Optimizing Blockchain Scalability for Secure Patient Health Records With Tri‐Layered Sharding Architecture (<scp>TLSA</scp>)

ABSTRACT Blockchain technology provides a decentralized, tamper‐resistant framework for managing sensitive healthcare data, ensuring transparency, data integrity, and patient privacy. However, its adoption in real‐time medical environments is hindered by significant scalability challenges, particularly in processing high volumes of transactions with low latency. Existing solutions such as Layer 2 enhancements, sidechains, and basic sharding offer partial improvements but often introduce trade‐offs in security, load balancing, or system complexity. To address these limitations, we propose the Tri‐Layered Sharding Architecture (TLSA). It is a novel, hierarchical model that organizes the network into three sharding layers: Transaction Layer, Data Layer, and Location Layer. This design enables parallel transaction processing, optimized data storage, and efficient node communication, resulting in improved system throughput and responsiveness. Simulation results show that TLSA achieves 4500 Transactions Per Second (TPS) with 95% security efficiency and an average latency of 12 ms. TLSA ensures scalability without compromising security and provides an efficient framework for large‐scale, real‐time deployment in healthcare and other data‐intensive sectors.