A hybrid blockchain migration framework for converting traditional databases into blockchain-based EMR systems.
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| Název: | A hybrid blockchain migration framework for converting traditional databases into blockchain-based EMR systems. |
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| Autoři: | Al-Busaidi A; Department of Mathematics and Computer Science, Modern College of Business and Science, Muscat, Oman. 20246403@mcbs.edu.om., Mani J; Department of Mathematics and Computer Science, Modern College of Business and Science, Muscat, Oman., Yoosuf MS; Department of Mathematics and Computer Science, Modern College of Business and Science, Muscat, Oman., P V; Department of Mathematics and Computer Science, Modern College of Business and Science, Muscat, Oman. |
| Zdroj: | Scientific reports [Sci Rep] 2026 Feb 05; Vol. 16 (1). Date of Electronic Publication: 2026 Feb 05. |
| Způsob vydávání: | Journal Article |
| Jazyk: | English |
| Informace o časopise: | Publisher: Nature Publishing Group Country of Publication: England NLM ID: 101563288 Publication Model: Electronic Cited Medium: Internet ISSN: 2045-2322 (Electronic) Linking ISSN: 20452322 NLM ISO Abbreviation: Sci Rep Subsets: MEDLINE; PubMed not MEDLINE |
| Imprint Name(s): | Original Publication: London : Nature Publishing Group, copyright 2011- |
| Abstrakt: | Electronic Medical Records (EMRs) are crucial to modern healthcare. However, traditional relational databases fail to fulfill increased expectations for integrity, auditability, and compliance in regulated environments. This paper proposes a Hybrid Blockchain Migration Framework that integrates a conventional MySQL-based EMR system (OpenMRS) with a permissioned blockchain network (Hyperledger Fabric). Sensitive data fields are selectively mirrored to the blockchain, ensuring tamper-evident logging while retaining the high performance of SQL for routine operations. A middleware layer, implemented using Java Spring Boot, monitors changes in the EMR and commits cryptographic hashes and metadata to the blockchain in near real-time. We evaluate the hybrid system against both standalone MySQL and full-blockchain implementations using controlled benchmarks, analyzing latency, throughput, resource utilization, and auditability. Results show that the hybrid architecture sustains near-native responsiveness (median 2.1 ms versus 1.6 ms for pure MySQL and 60.5 ms for Fabric) and delivers 480 Transaction Per Second (TPS), while incurring only modest overhead (47% of i7-9750H CPU, 1.15 GB RAM) and enhancing data integrity and compliance with regulations such as Oman's Personal Data Protection Law (PDPL). The framework is extensible to multi-institutional deployments and supports regulatory alignment, making it a viable pathway for blockchain adoption in clinical settings. (© 2026. The Author(s).) |
| Competing Interests: | Declarations. Competing interests: The authors declare no competing interests. |
| References: | Hölbl, M., Kompara, M., Kamišalić, A. & Zlatolas, L. N. A systematic review of the use of blockchain in healthcare. Symmetry 10(10), 470 (2018). (PMID: 10.3390/sym10100470) Agbo, C. C., Mahmoud, Q. H. & Eklund, J. M. Blockchain technology in healthcare: A systematic review. Healthcare 7(2), 56 (2019). (PMID: 10.3390/healthcare7020056309873336627742) Vazirani, A. A., O’Donoghue, O., Brindley, D. & Meinert, E. Implementing blockchains for efficient health care: Systematic review. J. Med. Internet Res. 21(2), e13529 (2019). (PMID: 10.2196/12439) Daraghmi, E.-Y., Daraghmi, Y.-A. & Yuan, S.-M. MedChain: A design of blockchain-based system for medical records access and permissions management. IEEE Access 7, 164595–164613 (2019). (PMID: 10.1109/ACCESS.2019.2952942) Siyal, A. A. Applications of blockchain technology in medicine and healthcare: Challenges and future perspectives. Cryptography 3(1), 3 (2019). (PMID: 10.3390/cryptography3010003) Ichikawa, D., Kashiyama, M. & Ueno, T. Tamper-resistant mobile health using blockchain technology. JMIR Mhealth Uhealth 5(7), e111 (2017). (PMID: 10.2196/mhealth.7938287472965550736) Rouhani, S. MediChain™: A secure decentralized medical data asset management system. In Proc. IEEE Cybermatics (Blockchain 2018 Workshop), pp. 1348–1355 (2018). Azaria, A., Ekblaw, A., Vieira, T. & Lippman, A. MedRec: Using blockchain for medical data access and permission management. In Proc. 2nd Int. Conf. Open Big Data (OBD), pp. 25–30 (2016). Hasnain, M., Albogamy, F. R., Alamri, A., Ghani, I. & Mehboob, B. The Hyperledger Fabric as a blockchain framework preserves the security of electronic health records. Front. Public Health 11, 1272787. https://doi.org/10.3389/fpubh.2023.1272787 (2023). (PMID: 10.3389/fpubh.2023.12727873808902210713743) Guo, H., Shi, H. & Zhao, C. Access control for electronic health records with hybrid blockchain-edge architecture. In Proc. IEEE Int. Conf. Blockchain, pp. 44–51 (2019). Wang, Q. & Qin, S. A Hyperledger Fabric-based system framework for healthcare data management. Appl. Sci. 11(24), 11693 (2021). (PMID: 10.3390/app112411693) Sultanate of Oman, Issuing the Personal Data Protection Law. Sultani Decree No. 6/2022, Oman Official Gazette, (2022). Stamatellis, C., Papadopoulos, P., Pitropakis, N., Katsikas, S. & Buchanan, W. J. PREHEALTH: A privacy-preserving healthcare framework using Hyperledger Fabric. Sensors 20(22), 6587 (2020). (PMID: 10.3390/s202265877698751) Mettler, M. Blockchain technology in healthcare: The revolution starts here. In Proc. IEEE 18th Int. Conf. e-Health Netw., Appl. Serv. (Healthcom), pp. 1–3 (2016). Lee, S., Kim, J. H., Kwon, Y., Kim, T. & Cho, S. Privacy preservation in patient information exchange systems based on blockchain: System design study. J. Med. Internet Res. 24(3), e29108 (2022). (PMID: 10.2196/29108353157788984831) Lopez, L. J. R., Millan Mayorga, D., Martinez Poveda, L. H., Amaya, A. F. C. & Reales, W. R. Hybrid architectures used in the protection of large healthcare records based on cloud and blockchain integration: A review. Computers 13(6), 15. https://doi.org/10.3390/computers13060152 (2024). OpenMRS Community. Our Impact – OpenMRS by the Numbers. OpenMRS. Available online: https://openmrs.org/what-we-do/our-impact/ (accessed on 7 December 2025). e-Estonia. KSI Blockchain Stack – Zero Trust Applications. Available online: https://digiexpo.e-estonia.com/cyber-security/ksi-blockchain-stack-zero-trust-applications/ (accessed on 8 December 2025). Ghafur, S. et al. A retrospective impact analysis of the WannaCry cyberattack on the NHS. NPJ Digit. Med. 2, 98 (2019). (PMID: 10.1038/s41746-019-0161-6316024046775064) National Audit Office. Investigation: The 2017 WannaCry cyber attack and the NHS. UK Parliament / NAO (2017). |
| Contributed Indexing: | Keywords: Blockchain; Compliance; Data integrity; Data migration; Electronic medical records; Healthcare IT; Hybrid database; Hyperledger fabric; Oman PDPL; OpenMRS |
| Entry Date(s): | Date Created: 20260205 Latest Revision: 20260223 |
| Update Code: | 20260223 |
| PubMed Central ID: | PMC12923707 |
| DOI: | 10.1038/s41598-026-36787-6 |
| PMID: | 41644591 |
| Databáze: | MEDLINE |
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Nájsť tento článok vo Web of Science | Abstrakt: | Electronic Medical Records (EMRs) are crucial to modern healthcare. However, traditional relational databases fail to fulfill increased expectations for integrity, auditability, and compliance in regulated environments. This paper proposes a Hybrid Blockchain Migration Framework that integrates a conventional MySQL-based EMR system (OpenMRS) with a permissioned blockchain network (Hyperledger Fabric). Sensitive data fields are selectively mirrored to the blockchain, ensuring tamper-evident logging while retaining the high performance of SQL for routine operations. A middleware layer, implemented using Java Spring Boot, monitors changes in the EMR and commits cryptographic hashes and metadata to the blockchain in near real-time. We evaluate the hybrid system against both standalone MySQL and full-blockchain implementations using controlled benchmarks, analyzing latency, throughput, resource utilization, and auditability. Results show that the hybrid architecture sustains near-native responsiveness (median 2.1 ms versus 1.6 ms for pure MySQL and 60.5 ms for Fabric) and delivers 480 Transaction Per Second (TPS), while incurring only modest overhead (47% of i7-9750H CPU, 1.15 GB RAM) and enhancing data integrity and compliance with regulations such as Oman's Personal Data Protection Law (PDPL). The framework is extensible to multi-institutional deployments and supports regulatory alignment, making it a viable pathway for blockchain adoption in clinical settings.<br /> (© 2026. The Author(s).) |
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| ISSN: | 2045-2322 |
| DOI: | 10.1038/s41598-026-36787-6 |