{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T17:04:24Z","timestamp":1778346264827,"version":"3.51.4"},"reference-count":38,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2025,2,11]],"date-time":"2025-02-11T00:00:00Z","timestamp":1739232000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Information"],"abstract":"<jats:p>The COVID-19 pandemic exposed critical vulnerabilities in global healthcare systems, particularly in data security and interoperability. This paper introduces the blockHealthSecure Framework, which integrates blockchain technology with advanced cybersecurity measures to address these weaknesses and build resilient post-pandemic healthcare systems. Blockchain\u2019s decentralized and immutable architecture enhances the accuracy, transparency, and protection of electronic medical records (EMRs) and sensitive healthcare data. Additionally, it facilitates seamless and secure data sharing among healthcare providers, addressing long-standing interoperability challenges. This study explores the challenges and benefits of blockchain integration in healthcare, with a focus on regulatory and ethical considerations such as HIPAA and GDPR compliance. Key contributions include detailed case studies and examples that demonstrate blockchain\u2019s ability to mitigate risks like ransomware, insider threats, and data breaches. This framework\u2019s design leverages smart contracts, cryptographic hashing, and zero-trust architecture to ensure secure data management and proactive threat mitigation. The findings emphasize the framework\u2019s potential to enhance data security, improve system adaptability, and support regulatory compliance in the face of evolving healthcare challenges. By bridging existing gaps in healthcare cybersecurity, the blockHealthSecure Framework offers a scalable, future-proof solution for safeguarding health outcomes and preparing for global health crises.<\/jats:p>","DOI":"10.3390\/info16020133","type":"journal-article","created":{"date-parts":[[2025,2,11]],"date-time":"2025-02-11T05:34:32Z","timestamp":1739252072000},"page":"133","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["blockHealthSecure: Integrating Blockchain and Cybersecurity in Post-Pandemic Healthcare Systems"],"prefix":"10.3390","volume":"16","author":[{"given":"Bishwo Prakash","family":"Pokharel","sequence":"first","affiliation":[{"name":"Sault College of Applied Arts and Technology, Sault Ste. Marie, ON P6B 4J3, Canada"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3282-7331","authenticated-orcid":false,"given":"Naresh","family":"Kshetri","sequence":"additional","affiliation":[{"name":"Department of Cybersecurity, Rochester Institute of Technology, Rochester, NY 14623, USA"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-0722-545X","authenticated-orcid":false,"given":"Suresh Raj","family":"Sharma","sequence":"additional","affiliation":[{"name":"Tribhuvan University, Birendra Multiple Campus, Bharatpur 44200, Chitwan, Nepal"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-5336-4355","authenticated-orcid":false,"given":"Sobaraj","family":"Paudel","sequence":"additional","affiliation":[{"name":"Tribhuvan University, Birendra Multiple Campus, Bharatpur 44200, Chitwan, Nepal"}]}],"member":"1968","published-online":{"date-parts":[[2025,2,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1889","DOI":"10.32604\/iasc.2023.028850","article-title":"Secured Cyber Security Algorithm for Healthcare System Using Blockchain Technology","volume":"35","author":"Miriam","year":"2023","journal-title":"Intell. Autom. Soft Comput."},{"key":"ref_2","unstructured":"Pokharel, B.P., and Kshetri, N. (2024). blockLAW: Blockchain Technology for Legal Automation and Workflow--Cyber Ethics and Cybersecurity Platforms. arXiv."},{"key":"ref_3","first-page":"364","article-title":"BCT-CS: Blockchain technology applications for Cyber defense and Cybersecurity: A survey and solutions","volume":"13","author":"Kshetri","year":"2022","journal-title":"Int. J. Adv. Comput. Sci. Appl."},{"key":"ref_4","unstructured":"(2024, December 20). IBM Security X-Force Threat Intelligence Index 2024. IBM. Available online: https:\/\/www.ibm.com\/reports\/threat-intelligence."},{"key":"ref_5","unstructured":"(2024, December 22). 2024 Data Breach Investigations Report. Verizon Business. Available online: https:\/\/www.verizon.com\/business\/resources\/reports\/dbir\/."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Begum, K., Rashid, M.M., Mozumder, M.A.I., and Kim, H.-C. (2023, January 13\u201315). Leveraging the Power of Blockchain for Secure Healthcare Data Management System. Proceedings of the 2023 26th International Conference on Computer and Information Technology (ICCIT), Cox\u2019s Bazar, Bangladesh.","DOI":"10.1109\/ICCIT60459.2023.10441220"},{"key":"ref_7","unstructured":"Sharma, S.R., and Kshetri, N. (2025). Blockchain Technology for Cybersecurity, Cyber Data, and Cyber Communication in Today\u2019s Cyber World. Blockchain Technology for Cyber Defense, Cybersecurity, and Countermeasures: Techniques, Solutions, and Applications, CRC Press."},{"key":"ref_8","unstructured":"(2024, December 14). HIPAA Compliance Guidelines. The HIPAA Journal. Available online: https:\/\/www.hipaajournal.com\/hipaa-compliance-guidelines\/."},{"key":"ref_9","unstructured":"(2024, December 14). Everything You Need to Know About GDPR Compliance. GDPR.eu. Available online: https:\/\/gdpr.eu\/compliance\/."},{"key":"ref_10","unstructured":"(2024, November 13). The NIST Cybersecurity Framework (CSF) 2.0, Available online: https:\/\/nvlpubs.nist.gov\/nistpubs\/CSWP\/NIST.CSWP.29.pdf."},{"key":"ref_11","unstructured":"Nakamoto, S. (2024, November 13). Bitcoin: A Peer-to-Peer Electronic Cash System. Bitcoin White Paper. Available online: https:\/\/bitcoin.org\/bitcoin.pdf."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1504\/IJWGS.2018.095647","article-title":"Blockchain challenges and opportunities: A survey","volume":"14","author":"Zheng","year":"2018","journal-title":"Int. J. Web Grid Serv."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"166","DOI":"10.56294\/dm2023166","article-title":"An overview of blockchain-based Electronic Health Records and compliance with GDPR and HIPAA","volume":"2","author":"Ettaloui","year":"2023","journal-title":"Data Metadata"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Zhang, W., Qamar, F., Abdali, T.-A.N., Hassan, R., Jafri, S.T., and Nguyen, Q.N. (2023). Blockchain technology: Security issues, healthcare applications, challenges, and future trends. Electronics, 12.","DOI":"10.3390\/electronics12030546"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Satybaldy, A., Hasselgren, A., and Nowostawski, M. (2022). Decentralized Identity Management for E-Health Applications: State-of-the-Art and Guidance for Future Work. Blockchain Healthc. Today, 5.","DOI":"10.30953\/bhty.v5.195"},{"key":"ref_16","first-page":"130","article-title":"Blockchain technology applications in Healthcare: An overview","volume":"2","author":"Haleem","year":"2021","journal-title":"Int. J. Intell. Netw."},{"key":"ref_17","unstructured":"Buterin, V. (2024, November 09). A Next-Generation Smart Contract and Decentralized Application Platform. Ethereum White Paper. Available online: https:\/\/ethereum.org\/en\/whitepaper\/."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"e13598","DOI":"10.2196\/13598","article-title":"Action-EHR: Patient-centric blockchain-based electronic health record data management for cancer care","volume":"22","author":"Dubovitskaya","year":"2020","journal-title":"J. Med. Internet Res."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"222310","DOI":"10.1109\/ACCESS.2020.3041951","article-title":"A survey on machine learning techniques for cyber security in the last decade","volume":"8","author":"Shaukat","year":"2020","journal-title":"IEEE Access"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Chaturvedi, I., Pawar, P.M., Muthalagu, R., and Tamizharasan, P.S. (2024). Zero Trust Security Architecture for Digital Privacy in Healthcare. Springer Tracts in Electrical and Electronics Engineering, Springer.","DOI":"10.1007\/978-981-97-0407-1_1"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e34407","DOI":"10.1016\/j.heliyon.2024.e34407","article-title":"Blockchain-enabled EHR Access Auditing: Enhancing Healthcare Data Security","volume":"10","author":"Ullah","year":"2024","journal-title":"Heliyon"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"e188","DOI":"10.7861\/fhj.2021-0095","article-title":"Artificial Intelligence in healthcare: Transforming the practice of medicine","volume":"8","author":"Bajwa","year":"2021","journal-title":"Future Healthc. J."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Satamraju, K.P. (2020). Proof of concept of scalable integration of internet of things and blockchain in Healthcare. Sensors, 20.","DOI":"10.3390\/s20051389"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"8137","DOI":"10.1109\/TII.2022.3217039","article-title":"Real-time medical data security solution for Smart Healthcare","volume":"19","author":"Sarosh","year":"2023","journal-title":"IEEE Trans. Ind. Inform."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Yigzaw, K.Y., Olabarriaga, S.D., Michalas, A., Marco-Ruiz, L., Hillen, C., Verginadis, Y., de Oliveira, M.T., Krefting, D., Penzel, T., and Bowden, J. (2022). Health Data Security and Privacy: Challenges and solutions for the future. Roadmap to Successful Digital Health Ecosystems, Academic Press.","DOI":"10.1016\/B978-0-12-823413-6.00014-8"},{"key":"ref_26","first-page":"1","article-title":"IOT-based applications in healthcare devices","volume":"2021","author":"Pradhan","year":"2021","journal-title":"J. Healthc. Eng."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"100139","DOI":"10.1016\/j.array.2022.100139","article-title":"M Blockchain in healthcare and IOT: A systematic literature review","volume":"14","author":"Adere","year":"2022","journal-title":"Array"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Liu, H., Crespo, R.G., and Mart\u00ednez, O.S. (2020). Enhancing privacy and data security across healthcare applications using blockchain and distributed ledger concepts. Healthcare, 8.","DOI":"10.3390\/healthcare8030243"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Nifakos, S., Chandramouli, K., Nikolaou, C.K., Papachristou, P., Koch, S., Panaousis, E., and Bonacina, S. (2021). Influence of human factors on cyber security within healthcare organisations: A systematic review. Sensors, 21.","DOI":"10.3390\/s21155119"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"79764","DOI":"10.1109\/ACCESS.2020.2988579","article-title":"Blockchain for Industry 4.0: A comprehensive review","volume":"8","author":"Bodkhe","year":"2020","journal-title":"IEEE Access"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Corte-Real, A., Nunes, T., and da Cunha, P.R. (2024). Reflections about Blockchain in health data sharing: Navigating a disruptive technology. Int. J. Environ. Res. Public Health, 21.","DOI":"10.20944\/preprints202401.1016.v1"},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Onik Md, M., Aich, S., Yang, J., Kim, C.-S., and Kim, H.-C. (2019). Blockchain in Healthcare: Challenges and solutions. Big Data Analytics for Intelligent Healthcare Management, Academic Press.","DOI":"10.1016\/B978-0-12-818146-1.00008-8"},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Angraal, S., Krumholz, H.M., and Schulz, W.L. (2017). Blockchain technology: Applications in Health Care. Circ. Cardiovasc. Qual. Outcomes, 10.","DOI":"10.1161\/CIRCOUTCOMES.117.003800"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"5629","DOI":"10.1109\/ACCESS.2023.3236505","article-title":"Blockchain for Healthcare Management Systems: A survey on interoperability and Security","volume":"11","author":"Villarreal","year":"2023","journal-title":"IEEE Access"},{"key":"ref_35","first-page":"63","article-title":"Smart contracts implementation, applications, benefits, and limitations","volume":"9","author":"Nzuva","year":"2019","journal-title":"J. Inf. Eng. Appl."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Ndayizigamiye, P., and Dube, S. (2019, January 21\u201322). Potential adoption of blockchain technology to enhance transparency and accountability in the public healthcare system in South Africa. Proceedings of the 2019 International Multidisciplinary Information Technology and Engineering Conference (IMITEC), Vanderbijlpark, South Africa.","DOI":"10.1109\/IMITEC45504.2019.9015920"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"e19846","DOI":"10.2196\/19846","article-title":"Blockchain integration with digital technology and the future of HealthCare Ecosystems: Systematic Review","volume":"23","author":"Fatoum","year":"2021","journal-title":"J. Med. Internet Res."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"103633","DOI":"10.1016\/j.jnca.2023.103633","article-title":"Blockchain for Healthcare Systems: Architecture, Security Challenges, Trends and Future Directions","volume":"215","author":"Andrew","year":"2023","journal-title":"J. Netw. Comput. 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