Blockchain Technology Applications and SecurityCryptography and Data SecurityBig Data and Digital Economy

C. Braghin, S. Cimato, Simone Pesci, E. Riccobene

2026.3.1Blockchain-Research and Applications

DOI: 10.1016/j.bcra.2026.100468

Abstract

The healthcare sector increasingly relies on digital infrastructures to manage large volumes of sensitive medical data. Ensuring integrity, controlled access, interoperability, and auditability remains a fundamental challenge. We propose BlockHealth, a hybrid blockchain-based framework that integrates smart contracts, distributed databases, and proxy re-encryption to support secure and verifiable healthcare data management. The system leverages Ethereum and NFT-based identities for access control, Merkle-tree commitment for tamper-evident integrity verification, and a distributed Cassandra storage layer for scalable and regulation-compliant off-chain data management. Proxy re-encryption enables secure delegation of access without exposing private keys, while a coordinating API service ensures interoperability with existing hospital infrastructures. Our evaluation demonstrates the feasibility and efficiency of core operations âĂŤ including hashing, on-chain commits, and re-encryption âĂŤ indicating that the proposed framework can provide a practical balance among verifiability, performance, and deployability in realistic healthcare environments.

Citation format

BRAGHIN, C., et al. Blockhealth: A blockchain based framework for secure and efficient healthcare data management. Blockchain-Research and Applications, 2026: 100468.