This study examines the issues of privacy protection, data security, and query efficiency in blockchain-based electronic medical record (EMR) sharing. It proposes a secure storage and sharing scheme for EMR based on Hyperledger Fabric and the InterPlanetary File System (IPFS). To mitigate the privacy risks of data mining that could reveal patient identities, we establish an attribution channel in Hyperledger Fabric to store EMR ownership information and a data channel to store the storage location, digest, and usage records of medical data. Encrypted medical data are stored in the IPFS. To improve query efficiency in the blockchain, we integrate queryable medical data attributes into a composite key for conditional queries, avoiding complex data filtering processes. Additionally, we use a zero-knowledge proof combined with smart contracts for decentralized identity verification, eliminating reliance on third-party centralized verification services and enhancing system security. We also integrate AES and proxy re-encryption techniques to ensure data security during sharing. This scheme provides a more secure, efficient, and privacy-preserving approach for EMR systems, with significant practical implications and broad application potential.
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