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Peer-reviewedCC BY 4.0Scientific Reports

Toward trustworthy IoMT healthcare: federated learning and verifiable blockchain for secure edge-driven EHR systems

Abstract

The advent of Internet of Medical Things (IoMT) has made it necessary to exchange electronic health records (EHRs) across distributed healthcare entities in a manner that ensures their authentication and preserves patients’ privacy. This paper proposes the Federated and Blockchain-enabled Electronic Health Record (FBEHR) framework whose major contribution is the Improved Universal Designated Verifier Signature Proof (IUDVSP). Different from all other pairing-based UDVSP schemes, the suggested solution uses elliptic curve arithmetic compatible with ECDSA to ensure signer authenticity, designated-verifier privacy, and verification control without employing bilinear pairings. According to our experiments in the × 86 edge-server environment, IUDVSP takes 0.22 ms to generate signatures and 0.28 ms to verify them. While these results are below 2-4 ms that we take as the cost of one pairing operation in the adopted reference architecture, they are not the result of a direct same-platform performance comparison of the suggested algorithm with a complete pairing-based UDVSP protocol. The framework also features blockchain-based EHR registration, validation, access, revocation and federated ANN-LSTM-based malicious-user detection. In an internal evaluation of the suggested system, activation of edge processing results in the mean registration and validation latency reduction from 9.87 to 3.59 s which corresponds to the 62.76% latency improvement relative to the same framework but without edge processing. Performance of the FBEHR relative to existing baselines is similar; thus, the primary benefit of FBEHR is its pairing-free designated-verifier security, not latency improvement over those systems. An estimation of the total cost of ownership for a month-long period of FBEHR deployment gives us USD 1850 for the considered FBEHR architecture and USD 12,500 for the same architecture but centralized. This difference of 85.2% is calculated based on a model and is not the experimental performance cost reduction.

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BibTeX
@article{chhabra2026toward,
  title = {{Toward trustworthy IoMT healthcare: federated learning and verifiable blockchain for secure edge-driven EHR systems}},
  author = {Gurpreet Singh Chhabra and Abhijeet Mahapatra and Kaushik Mishra and Goluguri N. V. Rajareddy and Santosh Kumar Majhi and Gaurav Sarma and Premananda Sahu},
  journal = {Scientific Reports},
  year = {2026},
  month = oct,
  doi = {10.1038/s41598-026-77090-8},
  url = {https://www.nature.com/articles/s41598-026-77090-8},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Toward trustworthy IoMT healthcare: federated learning and verifiable blockchain for secure edge-driven EHR systems
AU  - Gurpreet Singh Chhabra
AU  - Abhijeet Mahapatra
AU  - Kaushik Mishra
AU  - Goluguri N. V. Rajareddy
AU  - Santosh Kumar Majhi
AU  - Gaurav Sarma
AU  - Premananda Sahu
PY  - 2026
DA  - 2026/10/28
JO  - Scientific Reports
DO  - 10.1038/s41598-026-77090-8
UR  - https://www.nature.com/articles/s41598-026-77090-8
AB  - The advent of Internet of Medical Things (IoMT) has made it necessary to exchange electronic health records (EHRs) across distributed healthcare entities in a manner that ensures their authentication and preserves patients’ privacy. This paper proposes the Federated and Blockchain-enabled Electronic Health Record (FBEHR) framework whose major contribution is the Improved Universal Designated Verifier Signature Proof (IUDVSP). Different from all other pairing-based UDVSP schemes, the suggested solution uses elliptic curve arithmetic compatible with ECDSA to ensure signer authenticity, designated-verifier privacy, and verification control without employing bilinear pairings. According to our experiments in the × 86 edge-server environment, IUDVSP takes 0.22 ms to generate signatures and 0.28 ms to verify them. While these results are below 2-4 ms that we take as the cost of one pairing operation in the adopted reference architecture, they are not the result of a direct same-platform performance comparison of the suggested algorithm with a complete pairing-based UDVSP protocol. The framework also features blockchain-based EHR registration, validation, access, revocation and federated ANN-LSTM-based malicious-user detection. In an internal evaluation of the suggested system, activation of edge processing results in the mean registration and validation latency reduction from 9.87 to 3.59 s which corresponds to the 62.76% latency improvement relative to the same framework but without edge processing. Performance of the FBEHR relative to existing baselines is similar; thus, the primary benefit of FBEHR is its pairing-free designated-verifier security, not latency improvement over those systems. An estimation of the total cost of ownership for a month-long period of FBEHR deployment gives us USD 1850 for the considered FBEHR architecture and USD 12,500 for the same architecture but centralized. This difference of 85.2% is calculated based on a model and is not the experimental performance cost reduction.
SN  - 2045-2322
ER  -