Event-driven integration of electronic medical records with blockchain and InterPlanetary file system

The integrity, security, and accessibility of electronic medical record (EMR) are often compromised by traditional systems, which struggle to ensure data integrity, transparent audit trails, and secure long-term storage. This research addresses these challenges by integrating EMR with a private blockchain and InterPlanetary file system (IPFS) cluster, using change data capture (CDC) for real-time updates and integrate with existing EMR systems, avoiding the need for building new EMR software. Implemented in the OpenEMR framework, the system's performance is evaluated across various processes, including document uploading, sharing, access, deletion, and integrity verification. Testing with anonymized medical records in PDF formats ranging from 1 MB to 100 MB shows that uploading to IPFS takes 0.7 seconds per MB, blockchain transaction processing averages 4.2 seconds, CDC time is 1.1 seconds per MB, and OpenEMR uploads average 0.98 seconds per MB. These results demonstrate significant improvements in data security, integrity, and availability, following the CIA triad principles. The system provides a traceable and secure solution for EMR management.