Leveraging Blockchain for Enhanced EHR Access Monitoring: Integrating Context‐Aware and Attribute‐Based Tools for Comprehensive Data Security

The management of electronic health records (EHR) demands not only secure storage but also rigorous access monitoring to safeguard patient privacy and ensure regulatory compliance. While blockchain technology provides data immutability, many healthcare systems lack integrated and effective auditing mechanisms, exposing them to risks of data breaches, unauthorised access, and compliance failures. This study proposes a blockchain‐enabled EHR access monitoring framework that incorporates advanced auditing tools to capture comprehensive metadata on access events, including who accessed the data, when, where, how, and why. To address the limitations of traditional purpose‐based access control, the framework integrates context‐aware access control and attribute‐based access control models. These enable dynamic, context‐sensitive, and attribute‐driven access policies based on parameters such as user role, time, location, and data sensitivity. Additionally, real‐time auditing capabilities are enhanced using Elasticsearch, Splunk, and Grafana for log analysis, anomaly detection, data visualisation, and predictive analytics. This integration not only strengthens surveillance but also enables timely responses to suspicious activities. By leveraging blockchain's tamper‐proof ledger and combining it with automated auditing and intelligent access control, the proposed framework enhances security, supports compliance with regulations like HIPAA (health insurance portability and accountability act) and GDPR(general data protection regulation), and fosters institutional trust through transparent and accountable data governance in healthcare environments.