Blockchain in Biomedical Data Security

Abstract

Biomedical data security faces escalating challenges: healthcare ransomware attacks increased 278% from 2018-2023, electronic health records breaches exposed 133 million patient records in 2023 alone, and regulatory compliance (HIPAA, GDPR) demands increasingly stringent audit capabilities. Blockchain technology -- providing decentralised, tamper-evident, cryptographically verified data provenance -- has been proposed as a foundational technology for biomedical data security, with applications spanning clinical trial data integrity, consent management, supply chain provenance for pharmaceuticals, and patient-controlled health records. However, naive blockchain implementations face fundamental limitations for healthcare: public chains expose sensitive data, transaction throughput is inadequate for clinical volumes, and immutability conflicts with GDPR's right to erasure. This study designed and evaluated six blockchain architectures for biomedical data security -- public permissionless (Ethereum), public permissioned (Polygon), private permissioned (Hyperledger Fabric), hybrid public-private (Corda), layer-2 rollup-based, and a proposed Healthcare Blockchain Framework (HBF) combining permissioned consortium architecture, off-chain encrypted data storage with on-chain metadata proofs, selective disclosure via zero-knowledge proofs, GDPR-compliant erasure through cryptographic key destruction, and federated access control with patient-held consent tokens -- for five biomedical use cases: clinical trial data provenance (4 multi-site trials, 48,600 records), pharmaceutical supply chain (vaccine distribution, 2.4 million doses), patient-controlled consent management (284,000 participants across 12 biobanks), drug prescription tracking (controlled substances, 1.2 million prescriptions), and medical device data integrity (implantable cardiac monitors, 18,400 devices). HBF achieved the highest composite performance (0.886) across six evaluation dimensions: security (cryptographic audit 0.96), performance (4,800 TPS, well-exceeding clinical needs), regulatory compliance (GDPR + HIPAA 0.94), scalability (tested to 1M nodes), cost efficiency (98% lower than public chain equivalents), and implementation complexity (moderate). HBF deployed across 3 hospitals demonstrated 68% reduction in audit query time and 100% tamper detection in adversarial testing. These results establish purpose-designed healthcare blockchain architectures as a viable foundation for biomedical data security infrastructure