Patient-centric blockchain-governed ehr sharing framework for secure digital radiography sensor data and AI-assisted chest X-ray screening

Haddad, Alaa and Habaebi, Mohamed Hadi and Al Hussaini, Mohammed Abdulla Salim (2026) Patient-centric blockchain-governed ehr sharing framework for secure digital radiography sensor data and AI-assisted chest X-ray screening. Applied Science, 16 (19). pp. 1-25. ISSN 2076-3417

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Abstract

Secure exchange of electronic health records (EHRs) requires clinical confidentiality, verifiable provenance, patient-controlled authorization, and practical handling of high-resolution medical imaging payloads generated by IoMT digital radiography sensors. This study presents an end-to-end patient-centric framework linking digital radiography flat-panel detector streams and acquisition metadata to a blockchain-governed EHR management system. Clinical payloads are secured via authenticated symmetric bulk encryption (AES-256- GCM), stored off-chain on the InterPlanetary File System (IPFS), and referenced on-chain through cryptographic record hashes, ECDSA signatures, wrapped-key references, and stateful access control predicates. A smart contract enforces dynamic, patient-controlled view, edit, and prospective revocation rights. The framework incorporates a DenseNet121 deep learning module that computes clinician-reviewable probability vectors for 14 thoracic findings, cryptographically binding each inference output to the source-image hash, model version, execution timestamp, and reviewing clinician. To prevent data leakage, the NIH ChestX-ray dataset was split at the patient level (80/10/10). System evaluation across 50 benchmark trials demonstrates sub-second execution overhead: encryption and decryption of a 100 MB radiograph payload require 0.957 ± 0.032 s and 0.898 ± 0.028 s, respectively, while IPFS upload and download of a 500 MB imaging payload take 11.470 ± 0.450 s and 13.260 ± 0.520 s. Smart contract state-changing operations consume between 29,150 and 168,010 gas units. The proposed architecture establishes a cryptographically verifiable, high-throughput pipeline for digital radiography sensor data management and AI-assisted EHR decision support.

Item Type:	Article (Journal)
Uncontrolled Keywords:	digital radiography sensor; Internet of Medical Things (IoMT); electronic health record; blockchain; patient-centric access control; IPFS; AES-256-GCM; DenseNet121; clinical decision support
Subjects:	T Technology > TK Electrical engineering. Electronics Nuclear engineering > TK7800 Electronics. Computer engineering. Computer hardware. Photoelectronic devices > TK7885 Computer engineering
Kulliyyahs/Centres/Divisions/Institutes (Can select more than one option. Press CONTROL button):	Kulliyyah of Engineering > Department of Electrical and Computer Engineering
Depositing User:	Dr. Mohamed Hadi Habaebi
Date Deposited:	12 Oct 2026 10:27
Last Update:	12 Oct 2026 10:27
Queue Number:	2026-10-Q5539
URI:	http://irep.iium.edu.my/id/eprint/131840
Indexed In:	WOS and SCOPUS

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