{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T13:36:00Z","timestamp":1787578560809,"version":"build-2736575974"},"reference-count":26,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:00:00Z","timestamp":1787097600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Technology and Health Care"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Modern healthcare system produces large amount of sensitive clinical data, but no existing framework simultaneously addresses and satisfy rigorous security guarantees, storage efficiency and the throughput demand of clinical operations\/transactions. All existing framework addresses these requirements in isolation such as cloud architectures lack cryptographic immutability and standalone blockchain systems suffer by high gas costs and block size limitations. To resolve this gap, we present the Blockchain-Integrated Cloud Compression Model (BICCM) a three-tier architecture that combines (i) Ethereum based smart contracts with Role-Based Access Control (RBAC) and Zero-Knowledge Proof (ZKP) authentication, (ii) Lempel-Ziv-Welch (LZW) lossless compression applied at a dedicated light node layer and (iii) a blockchain secured cloud object store with on-chain SHA-256 has anchoring. COVID-19 medical records from Pakistan Bureau of statistics (PBS-2023) in six size classes range from 4.93 to 39.80KB were used for evaluation.BICCM achieves 65.81 to 85.34% storage reduction, 64.3 to 84.4% gas savings (mean 76.4%), 45.4 to 83.2% execution-time improvement, and 50% transaction cost reduction Compared to the traditional Ethereum blockchain outperformed four competing algorithms (LZ-String, LZ77, Run-Length Encoding, Huffman) for all evaluated data sizes, attaining compression ratios of 2.92 to 6.82. Smart contract deployment on auxiliary nodes reduced ETH costs by 88.6% compared to the main deployment node. BICCM offers a scalable, safe and HIPAA\/GDPR complaint platform for blockchain cloud healthcare data management with full implementation across all twelve assessed security criteria. Future work will follow a strategy for federated learning integration and post-quantum cryptography transition.<\/jats:p>","DOI":"10.1177\/09287329261479267","type":"journal-article","created":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T02:04:39Z","timestamp":1787191479000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Enhancing security and efficiency in healthcare cloud computing with blockchain integration and LZW compression: The BICCM framework"],"prefix":"10.1177","author":[{"given":"Fareed","family":"Ullah","sequence":"first","affiliation":[{"name":"Institute of Computing and Information Technology, Gomal University, Dera Ismail Khan, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zia","family":"Uddin","sequence":"additional","affiliation":[{"name":"Institute of Computing and Information Technology, Gomal University, Dera Ismail Khan, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad","family":"Sardaraz","sequence":"additional","affiliation":[{"name":"Department of Computer Science, COMSATS University Islamabad, Attock Campus, Attock, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad","family":"Javed","sequence":"additional","affiliation":[{"name":"Institute of Computing and Information Technology, Gomal University, Dera Ismail Khan, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toba","family":"Aziz","sequence":"additional","affiliation":[{"name":"Department of computer Science, Mohi-ud-Din Islamic University AJ&amp;K, Nerian Sharif, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,19]]},"reference":[{"key":"e_1_3_3_2_2","first-page":"898","volume-title":"A security model for the enhancement of data privacy in cloud computing2019 Amity International Conference on Artificial Intelligence (AICAI)","author":"Sharma Y","unstructured":"Sharma Y, Gupta H, Khatri SK. A security model for the enhancement of data privacy in cloud computing. In: 2019 Amity International Conference on Artificial Intelligence (AICAI), 2019, February, pp.898\u2013902: IEEE."},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrg.2017.113"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.procs.2017.12.089"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1109\/MCC.2018.022171667"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11042-019-7724-z"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10916-019-1445-8"},{"key":"e_1_3_3_8_2","first-page":"647","article-title":"A data security-based efficient compression and encryption for cloud computing","author":"Kumar S","year":"2017","unstructured":"Kumar S, Sundaresan P, Logith R, et al. A data security-based efficient compression and encryption for cloud computing. 7th International Conference on Trends in Electronics and Informatics 2017: 647\u2013653.","journal-title":"7th International Conference on Trends in Electronics and Informatics"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijinfomgt.2019.02.005"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1101\/gr.207464.116"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.3390\/app9091736"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.3390\/app11209372"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1109\/ACCESS.2021.3050241"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.future.2019.11.013"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11227-020-03213-1"},{"key":"e_1_3_3_16_2","first-page":"012038","volume-title":"(Vol","volume":"1979","author":"Alenizi BA","unstructured":"Alenizi BA, Humayun M, Jhanjhi NZ. Security and privacy issues in cloud computing. In Journal of Physics: Conference Series (Vol. 1979, No. , p. 012038). 2021, August, IOP Publishing."},{"key":"e_1_3_3_17_2","first-page":"022065","volume-title":"A research on security problems with data storage in cloud computingIOP Conference Series: Materials Science and Engineering","volume":"981","author":"Kumar KS","unstructured":"Kumar KS, Chythanya KR, Jamalpur B, et al. A research on security problems with data storage in cloud computing. In IOP Conference Series: Materials Science and Engineering (Vol. 981, No. , p. 022065). 2020, December, IOP Publishing."},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10916-018-0982-x"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1109\/JSYST.2020.2963840"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-030-13705-2_10"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.3390\/cryptography3010003"},{"key":"e_1_3_3_22_2","first-page":"650","volume-title":"(Vol","author":"Dubovitskaya A","year":"2017","unstructured":"Dubovitskaya A, Xu Z, Ryu S, et al. Secure and trustable electronic medical records sharing using blockchain. 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