021J01167.

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