CertiMed: Identity-Aware Access Framework for Electronic Health Records

CertiMed: Identity-Aware Access Framework for Electronic Health Records | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article CertiMed: Identity-Aware Access Framework for Electronic Health Records Son X. Ha, Phat T. Tran-Truong, Hieu T. Thai, Binh T. Nguyen, and 6 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7442795/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Electronic Health Records (EHRs) require sophisticated architectural frameworks to ensure secure data sharing while maintaining privacy, integrity, and availability across distributed healthcare networks. Existing approaches, including Attribute-Based Encryption (ABE) systems, Multi-Authority schemes, and blockchain-based solutions, suffer from architectural limitations including high computational overhead, centralized vulnerabilities, inadequate temporal access controls, and limited scalability for large healthcare deployments. This article presents CertiMed, a novel four-layer hierarchical architecture that integrates Identity-Based Encryption (IBE) with blockchain technology for scalable and secure EHR management. The architecture employs a systematic separation of concerns across blockchain consensus, IBE cryptographic operations, application services, and distributed storage layers. CertiMed introduces three key architectural innovations: (1) time-bound IBE delegation enabling automatic key expiration without re-encryption overhead, (2) decentralized Know Your Customer (KYC) verification through smart contracts eliminating single points of failure, and (3) immutable blockchain-based audit trails providing comprehensive compliance and traceability. Comprehensive evaluation demonstrates significant performance improvements over existing ABE-based systems, including 68-69% reduction in encryption/decryption latency, linear scalability supporting 100,000+ concurrent users, and 99.8% cost reduction through Layer 2 blockchain deployment. Security analysis validates robust resistance against network attacks (0% MITM success rate), side-channel attacks ($<5%$ success rate), and comprehensive compliance with healthcare regulations. The modular architecture enables cost-effective deployment with transaction costs below $0.002 while maintaining enterprise-grade security guarantees suitable for large-scale healthcare networks. Electronic Health Records Access Control Identity-Based Encryption Blockchain Auditing Time-Bound Delegation Privacy Protection Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7442795","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":514361585,"identity":"6018b9bd-f56e-4f0b-b836-4509381f9d0f","order_by":0,"name":"Son X. Ha","email":"","orcid":"","institution":"RMIT Vietnam","correspondingAuthor":false,"prefix":"","firstName":"Son","middleName":"X.","lastName":"Ha","suffix":""},{"id":514361586,"identity":"f8a5398d-cdda-4c3c-bbc0-6254ea037a5e","order_by":1,"name":"Phat T. 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Existing approaches, including Attribute-Based Encryption (ABE) systems, Multi-Authority schemes, and blockchain-based solutions, suffer from architectural limitations including high computational overhead, centralized vulnerabilities, inadequate temporal access controls, and limited scalability for large healthcare deployments. This article presents CertiMed, a novel four-layer hierarchical architecture that integrates Identity-Based Encryption (IBE) with blockchain technology for scalable and secure EHR management. The architecture employs a systematic separation of concerns across blockchain consensus, IBE cryptographic operations, application services, and distributed storage layers. CertiMed introduces three key architectural innovations: (1) time-bound IBE delegation enabling automatic key expiration without re-encryption overhead, (2) decentralized Know Your Customer (KYC) verification through smart contracts eliminating single points of failure, and (3) immutable blockchain-based audit trails providing comprehensive compliance and traceability. Comprehensive evaluation demonstrates significant performance improvements over existing ABE-based systems, including 68-69\\% reduction in encryption/decryption latency, linear scalability supporting 100,000+ concurrent users, and 99.8\\% cost reduction through Layer 2 blockchain deployment. Security analysis validates robust resistance against network attacks (0\\% MITM success rate), side-channel attacks ($\u003c5\\%$ success rate), and comprehensive compliance with healthcare regulations. 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