Innovative blockchain and NFT solutions for enhanced security and interoperability in EHR Management: A review

Abstract

Electronic Health Record (EHR) management is one of the challenging problems in digital healthcare and is related to several issues such as data security, privacy, scalability, interoperability, and ownership which are very crucial for reliable exchange of information. This review discusses the recent trend and technological solutions for the mentioned challenges. These solutions mainly focus on cloudbased infrastructures, attribute-based encryption (ABE), blockchain frameworks, and Non-Fungible Token (NFT)-based data ownership. This study highlights the strengths and limitations of each approach using comparative analysis and evaluations. Also, this review introduces a conceptual integration framework that combines graph neural networks (GNNs), multi-reference attribute-based encryption (MA-ABE), blockchain, and NFTs. The proposed model integrates predictive artificial intelligence, decentralized mechanism, immutable auditing, and verifiable ownership in a multi-layered architecture to address the issues and challenges of HER systems. Quantitative analysis of the reviewed literature reveals a clear upward trend in research activity, with more than 80 peer-reviewed studies published between 2017 and 2024, representing an approximate 250% growth in blockchain-, ABE-, and NFT-based EHR solutions. Among these, 41% focus on security and privacy, 27% on scalability, and 19% on interoperability, underscoring the field’s growing emphasis on decentralized and intelligent healthcare systems. This article not only contributes to a comprehensive review of the previous researches, but also provides a perspective on how the future of healthcare systems will be reshaped by intelligent and decentralized technologies.