Lightweight Privacy-Preserving Blockchain Framework for Healthcare: A Simulation-Based Approach to Reducing Computational Overhead

Authors

  • MD. Asrar Ahmed Department of Computer Science and Engineering, Muffakham Jah College of Engineering and Technology, Hyderabad, Telangana, India
  • Mohammed Abid Ali Sameer Department of Information Technology, Muffakham Jah College of Engineering and Technology, Hyderabad, Telangana, India
  • Mousmi Ajay Chaurasia, M.Eng Professor, Department of Information Technology, Muffakham Jah College of Engineering and Technology, Hyderabad, Telangana, India https://orcid.org/0000-0003-4904-6643
  • S. Nallusamy, PhD (Eng) School of Engineering Management and Continuing Education, Jadavpur University

DOI:

https://doi.org/10.30953/bhty.v9.516

Keywords:

AES-128, blockchain framework, computational overhead, lightweight privacy, privacy and security

Abstract

Background: The privacy and security of electronic health records (HER) in blockchain-based systems remains a major research problem because of high computational overhead and scalability restrictions. Privacy-preserving techniques such as encryption and zero-knowledge proofs strengthen blockchain’s transparency and immutability but often add significant latency and resource use. This study proposes a lightweight, simulation-based blockchain model balancing privacy protection and computational efficiency for healthcare data-sharing, incorporating hybrid encryption (AES with asymmetric-key exchange), zero-knowledge verification (zk-SNARK), and homomorphic aggregation to protect patient information while reducing processing cost. 

Methods: A five-stage simulation tested encryption/decryption latency, IPFS-based upload/download performance, proof generation/verification time, and scalability across key sizes, plus a sixth phase val­idating the framework on two real, publicly available, de-identified healthcare datasets—the Medical Information Mart for Intensive Care (MIMIC)-IV  demo (100 real ICU patients) and the University of California “Diabetes 130-US Hospitals” dataset (101,766 real inpatient encounters). Every metric is reported as a mean with a 95% confidence interval from 15 to 20 repeated trials.

Results: The AES-128 has the lowest overhead among tested key sizes (10% to 14% below AES-192/256), zk-SNARK verification averages 30.8 to 32.4 ms (n = 20 to 100 trials)—well within real-time requirements for on-chain access decisions—and proof generation and gas cost are statistically indistinguishable between a minimal baseline circuit and the consent-verification circuit, indicating negligible marginal overhead from the added consent logic. Computing cost scales linearly with data size: 

·      confirming lightweight scalability, with

·      real-data results closely tracking synthetic-data results, with

·      a narrowly scoped comparison showing error correction code memory (ECC (memory (secp256r1) key exchange is 93.5% faster than RSA-3072 key wrapping. 

Conclusions: This work demonstrates that efficient cryptographic integration and optimization through simulation can produce a privacy-preserving blockchain for healthcare that streamlines EHR handling securely and at scale.

 

Plain Language Summary

Unlike centralized health information systems, blockchain allows secure, decentralized storage of medical data, avoiding single points of failure. Furthermore, blockchain supports healthcare infrastructures with better accountability among hospitals, insurers, and patients. However, surveys and reviews reveal many proposed solutions. However, most privacy-sensitive healthcare blockchain systems are characterized by the following:

·      theoretical or tested only in limited-scale simulations, 

·      little detailed performance optimization of cryptographic workloads and 

·      storage requirements as well.

However, blockchain in healthcare also brings drawbacks for privacy and efficient computing. This and more are discussed here.

Key Takeaways

- Off-chain actions are the latency bottleneck. 

- zk-SNARKs introduce privacy effectively.

- Partially homomorphic encryption supports analytics without sacrificing security.

- Hybrid key exchange substantially reduces cryptographic overhead.

Downloads

Download data is not yet available.

References

[1] Liu, J., Li, X., Ye, L., Zhang, H., Du, X., & Guizani, M. (2018). “BPDS: A blockchain based privacy-preserving data sharing for electronic medical records.” 2018 IEEE Global Communications Conference (GLOBECOM), 1–6. https://doi.org/10.1109/GLOCOM.2018.8647713

[2] Bai, T., Hu, Y., He, J., Fan, H., & An, Z. (2022). “Health-zkIDM: A healthcare identity system based on fabric blockchain and zero-knowledge proof.” Sensors, 22(20), 7716. https://doi.org/10.3390/s22207716

[3] Padma, A., & Ramaiah, M. (2025). “Lightweight privacy preservation blockchain framework for healthcare applications using GM-SSO.” Results in Engineering, 25, 103882. https://doi.org/10.1016/j.rineng.2024.103882

[4] Azaria, A., Ekblaw, A., Vieira, T., & Lippman, A. (2016). “MedRec: Using blockchain for medical data access and permission management.” 2016 2nd International Conference on Open and Big Data (OBD), 25–30. https://doi.org/10.1109/OBD.2016.11

[5] Tawfik, A. M., Al-Ahwal, A., Tag Eldien, A. S., & Zayed, H. H. (2025). “PriCollabAnalysis: Privacy-preserving healthcare collaborative analysis on blockchain using homomorphic encryption and secure multiparty computation.” Cluster Computing, 28(3), 191–208. https://doi.org/10.1007/s10586-024-04928-z

[6] Zhang, R., Xue, R., & Liu, L. (2021). “Security and privacy for healthcare blockchains.” IEEE Transactions on Services Computing, 15(6), 3668–3686. https://doi.org/10.1109/TSC.2021.3085913

[7] Wang, L., Liu, X., Shao, W., Guan, C., Huang, Q., Xu, S., & Zhang, S. (2024). “A blockchain-based privacy-preserving healthcare data sharing scheme for incremental updates.” Symmetry, 16(1), 89. https://doi.org/10.3390/sym16010089

[8] Alahmari, S., Alshardan, A., Al-Wesabi, F. N., Sorour, S., Alghushairy, O., Alsini, R., Khadidos, A. O., & Al Duhayyim, M. (2025). “A decentralized and privacy-preserving framework for electronic health records using blockchain.” Alexandria Engineering Journal, 126, 196–203. https://doi.org/10.1016/j.aej.2025.04.069

[9] Sabiri, K., Sousa, F., & Rocha, T. (2025). “A systematic review of privacy-preserving blockchain applications in healthcare.” Multimedia Tools and Applications, 1–56. https://doi.org/10.1007/s11042-024-20541-z

[10] Kasralikar, P., Polu, O. R., Chamarthi, B., Rupavath, R. V., Patel, S., & Tumati, R. (2025). “Blockchain for securing AI-driven healthcare systems: A systematic review and future research perspectives.” Cureus, 17(4), e83136. https://doi.org/10.7759/cureus.83136

[11] Myeong, G. E., & Ram, K. S. (2025). “Blockchain-based zero-knowledge proof protocol for privacy-preserving healthcare data sharing.” Journal of Technology Informatics and Engineering, 4(1), 171–189. https://doi.org/10.51903/jtie.v4i1.296

[12] Haleem, A., Javaid, M., Singh, R. P., Suman, R., & Rab, S. (2021). “Blockchain technology applications in healthcare: An overview.” International Journal of Intelligent Networks, 2, 130–139. https://doi.org/10.1016/j.ijin.2021.09.005

[13] Tawfik, A. M., Al-Ahwal, A., Tag Eldien, A. S., & Zayed, H. H. (2025). “Blockchain-based access control and privacy preservation in healthcare: A comprehensive survey.” Cluster Computing, 28, 529. https://doi.org/10.1007/s10586-025-05308-x

[14] Li, K., Lohachab, A., Dumontier, M., & Urovi, V. (2025). “Privacy preservation in blockchain-based healthcare data sharing: A systematic review.” Peer-to-Peer Networking and Applications, 18, 302. https://doi.org/10.1007/s12083-025-02148-9

[15] Zhao, L., Dong, G., & Yuan, H. (2025). “A blockchain-based verifiable CP-ABE scheme for medical data privacy protection.” Scientific Reports, 15, 27325. https://doi.org/10.1038/s41598-025-13069-1

[16] Wang, S., Xie, X., Wang, T., & Ma, J. (2025). “Attribute-based encryption and zk-SNARK authentication scheme for healthcare systems.” Journal of Information Security and Applications, 94, 104241. https://doi.org/10.1016/j.jisa.2025.104241

[17] Yin, H., Zhao, Y., Zhang, L., Qiao, B., Chen, W., & Wang, H. (2024). “Attribute-based searchable encryption with decentralized key management for healthcare data sharing.” Journal of Systems Architecture, 148, 103081. https://doi.org/10.1016/j.sysarc.2024.103081

[18] Maheshwari, V., & Prasanna, M. (2025). “Privacy-preserving authentication for 5G healthcare with HBZKP: Hierarchical blockchain-based zero knowledge proof for secure edge devices.” Ain Shams Engineering Journal, 16, 103463. https://doi.org/10.1016/j.asej.2025.103463

[19] Khan, A. A., Laghari, A. A., Almansour, H., Kumar, T., Jaghdam, I. H., Hajjej, F., & Mohamed, M. A. (2025). “Leveraging blockchain with zero knowledge proofs in wearable health technologies for personalized healthcare.” Scientific Reports, 15, 45672. https://doi.org/10.1038/s41598-025-25146-6

[20] Guo, H., Li, W., Nejad, M., & Shen, C.-C. (2022). “A hybrid blockchain-edge architecture for electronic health record management with attribute-based cryptographic mechanisms.” IEEE Transactions on Network and Service Management, 19(4), 5038–5053. https://doi.org/10.1109/TNSM.2022.3186006

[21] Alruwaill, M. N., Mohanty, S. P., & Kougianos, E. (2025). “HCHAIN 4.0: A secure and scalable permissioned blockchain for EHR management in smart healthcare.” arXiv preprint arXiv:2505.13861. https://doi.org/10.48550/arXiv.2505.13861

[22] Yang, J., Li, L., Gu, Y., & Wu, H. (2025). “Fast authenticated and interoperable multimedia healthcare data over hybrid-storage blockchains.” arXiv preprint arXiv:2510.13318. https://doi.org/10.48550/arXiv.2510.13318

[23] Manivannan, D. (2025). “Attribute-based encryption for secure access control in personal health records.” Computer Systems Science and Engineering. https://doi.org/10.32604/csse.2025.072267

[24] Walid, R., Joshi, K. P., & Choi, S. G. (2024). “Comparison of attribute-based encryption schemes in securing healthcare systems.” Scientific Reports, 14, 7147. https://doi.org/10.1038/s41598-024-57692-w

[25] Zhao, Z., Yu, X., & Ma, Z. (2024). “Attribute encryption based blockchain electronic medical record traceability method.” 2024 3rd International Conference on Cryptography, Network Security and Communication Technology (CNSCT), 1–8. https://doi.org/10.1145/3673277.3673281

[26] Johnson, A. E. W., Bulgarelli, L., Pollard, T. J., Horng, S., Celi, L. A., & Mark, R. G. (2022). “MIMIC-IV Clinical Database Demo” (version 2.2). PhysioNet. https://doi.org/10.13026/dp1f-ex47 (accessed via physionet.org/content/mimic-iv-demo/2.2/).

[27] Strack, B., DeShazo, J. P., Gennings, C., Olmo, J. L., Ventura, S., Cios, K. J., & Clore, J. N. (2014). “Diabetes 130-US hospitals for years 1999–2008.” UCI Machine Learning Repository. https://doi.org/10.24432/C5230J.

Published

2026-08-31

How to Cite

Asrar Ahmed, M., Abid Ali Sameer, M., Ajay Chaurasia, M., & Nallusamy, S. (2026). Lightweight Privacy-Preserving Blockchain Framework for Healthcare: A Simulation-Based Approach to Reducing Computational Overhead. Blockchain in Healthcare Today, 9(2). https://doi.org/10.30953/bhty.v9.516

Issue

Section

Narrative/Systematic Review/Meta-Analysis