A

Project Report
On
DECENTRALISED HEALTH RECORD MANAGEMENT
Submitted for partial fulfillment of the requirements for the award of the degree
Of
BACHELOR OF ENGINEERING
In
COMPUTER SCIENCE AND ENGINEERING
By
Ms. Satya Sree Donga (2451-21-733-071)
Ms. Veda Vamsitha Bogem (2451-21-733-080)
Under the guidance of
Mrs. N. Sabitha
Assistant Professor
Department of CSE

MATURI VENKATA SUBBA RAO(MVSR) ENGINEERING COLLEGE

Department of Computer Science and Engineering
(Affiliated to Osmania University & Recognized by AICTE)
Nadergul, Saroor Nagar Mandal, Hyderabad – 501510
Academic Year: 2024-25
 Maturi Venkata Subba Rao Engineering College
(Affiliated to Osmania University, Hyderabad)
Nadergul(V), Hyderabad-501510

Certificate

This is to certify that the project work entitled “Decentralised Health Record
Management” is a bonafide work carried out by Ms. Satya Sree Donga(2451-21-
733-071) and Ms.Veda Vamsitha Bogem(2451-21-733-080)in partial fulfilment of
the requirements for the award of degree of Bachelor of Engineering in Computer
Science and Engineering from Maturi Venkata Subba Rao (MVSR) Engineering
College, affiliated to OSMANIA UNIVERSITY, Hyderabad, during the Academic Year
2023-24 under our guidance and supervision.

The results embodied in this report have not been submitted to any other university or
institute for the award of any degree or diploma to the best of our knowledge and
belief.

Internal Guide Head of Department

Mrs. N Sabitha Prof. J Prasanna Kumar
Assistant Professor Professor
Department of CSE Department of CSE
MVSREC. MVSREC.

External Examiner

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 DECLARATION

This is to certify that the work reported in the present project entitled
“Decentralised Health Record Management” is a record of bonafide work done by
us in the Department of Computer Science and Engineering, Maturi Venkata Subba
Rao (MVSR) Engineering College, Osmania University during the Academic Year
2024-25. The reports are based on the project work done entirely by us and not copied
from any other source. The results embodied in this project report have not been
submitted to any other University or Institute for the award of any degree or diploma.

Mr. Satya Sree Donga Ms. Veda Vamsitha Bogem

2451-21-733-071 2451-21-733-080

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 ACKNOWLEDGEMENTS

We would like to express our sincere gratitude and indebtedness to our project
guide Mrs. N Sabitha for her valuable suggestions and interest throughout the course
of this project.

We are also thankful to our principal Dr. Vijaya Gunturu and Mr. J Prasanna
Kumar, Professor and Head, Department of Computer Science and Engineering,
Maturi Venkata Subba Rao Engineering College, Hyderabad for providing excellent
infrastructure for completing this project successfully as a part of our B.E. Degree
(CSE). We would like to thank our project coordinator for her constant monitoring,
guidance and support.

We convey our heartfelt thanks to the lab staff for allowing us to use the required
equipment whenever needed. We sincerely acknowledge and thank all those who gave
directly or indirectly their support in the completion of this work.

Mrs. Satya Sree Donga (2451-21-733-071)

Mrs. Veda Vamshitha Bogem (2451-21-733-080)

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VISION
 To impart technical education of the highest standards, producing competent
and confident engineers with an ability to use computer science knowledge to
solve societal problems.
MISSION
 To make learning process exciting, stimulating and interesting.
 To impart adequate fundamental knowledge and soft skills to students.
 To expose students to advanced computer technologies in order to excel in
engineering practices by bringing out the creativity in students.
 To develop economically feasible and socially acceptable software.
PEOs:
PEO-1: Achieve recognition through demonstration of technical competence for
successful execution of software projects to meet customer business objectives.
PEO-2: Practice life-long learning by pursuing professional certifications, higher
education or research in the emerging areas of information processing and intelligent
systems at a global level.
PEO-3: Contribute to society by understanding the impact of computing using a
multidisciplinary and ethical approach.
PROGRAM OUTCOMES (POs)
At the end of the program the students (Engineering Graduates) will be able to:
1. Engineering knowledge: Apply the knowledge of mathematics, science,
engineering fundamentals, and an engineering specialisation for the solution of
complex engineering problems.
2. Problem analysis: Identify, formulate, research literature, and analyse
complex engineering problems reaching substantiated conclusions using first
principles of mathematics, natural sciences, and engineering sciences.
3. Design/development of solutions: Design solutions for complex engineering
problems and design system components or processes that meet the specified
needs with appropriate consideration for public health and safety, and cultural,
societal, and environmental considerations.
4. Conduct investigations of complex problems: Use research-based
knowledge research methods including design of experiments, analysis an
interpretation of data, and synthesis of the information to provide valid
conclusions.

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 5. Modern tool usage: Create, select, and apply appropriate techniques,
resources, and modern engineering and IT tools including prediction and
modelling to complex engineering activities with an understanding of the
limitations.
6. The engineer and society: Apply reasoning informed by the contextual
knowledge to assess societal, health, safety, legal, and cultural issues and the
consequent responsibilities relevant to the professional engineering practice.
7. Environment and sustainability: Understand the impact of the professional
engineering solutions in societal and environmental contexts, and demonstrate
the knowledge of, and the need for sustainable development.
8. Ethics: Apply ethical principles and commit to professional ethics and
responsibilities and norms of the engineering practice.
9. Individual and teamwork: Function effectively as an individual, and as a
member or leader in diverse teams, and in multidisciplinary settings.
10. Communication: Communicate effectively on complex engineering activities
with the engineering community and with the society at large, such as being
able to comprehend and write effective reports and design documentation,
make effective presentations, and give and receive clear instructions.
11. Project management and finance: Demonstrate knowledge and
understanding of the engineering and management principles and apply these
to one’s work, as a member and leader in a team, to manage projects and in
multidisciplinary environments.
12. Lifelong learning: Recognise the need for and have the preparation and
ability to engage in independent and life-long learning in the broadest context
of technological change.
PROGRAM SPECIFIC OUTCOMES (PSOs)
13. (PSO-1) Demonstrate competence to build effective solutions for
computational real-world problems using software and hardware across multi-
disciplinary domains.
14. (PSO-2) Adapt to current computing trends for meeting the industrial and
societal needs through a holistic professional development leading to
pioneering careers or entrepreneurship.

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 COURSE OBJECTIVES AND OUTCOMES
Course Code: U21PW881CS
Course Objectives
 To enhance practical and professional skills.
 To familiarize tools and techniques of systematic Literature survey and
documentation.
 To expose the students to industry practices and teamwork.
 To encourage students to work with innovative and entrepreneurial ideas.
Course Outcomes
Upon completion of the course, the student will be able to:
1. Demonstrate the ability to synthesize and apply the knowledge and skills
acquired in the academic program to real-world problems.
2. Evaluate different solutions based on economic and technical feasibility.
3. Effectively plan a project and confidently perform all the aspects of project
management.
4. Demonstrate effective written and oral communication skills.
5. Present the proposed project using PPT.

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 ABSTRACT
MedRecChain is a decentralized solution designed to address the challenges faced
by Electronic Medical Records (EMR) sharing systems. Leveraging the Ethereum
network and IPFS technology, MedRecChain offers a secure and efficient platform
for storing and exchanging medical records. Traditional EMR systems often
encounter issues such as data breaches, lack of interoperability, and limited patient
control over their own records. MedRecChain aims to overcome these challenges by
employing blockchain technology, ensuring data immutability, transparency, and
enhanced security. By utilizing the Ethereum network, MedRecChain establishes a
decentralized infrastructure that allows healthcare providers, patients, and other
authorized parties to access and share medical records in a seamless and trustless
manner.
The use of smart contracts further enhances the integrity and reliability of
transactions, enabling automated and auditable interactions. In addition,
MedRecChain incorporates IPFS (InterPlanetary File System) technology to
efficiently store and distribute medical records. IPFS facilitates the decentralized
storage and retrieval of data, eliminating reliance on a single central server and
enabling greater scalability and resilience. The key features of MedRecChain include
secure patient identification, granular access control, data privacy, and auditability.
Patients have full control over their medical records, granting or revoking access to
healthcare providers as needed. The system ensures data privacy through encryption
techniques, while still allowing authorized parties to trace and audit record access and
modifications.
Through the implementation of MedRecChain, the healthcare industry can benefit
from a decentralized and secure solution for EMR sharing. It has the potential to
streamline record management, enhance patient privacy and control, and foster
interoperability among different healthcare entities.

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 TABLE OF CONTENTS

PAGE NOS.
Certificate …………………………………………………………………….. i
Declaration ...…………………………………………………………………… ii
Acknowledgment……………………………………………………………..… iii
Vision & Missions,PEOs,Pos and PSOs….…………………………………….. iv
Course Objectives and Outcomes…………………………………………….… vi
Abstract………………………………………………………………….……… vii
Table of Contents…………………………………………………….…………. viii
List of Figures …………………………………………………..…………….. x
List of Tables…………………………………….….………………..………… x

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 CONTENTS
CHAPTER I
1. INTRODUCTION 01 - 05
1.1 PROBLEM STATEMENT 02
1.2 OBJECTIVE 02
1.3 MOTIVATION 02-03
1.4 SCOPE OF THE PROJECT 03-04
1.5 SOFTWARE REQUIREMENTS 04-05
CHAPTER II
2. LITERATURE SURVEY 06-07
CHAPTER III
3. SYSTEM DESIGN 08-16
3.1 FLOW CHARTS 08
3.2 SYSTEM ARCHITECTURE 08-09
3.3 UML DIAGRAMS 09-13
3.4 PROJECT PLAN 13-16
CHAPTER IV
4. SYSTEM IMPLEMENTATION & METHODOLOGIES 17-26
4.1 SYSTEM IMPLEMENTATION 17
4.2 TECHNOLOGY STACK 17-18
4.3 SYSTEM ARCHITECTURE 18
4.4 USER ROLES AND PERMISSIONS 18-20
4.5 SYSTEM WORKFLOW 20-21
4.6 METHODOLOGIES USED 21-22
4.7 USER INTERFACE 23-26

CHAPTER V
5. TESTING AND RESULTS 27-30
CHAPTER VI
6. CONCLUSION & FUTURE ENHANCEMENTS 31-32
REFERENCES 33-34
APPENDIX 1-6

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 LIST OF FIGURES

Figure No. Figure Name Page No.

Fig 3.1 Data flow 8
Fig 3.2 System Diagram 9
Fig 3.3 Use case Diagram 10
Fig 3.4 State Diagram 11
Fig 3.5 Sequence Diagram 13
Fig 4.1 Home screen 23
Fig 4.2 dashboard 24
Fig 4.3 admin dashboard 24
Fig 4.4 hospital dashboard 25
Fig 4.5 doctor dashboard 25
Fig 4.6 patient profile 26
Fig 5.1 Test case I 27
Fig 5.2 Test case II 28
Fig 5.3 Test case III 28
Fig 5.4 Test case IV 29
Fig 5.5.1 Test case V 29
Fig 5.5.2 Test case 30

LIST OF TABLES

Table No. Table Name Page No.

Table 2.1 survey 8
Table 4.1 roles 19
Table 4.2 components 20

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CHAPTER 1
INTRODUCTION
In the context of healthcare, Electronic Health Records refer to electronic
versions of a patient's medical history, containing essential clinical and administrative
data relevant to their healthcare. EHRs aim to streamline healthcare processes,
improve patient care, and enable seamless information exchange between healthcare
providers. However, traditional EHR systems often encounter issues like security of
data and vulnerabilities, privacy concerns, and interoperability challenges. Blockchain
provides a decentralized and secure approach to managing EHRs. By leveraging its
distributed ledger capabilities, blockchain ensures the integrity of records through
cryptographic hashing, making it difficult to modify data without consensus from
many network participants. Public-key cryptography is utilized to secure data and
ensure confidentiality, with each user having a unique public and private key. This
cryptographic framework enhances data security and mitigates the risk of
unauthorized access to patient information.
The implementation of blockchain technology in EHRs offers solutions to
various issues faced by traditional systems. One significant problem is the lack of
interoperability between different healthcare organizations and systems . Blockchain's
decentralized nature enables seamless sharing of data among trusted parties,
eliminating the need for costly and inefficient methods of transferring records.
Authorized sharing of data can be done securely and efficiently, improving continuity
of care and overall efficiency in healthcare delivery. Blockchain technology facilitates
the execution of smart contracts, which are automated agreements that carry out
actions according to predetermined criteria.
These smart contracts streamline the management of consent by allowing data
access only under specific conditions. Consequently, this approach addresses privacy
apprehensions and aligns with regulatory mandates such as the General Data
Protection Regulation (GDPR). When integrated with Electronic Health Records
(EHRs), blockchain empowers healthcare systems to bolster data security, enhance
privacy, promote interoperability, and empower patients to have greater control over
their health data.

1.1 Problem Statement

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The traditional centralized EHR systems face numerous challenges, in terms of

data security, privacy, and accessibility. Centralized systems are vulnerable to data
breaches, lack transparency, and often require complex procedures for data sharing.
These issues can hinder healthcare professionals' ability to access and utilize patient
information efficiently, leading to potential errors and delays in treatment. Blockchain
offers a decentralized, tamper-resistant, and transparent platform for secure data
storage and access. It ensures privacy, consent management, and data integrity, and
mitigates the risk of fraud or unauthorized access.

1.2 Objective
The objective of blockchain-based health record management is:

1. To address interoperability issues and enable seamless data exchange among

healthcare providers using distributed ledger, standardized protocols, and
secure data sharing mechanisms.

2. To automate and enforce privacy policies and data access controls, securing
patient health records by allowing access and interactions solely for authorized
individuals in accordance with pre-established rules and conditions

1.3 Motivation
Our motivation stems from the need to revolutionize healthcare by addressing the
complex challenges of decentralized health record management, leveraging the power
0f blockchain technology and the Inter Planetary File System (IPFS). Imagine a
healthcare ecosystem where patient data is securely stored, easily accessible, and fully
controlled by patients themselves, ensuring that their health history is transparent,
immutable, and seamlessly shared among authorized entities.

This vision serves as the driving force behind our pursuit of a decentralized
health record management system. In today's world, healthcare data is often siloed
and fragmented across various systems, leading to inefficiencies, errors, and even loss
of critical patient information. This fragmentation can result in delayed diagnoses,
unnecessary treatments, and compromised patient safety. Our motivation is to address
these issues head-on by creating a unified, blockchain-based solution that guarantees

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data integrity, privacy, and access control while empowering patients to own and
manage their health records.

Blockchain technology offers a unique solution to these challenges. Its

decentralized, transparent, and immutable nature ensures that patient data is not only
secure but also easily accessible, fostering greater collaboration and trust among
healthcare providers. By integrating IPFS, a distributed file system, we aim to
enhance data storage capabilities. IPFS allows patient records to be stored in a
decentralized manner, enabling efficient, secure access to large datasets without
relying on a central server. This system can scale, making it easy to store and retrieve
large volumes of medical data, such as imaging files, diagnostic results, and health
histories, all while maintaining patient privacy and confidentiality.

In essence, our motivation lies in the desire to enhance healthcare outcomes by

eliminating data fragmentation, improving patient safety, and ensuring that patients
have complete ownership and control of their health information. By leveraging
cutting-edge technologies like blockchain and IPFS, we aim to create a seamless,
efficient, and secure environment for decentralized health record management. This
will transform how healthcare data is stored, accessed, and shared, ultimately
improving patient care and fostering a more connected, innovative healthcare
ecosystem.
1.4 Scope of the Project

After talking about these problems, we will try to solve them through
a web application to serve patients and doctors.

 First: we will solve the main challenges existing in the current

way hospitals manage their data and the lack of sharing with other
institutes as they can easily find all the information from different
institutes organized in one place.
 Second: patients can have all their medical information as it is
difficult for them to keep up with their medical history, either be it
complicated or long.
 Third: specialist’s diagnosis will be more accurate as it
will depend on the patient’s condition in similar situations
that he will get it from the patient’s medical history.

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The project contributes to save people’s lives through their knowledge of

their health and knowledge of their diseases that can be detected early from
their medical history such as hepatitis B, C, cancer, diabetes, and herpes virus
which are the most diseases that can be predictable from the patient’s medical
history like it’s updatable test blood and his past diseases or from their
family medical history as they can share their information with other patients
like their family. Each person will have a medical file containing its own
medical history.

Provides medical history will help doctors to diagnose the disease as by

knowing the patients’ old diseases will increase the percentage of accurate
diagnose in a lot of diseases as we mentioned before and save doctors and
patient’s time.Our project will provide a single format for all patient’s medical
record so it will be more readable and easier to record it from different
institutes.

1.5 Software Requirements

We have used a combination of technology and tools that help build a

decentralized medical record system:

1. Front-End:
 HTML, CSS, JavaScript
 React.js
 Bootstrap
2. Back-End:
 Web3.js (library that allows to interact with a Ethereum
node, smart contract, and your app)
 Solidity (Programming language for implementing smart
contracts on blockchain network)
3. Blockchain:
 Ethereum network
 Truffle (Farmwork for Dapp that provide EVM (Ethereum
Virtual Machine) so we can deploy and test)

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 Ganache (It is local Ethereum blockchain. It provided us

with number of accounts allowed us to test and deploy the
application and dividing them among application different
end users.)
 MetaMask (Browser extension that is gateway to
blockchain apps by make account to manage Ethereum
smart contract)
 IPFS (It is a protocol and peer-to-peer network for data
storage and sharing in a distributed file system.)
4. Workspace
 Visual Studio Code & GitHub

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CHAPTER 2
LITERATURE SURVEY
Traditional EHR systems face security, privacy, and interoperability challenges.
Blockchain ensures tamper-proof record-keeping, while IPFS provides efficient off-
chain storage. This combination enhances data integrity and accessibility across
healthcare institutions.

Table 2.1 Survey

S.No Year of Author(s) Technique Summary Limitation

Publication

1 2018 Qi Xia, Blockchain- Introduced a High

Emmanuel Based EHR secure computational
Boateng System framework using cost due to
Sifah, Abla blockchain to blockchain
Smahi, store patient data transaction
Sandro with role-based processing.
Amofa, and access control.
Xiaosong
Zhang.

2 2020 Hassan Medical Data Proposed a Scalability

Mansur Sharing with hybrid challenges
Hussien, IPFS and approach using with large-
Sharifah Md Blockchain
IPFS for scale
Yasin, Nur
efficient data healthcare
Izura Udzir,
storage and systems..
and Mohd
blockchain for
Izuan Hafez
Ninggal. access control.

3 2021 Liu, J., Permissioned Implemented a Limited

Wang, Y., Blockchain Hyperledger flexibility for
and Wu, J. for EHR Fabric-based cross-platform
system that

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ensures only integration.

authorized
access to
patient records.

4 2022 Sharma, S., Smart Designed High gas fees

Singh, S., Contracts for Ethereum- due to
and Kumar, EHR Access based smart Ethereum's
P. Control contracts to transaction
regulate EHR costs.
sharing
between
hospitals and
patients.

The reviewed studies collectively highlight the potential of blockchain and IPFS in
revolutionizing healthcare record management. Blockchain's immutability ensures
that records cannot be tampered with, while cryptographic techniques secure data
access, enhancing security and privacy. Additionally, decentralized systems enable
seamless sharing of records across different healthcare institutions, improving
interoperability. While IPFS addresses blockchain storage limitations, large-scale
implementation still requires optimization to efficiently handle millions of records,
posing scalability challenges. Furthermore, patients gain greater control over their
medical data, allowing them to securely share information with healthcare providers
through smart contracts, thus enhancing accessibility and data security in
decentralized health record management.

CHAPTER 3
SYSTEM DESIGN
3.1 Flowchart

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Fig 3.1 Data

flow

The depicted
flowchart
outlines the
functioning of
the Electronic
Health Record
Management
System. It
visually
represents the
processes of
encryption,
key
generation, and access control

3.2 System Architecture

The architecture of the system adheres to multiple high-level patterns and
principles. It primarily emphasizes the external components of the system that are
visible to users and their interactions with one another. Figure 1 illustrates the overall
architecture of the system. In this architecture, it consists of three modules (Layers).
The first module is the User Management Layer, which provides a user
interface for patients and doctors to interact with the Electronic Health Record
system. Through this module, users can input and retrieve data that will be stored in
decentralized storage

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Fig 3.2
System

Architecture

The second module is the EHR Storage Layer, which serves as the backbone
of the project. In this module, data is stored in blockchains maintained by hospitals,
with databases that are distributed across the network. Popular tools that have been
used in this module include Next.js, Ganache, Truffle, and MetaMask. APIs are used
to facilitate communication between the User Management Layer and the EHR
Storage Layer, with incoming requests triggering data storage procedures in the latter.

The third module is the EHR Generation and View Layer, which provides a
comprehensive and efficient means of managing patient health information in
electronic format. Healthcare providers can access patient data from multiple sources
through this module, which includes tools for searching, filtering, and visualizing
trends and patterns in the data.

3.3 UML Diagrams

Use case diagram:

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Fig 3.3 Use Case Diagram

The use-case diagram is shown in Figure 3.3. This application’s use-case has
three key entities: an Admin, a patient, and a doctor. various user roles interact to
facilitate secure and efficient healthcare management
State diagram:

The UML state diagram for the MedRecChain system illustrates the various
states and transitions involved in its operation. The system begins in the Start state,
where users initiate the login process. Upon entering the Login state, the system
verifies the user's Ethereum account. If authentication succeeds, the user transitions to
their respective dashboards: Admin Dashboard, Hospital Dashboard, Doctor
Dashboard, or Patient Dashboard, based on their role. If authentication fails, the
system moves to the Login Error state.

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Fig 3.4 State Diagram

Sequence diagram:

The Sequential Diagram below offers a visual representation illustrating the

interactions and communication flow among various entities, including the Patient,

Doctor, Web Server, Smart Contract, and IPFS. The following sequential diagram

provides insights into the communication process and the steps involved in how

patient upload their medical records, subsequently accessed by doctors via blockchain

Technology

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Fig 3.5 Sequence Diagram

3.4 Project Plan

Our 8-week project aims to develop Decentralized Health Record Management,
an innovative system enhancing patient data privacy and accessibility using
blockchain technology. This project will focus on unifying various health record
formats, configuring and implementing a decentralized ledger, organizing datasets
securely, and developing a user-friendly interface. The system will ensure secure,
tamper-proof, and efficient management of medical records, empowering patients
with control over their health data and streamlining access for healthcare providers.

Week 1: Project Initiation and Environment Setup

Objective: Establish the project foundation and prepare the development

environment.

Tasks:

• Conduct a project kickoff meeting to align the team on objectives, roles, and
responsibilities.

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• Create a new BlockChain environment and install necessary dependencies.

• Configure the development environment for GPU usage to ensure optimal
performance.
• Set up version control with Git and establish a repository for the project.

Week 2: Blockchain and IPFS Setup

Objective: Set up the blockchain network and IPFS for decentralized storage.

Tasks:

 Initialize a private blockchain network or connect to a testnet (e.g., Ethereum

Rinkeby, Polygon).

 Set up IPFS for decentralized file storage and configure local or cloud-based

IPFS nodes.
 Develop and test scripts for uploading, retrieving, and pinning files on IPFS.

 Establish a connection between the blockchain and IPFS for storing file hashes

securely.

 Perform initial tests to ensure blockchain transactions and IPFS integration work
seamlessly.

Week 3: Smart Contract Development

Objective: Develop and deploy smart contracts for health record management

Tasks:

• Define smart contract functionalities, including record creation, access control,

and permission management.
• Develop smart contracts using Solidity or another blockchain programming
language.
• Test smart contracts on a local blockchain environment using tools like
Ganache.

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• Deploy the contracts to the testnet and verify their functionality.

• Document the contract APIs and integrate them with the backend.

Week 4: Frontend Development

Objective: Create a user-friendly interface for interacting with the system.

Tasks:

• Design the frontend using frameworks Reactjs.

• Develop components for user authentication, health record upload, and record
access.
• Implement a dashboard for users to view and manage their health records.
• Integrate the frontend with backend APIs to enable real-time interactions.
• Test the interface for usability and responsiveness across devices.

Week 5: Backend Development and Integration

Objective: Build the backend to interact with the blockchain and IPFS.

Tasks:

• Set up the backend framework (e.g., Node.js, Flask, or Django).

• Implement APIs for creating, updating, and retrieving health records via the
blockchain.

• Integrate backend logic to interact with IPFS for storing and retrieving files.

• Implement encryption mechanisms for sensitive data before uploading to

IPFS.

• Test the backend thoroughly to ensure seamless integration with blockchain

and IPFS.

Week 6: Security and Optimization

Objective: Enhance system security and optimize performance.

Tasks:

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• Implement access control mechanisms to ensure only authorized users can

access specific records.

• Enhance transaction security using private keys and wallets (e.g., MetaMask).

• Optimize IPFS file retrieval for faster access.

• Test for vulnerabilities, such as reentrancy attacks and data leakage.

• Refine smart contracts and backend logic for performance improvements.

Week 7: System Integration and Testing

Objective: Integrate all components and conduct thorough testing of the system.

Tasks:

• Integrate the frontend, backend, blockchain, and IPFS components into a

cohesive system.
• Perform end-to-end testing to ensure all components work seamlessly.
• Identify and resolve any integration issues or bugs.
• Conduct user acceptance testing with healthcare professionals or a small user
group to gather feedback
• Refine the system based on feedback to ensure reliability and usability.

Week 8: Deployment and Project Closure

Objective: Deploy the system and conclude the project.

Tasks:

• Prepare the deployment environment and configure server settings for hosting
the application.
• Deploy the system to a cloud platform (e.g., AWS, Azure) or decentralized
hosting services (e.g., Fleek, Filecoin).
• Provide comprehensive documentation, including a user manual, developer
guide, and system architecture.
• Conduct a final project review meeting to discuss achievements, challenges,
and future enhancements.

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CHAPTER 4
SYSTEM IMPLEMENTATION & METHODOLOGIES
4.1 System Implementation
With the increasing adoption of digital healthcare systems, Electronic Health
Records (EHRs) have emerged as the most informative and diverse form of medical
documentation. These records are collected in a variety of formats, including
structured clinical notes, unstructured physician narratives, medical imaging reports,
and real-time patient monitoring data. Given the massive scale and diverse data
formats, automatically identifying relevant medical events based on user queries has
become a critical capability for efficient healthcare data management.
This growing need has led to several EHR-related tasks, including clinical
event extraction, anomaly detection, and medical summarization. Specifically:
 Clinical event extraction involves identifying consecutive medical events (e.g.,
symptoms, diagnoses, treatments) from unstructured EHR data based on
natural language queries (e.g., "Find instances of diabetic complications").
 Anomaly detection aims to pinpoint critical abnormalities in patient records
(e.g., sudden spikes in vital signs, medication interactions).
 Medical summarization extracts and organizes key patient history elements
into concise, structured summaries, either general or tailored to specific
clinical needs.

4.2 Technology Stack

Blockchain Layer:

Ethereum (Smart Contracts using Solidity)

Storage Layer:

IPFS (InterPlanetary File System) for storing medical records securely

Access Control:

Smart contracts and cryptographic techniques (e.g., public-private key

encryption)

Frontend:

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React.js, Next.js, or Vue.js for UI

Backend:

Node.js/Express.js for API interactions

Development & Testing:

Ganache (local blockchain), Truffle/Hardhat (for development & testing)

Wallet & Authentication:

MetaMask/Web3.js for user authentication and transactions

4.3 System Architecture

The system follows a three-layered architecture:

4.3.1 Blockchain Layer

 Stores metadata (IPFS hashes, user roles, access control).

 Implements smart contracts for permission management.

 Logs transactions (record uploads, access grants, modifications).

4.3.2 IPFS Storage Layer

 Encrypts and stores health records off-chain.

 Generates a Content Identifier (CID) that is stored on-chain.

 Ensures decentralized and tamper-proof storage.

4.3.3 Application Layer

 User-friendly interface for patients, doctors, and hospitals.

 Web3 integration for authentication and blockchain interaction.

 Role-based dashboards for managing records

4.4 User Roles and Permissions

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Role Description Key Permissions

Administrator Manages system Create/manage user

(IT/Admin) settings, security, and accounts Assign roles &
access control. permissions Monitor
system logs & security
Cannot access medical
records
Doctor Provides medical care View patient records
and requires access to Update/add clinical
patient records for notes Prescribe
diagnosis and treatment. medications Request lab
tests Cannot delete
records
Patient The owner of the health View personal health
record who can view and records Grant/revoke
share their medical data. access to providers
Schedule appointments
Update personal details
(limited fields)

Hospital Oversees medical data Manage doctor accounts

management and Assign patient-doctor
ensures regulatory relationships Monitor
compliance. hospital-wide record
access Cannot modify
patient records

Table 4.1 roles

4.4.1 Role-based Access Control

Role-Based Access Control (RBAC) is a security model that restricts EHR

access based on predefined user roles. It ensures that only authorized personnel can
access, modify, or share sensitive patient data, aligning with HIPAA, GDPR, and
other healthcare regulations.

RBAC minimizes security risks by assigning permissions based on job

responsibilities, preventing unauthorized access while ensuring that healthcare
providers have the information they need.

Key Components of RBAC

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Component Description

Roles Defined job functions (e.g., Doctor, Nurse, Admin) that

determine access permissions.

Permissions Specific rights assigned to roles, such as "Read patient

records" or "Update prescriptions."

Users Individuals assigned to specific roles based on their job in the

healthcare facility.

AccessControl Rules that dictate how and when users can access EHR data.
Policies

Table 4.2 components

4.5 System Workflow

Step 1: User Registration & Authentication

Users register using Ethereum wallets such as MetaMask or WalletConnect,

ensuring a secure and decentralized authentication process. Instead of relying on a
centralized user database, the system adopts a Decentralized Identity (DID) approach,
where users' credentials are linked to their blockchain addresses, enhancing security
and user control.

Step 2: Uploading a Medical Record

When a patient wants to upload a medical record, the file is first encrypted
using AES encryption to ensure confidentiality. The encrypted file is then stored on
IPFS, a decentralized storage network, which generates a unique Content Identifier
(CID) for retrieval. This CID is subsequently recorded in the blockchain smart
contract, ensuring the data’s integrity and providing a tamper-proof reference for
future access.

Step 3: Granting Access to a Doctor

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To share medical records, the patient must explicitly grant access by updating
the smart contract. The patient whitelists the doctor’s or hospital’s Ethereum address,
enabling them to retrieve the necessary CID from the blockchain. This ensures that
only authorized healthcare providers can access the patient's medical data while
maintaining transparency and security.

Step 4: Accessing a Medical Record

When a doctor needs to access a patient’s medical record, they must first
request access through the smart contract. If the doctor has been granted permission,
they can retrieve the CID from the blockchain. Using the CID, they can then fetch the
encrypted file from IPFS and decrypt it with the encryption key shared by the patient,
ensuring that only authorized individuals can view the sensitive medical information.

Step 5: Updating or Revoking Access

Patients retain full control over their medical records and can update or revoke
access at any time. If access is revoked, the doctor or hospital can no longer retrieve
the CID from the blockchain, effectively restricting their ability to access the stored
medical record. This dynamic access control mechanism enhances patient privacy and
ensures that only currently authorized individuals can view the data.

4.6 Methodologies Used

4.6.1 Blockchain-Based Access Control

The system employs Ethereum smart contracts to implement blockchain-based

access control, ensuring that only authorized users can access medical records.
Modifier functions in Solidity verify access permissions before allowing any retrieval,
preventing unauthorized access. Additionally, patients have the ability to revoke
access dynamically, enhancing security and patient control over their records.

4.6.2 IPFS-Based Storage

Medical records are encrypted and stored on the InterPlanetary File System
(IPFS) to ensure decentralized and tamper-proof storage. Instead of storing large files
on-chain, the system saves only the IPFS Content Identifier (CID) on the blockchain

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for verification. This approach significantly reduces blockchain storage costs while
maintaining efficiency and data integrity.

4.6.3 Encryption & Security

To ensure data confidentiality, each record is encrypted using Advanced

Encryption Standard (AES) before being uploaded to IPFS. Public-key cryptography,
specifically Elliptic Curve Cryptography (ECC), is used to allow only authorized
users to decrypt files. Additionally, all access attempts are recorded in smart contract
logs, ensuring auditability and accountability within the system.

4.6.4 Decentralized Identity (DID)

The system incorporates Ethereum-based identity verification, such as Self-

Sovereign Identity (SSI), to provide users with complete control over their digital
identities. Unlike traditional centralized identity systems, this approach ensures that
no central authority can manipulate or revoke user identities. Patients authenticate
using Decentralized Identifiers (DIDs), enhancing security and privacy.

4.6.5 Smart Contract Development

The core functionalities of the system are implemented using Solidity-based

smart contracts. These contracts are deployed and tested using development
frameworks such as Truffle and Hardhat. Key features include event logging for
transaction history, Access Control Lists (ACLs) for managing user permissions, and
modifier functions that enforce strict validation rules before executing actions.

4.6.6 Web3 Integration

For seamless interaction between the blockchain and the frontend application,
the system integrates Web3.js or Ethers.js. Patients and doctors connect via
MetaMask to authenticate and interact with smart contracts, eliminating the need for
centralized login credentials. This decentralized approach enhances security and
provides users with direct control over their medical records.

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4.7 User Interface

Fig 4.1 Home screen

A user-friendly and role-based UI is crucial for an EHR system to ensure that

patients, doctors, and administrators can efficiently access and manage medical
records while maintaining security and compliance.The dashboard provides rolebased
interface for managing electronic health records.

Super Admins oversee system access, Hospitals manage doctors, Doctors request
and update patient records, and Patients control their data, granting or revoking
access. This secure, blockchain-based system ensures transparency, privacy, and
efficient healthcare data management.

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Fig 4.2 Dashboard

The admin dashboard in provides an overview of the system, displaying the

number of registered hospitals, doctors, and patients. It includes data visualizations
for medical record distribution, enabling administrators to monitor user activity and
system performance efficiently while ensuring secure access control and regulatory
compliance.

Fig 4.3 admin dashboard

The hospital dashboard provides an overview of registered hospitals, doctors,

and patients. It displays hospital details, including address, phone number, and public
key.

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Fig 4.4 hospital dashboard

The doctor dashboard allows doctors to access and manage patient records
securely. It provides an overview of assigned patients and medical data. Doctors can
update clinical notes, prescribe medications, and request access to records

Fig 4.5 doctor dashboard

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The patient dashboard allows users to manage their medical records and control
access permissions. Patients can view their health data, grant or revoke access to
doctors, and monitor record requests.

Fig 4.6 patient profile

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-CHAPTER 5

TESTING AND RESULTS

5.1 Test Cases

5.1.1 Test Case I

Test Case: The objective of this test case is to verify that users can successfully
connect their MetaMask wallet for authentication. The user clicks the "Connect
Wallet" button, selects MetaMask, and approves the connection request. The
system should verify the wallet address and authenticate the user based on their
role.

Expected Result: The user should successfully connect their MetaMask wallet
and be redirected to the appropriate dashboard. If the connection fails or the wallet
is not recognized, the system should display an error message and deny access

Fig 5.1 Test case I

5.1.2 Test Case II

Test Case: This test case verifies that an administrator can successfully add a new
hospital to the system. The admin logs in, navigates to the hospital management
section, enters the required hospital details, and clicks the "Add" button to submit
the information.

Expected Result: The hospital should be successfully added to the system.

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Fig 5.2 Test case II

5.1.3 Test Case III

Test Case: Verify that users can only access dashboards assigned to their role based
on their MetaMask login.

Expected Result: If the logged-in MetaMask account is assigned as an admin,

attempting to access hospital, doctor, or patient dashboards should trigger an error
message stating "Not your role." Only the assigned role's dashboard should be
accessible.

Fig 5.3 Test case III

5.1.4 Test Case IV

Test Case: This test case ensures that a doctor, after logging in via MetaMask, can
upload a patient’s medical record. The system should verify that the doctor has the
necessary permissions and associate the uploaded record with the correct patient.

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Expected Result: The system should allow the doctor to upload the record only for
assigned patients. Upon successful upload, the record should be stored in IPFS, and
the corresponding hash should be saved on the blockchain.

Fig 5.4 Test Case IV

5.1.5 Test Case V

Test Case: Verify that a doctor can send a request to a patient for access to their
medical records

Expected Result: The patient should receive the access request notification. The
system should not allow a doctor to request access for an unassigned patient. If
approved, the doctor gains access,otherwise, access remains restricted.

Fig 5.5.1 Test case V

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Fig 5.5.2 Test case

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CHAPTER 6

CONCLUSION AND FUTURE ENHANCEMENTS

6.1 Future Enhancements

There are several areas of future work that can further enhance
MedRecChain and its decentralized solution for Electronic Medical Records
(EMR) sharing systems. Here are some potential avenues for future
development

1.Interoperability with other blockchain platforms: While MedRecChain

currently utilizes the Ethereum network, exploring interoperability with other
blockchain platforms could enhance its reach and connectivity with different
healthcare systems. Integration with other blockchain networks, such as
Hyperledger or Corda, could enable seamless data exchange and collaboration
across diverse platforms.
2. Integration with emerging technologies: As technology continues to evolve,
incorporating emerging technologies like artificial intelligence (AI) and
machine learning (ML) into MedRecChain can unlock new possibilities. AI
and ML algorithms can be employed to analyze medical records, identify
patterns, and provide valuable insights for healthcare providers, ultimately
improving patient care and treatment outcomes.
3. Enhancing privacy and data protection: While blockchain technology
inherently provides security and immutability, ongoing efforts to enhance
privacy and data protection are crucial. Exploring privacy-preserving
techniques like zero-knowledge proofs or differential privacy can further
safeguard sensitive medical information while maintaining the benefits of a
decentralized system.
4. Scalability and performance optimization: As the usage of MedRecChain
expands, addressing scalability challenges will be important. Exploring
solutions like sharding, off-chain storage, or layer- 2 scaling techniques can
enhance system performance and accommodate a larger volume of medical
records and users.

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5.User experience and interface design: Continued focus on user experience and
interface design will ensure that MedRecChain remains accessible and intuitive for
both technical and non-technical users. Incorporating user feedback, conducting
usability studies, and employing modern design principles can further enhance the
platform's usability and adoption

6.2 Conclusion

In conclusion, MedRecChain represents a decentralized solution for

Electronic Medical Records (EMR) sharing systems, utilizing the Ethereum
network and IPFS technology. By leveraging the transparency, security, and
immutability of blockchain and the distributed storage capabilities of IPFS,
MedRecChain offers a promising approach to address the challenges
associated with centralized EMR systems.

The combination of the Ethereum network and IPFS technology

empowers patients, healthcare providers, and relevant parties to securely store,
access, and share electronic medical records. It promotes data integrity,
privacy, and control, while facilitating efficient interoperability and
collaboration among healthcare systems.

Looking ahead, future work can focus on areas such as interoperability

with other blockchain platforms, integration with emerging technologies,
enhancing privacy and data protection, addressing scalability and performance
challenges, and refining the user experience and interface design.

Overall, MedRecChain decentralized solution has the potential to revolutionize

the management and sharing of electronic medical records, improving efficiency,
security, and accessibility in the healthcare industry. As advancements are made and
new opportunities arise, MedRecChain can continue to evolve and contribute to the
advancement of healthcare systems worldwide.

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REFERENCES
[1] Sharma, Ashutosh, Sarishma, Ravi Tomar, Naveen Chilamkurti, and Byung-
Gyu Kim. "Blockchain based smart contracts for internet of medical things in e-
healthcare." Electronics 9, no. 10 (2020): 1609.

[2] Watkinson-Powell, Anna, and A. Lee. "Benefits of an electronic medical

records system in rural Nepal." Journal of the Nepal Medical Association 52, no. 188
(2012).

[3] Yang, Huihui, and Bian Yang. "A blockchain-based approach to the secure
sharing of healthcare data." In Proceedings of the norwegian information security
conference, pp. 100-111. Oslo, Norway: Nisk J, 2017.

[4] Azaria, Asaph, Ariel Ekblaw, Thiago Vieira, and Andrew Lippman. "Medrec:
Using blockchain for medical data access and permission management." In 2016 2nd
international conference on open and big data (OBD), pp. 25-30. IEEE, 2016.

[5] Gharat, Anurag, Pratik Aher, Punit Chaudhari, and Bhavana Alte. "A
framework for secure storage and sharing of electronic health records using
blockchain technology." In ITM Web of Conferences, vol. 40, p. 03037. EDP
Sciences, 2021.

[6] Sheth, Alpen, and Hemang Subramanian. "Blockchain and contract theory:
modeling smart contracts using insurance markets." Managerial Finance 46, no. 6
(2019): 803-814.

[7] Nishi, Farjana Khanam, Mahizebin Shams-E-Mofiz, Mohammad

Monirujjaman Khan, Abdulmajeed Alsufyani, Sami Bourouis, Punit Gupta, and
Dinesh Kumar Saini. "Electronic healthcare data record security using blockchain and
smart contract." Journal of Sensors 2022 (2022): 1-22.

[8] Linn, Laure A., and Martha B. Koo. "Blockchain for health data and its
potential use in health it and health care related research." In ONC/NIST Use of
Blockchain for Healthcare and Research Workshop. Gaithersburg, Maryland, United
States: ONC/NIST, pp. 1-10. 2016.

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[9] Akhter Md Hasib, Kazi Tamzid, Ixion Chowdhury, Saadman Sakib,

Mohammad Monirujjaman Khan, Nawal Alsufyani, Abdulmajeed Alsufyani, and
Sami Bourouis. "Electronic health record monitoring system and data security using
blockchain technology." Security and Communication Networks 2022 (2022): 1-15.

[10] Yue, Xiao, Huiju Wang, Dawei Jin, Mingqiang Li, and Wei Jiang. "Healthcare
data gateways: found healthcare intelligence on blockchain with novel privacy risk
control." Journal of medical systems 40 (2016): 1-8.

[11] Albeyatti, A. "Medicalchain whitepaper 2.1." (2018).

[12] Chaudhuri, A. B. Flowchart and algorithm basics: The art of programming.

Mercury Learning and Information, 2020.

[13] Jiang, Shan, Jiannong Cao, Hanqing Wu, Yanni Yang, Mingyu Ma, and Jianfei
He. "Blochie: a blockchain-based platform for healthcare information exchange." In
2018 ieee international conference on smart computing (smartcomp), pp. 49-56.
IEEE, 2018.

[14] Buterin, Vitalik. "A next-generation smart contract and decentralized

application platform." white paper 3, no. 37 (2014): 2-1.

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APPENDIX
File name:main.js
import React from "react";

import ReactDOM from "react-dom/client";

import "bootstrap/dist/css/bootstrap.css";

import "../src/assets/css/style.css";

import { createBrowserRouter, RouterProvider } from "react-router-dom";

import "react-bootstrap-icons";

import Home from "./pages/Home.jsx";

import Admin from "./pages/Admin";

import About from "./pages/About";

import Dashboard from "./pages/Dashboard";

import ContactUs from "./pages/ContactUs";

import ErrorPage from "./pages/ErrorPage";

import PatientRecords from "./pages/PatientRecords";

import PatientProfile from "./pages/PatientProfile";

import AddHospital from "./pages/AddHospital";

import AddDoctor from "./pages/AddDoctor";

import HospitalProfile from "./pages/HospitalProfile";

import AddPatient from "./pages/AddPatient";

import DoctorProfile from "./pages/DoctorProfile";

import PatientPermission from "./pages/PatientPermission";

import DoctorRequest from "./pages/DoctorRequest";

import AddRecord from "./pages/AddRecord";

import PatientRecordsForDoctor from "./pages/PatientRecordsForDoctor";

import RegisteredHospitals from "./pages/RegisteredHospitals";

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 Smart Event Timestamping: Query-Driven VTG

import RegisteredPatients from "./pages/RegisteredPatients";

import RegisteredDoctors from "./pages/RegisteredDoctors";

import PreviewRecordForPatient from "./pages/PreviewRecordForPatient";

import PreviewRecordForDoctor from "./pages/PreviewRecordForDoctor";

import ShowAllDocrorsForHospital from "./pages/ShowAllDocrorsForHospital";

import ShowAllPatientForHospital from "./pages/ShowAllPatientForHospital";

import AllRequestes from "./pages/AllRequestes";

const router = createBrowserRouter([

path: "/",

element: <Home />,

errorElement: <ErrorPage />,

},

path: "/home",

element: <Home />,

errorElement: <ErrorPage />,

},

path: "/admin",

element: <Admin />,

errorElement: <ErrorPage />,

},

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path: "/registeredHospitals",

element: <RegisteredHospitals />,

errorElement: <ErrorPage />,

},

path: "/registeredDoctors",

element: <RegisteredDoctors />,

errorElement: <ErrorPage />,

},

path: "/registeredPatients",

element: <RegisteredPatients />,

errorElement: <ErrorPage />,

},

path: "/patientPermission",

element: <PatientPermission />,

errorElement: <ErrorPage />,

},

path: "/patientRecords",

element: <PatientRecords />,

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 Smart Event Timestamping: Query-Driven VTG

errorElement: <ErrorPage />,

},

path: "/previewRecordForDoctor",

element: <PreviewRecordForDoctor />,

errorElement: <ErrorPage />,

},

path: "/previewRecordForPatient",

element: <PreviewRecordForPatient />,

errorElement: <ErrorPage />,

},

path: "/patientProfile",

element: <PatientProfile />,

errorElement: <ErrorPage />,

},

path: "/about",

element: <About />,

errorElement: <ErrorPage />,

},

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 Smart Event Timestamping: Query-Driven VTG

path: "/dashboard",

element: <Dashboard />,

errorElement: <ErrorPage />,

},

path: "/contact",

element: <ContactUs />,

errorElement: <ErrorPage />,

},

path: "/addHospital",

element: <AddHospital />,

errorElement: <ErrorPage />,

},

path: "/addDoctor",

element: <AddDoctor />,

errorElement: <ErrorPage />,

},

path: "/addPatient",

element: <AddPatient />,

errorElement: <ErrorPage />,

},

path: "/addRecord",

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 Smart Event Timestamping: Query-Driven VTG

element: <AddRecord />,

errorElement: <ErrorPage />,

},

path: "/doctorProfile",

element: <DoctorProfile />,

errorElement: <ErrorPage />,

},

path: "/PatientRecordsForDoctor",

element: <PatientRecordsForDoctor />,

errorElement: <ErrorPage />,

},

path: "/doctorRequest",

element: <DoctorRequest />,

errorElement: <ErrorPage />,

},

path: "/hospitalProfile",

element: <HospitalProfile />,

errorElement: <ErrorPage />,

},

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 Smart Event Timestamping: Query-Driven VTG

path: "/showAllDocrorsForHospital",

element: <ShowAllDocrorsForHospital />,

errorElement: <ErrorPage />,

},

path: "/showAllPatientForHospital",

element: <ShowAllPatientForHospital />,

errorElement: <ErrorPage />,

},

path: "/allRequestes",

element: <AllRequestes />,

errorElement: <ErrorPage />,

},

]);

const root = ReactDOM.createRoot(document.getElementById("root"));

root.render(

<React.StrictMode>

<RouterProvider router={router} />

</React.StrictMode>

);

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