Breaking barriers in healthcare: A secure identity framework for seamless access

The digitization of healthcare data has heightened concerns about security, privacy, and interoperability. Traditional centralized systems are vulnerable to cyberattacks and data breaches, risking the exposure of sensitive patient information and decreasing trust in digital healthcare services. In addition, healthcare stakeholders use various standards and formats, creating challenges for data sharing and seamless communication. To address these points, this article identifies all the healthcare stakeholders and translates each useful element of a patient’s electronic health record (EHR) into Fast Healthcare Interoperability Resources (FHIR), to propose a complete role-based access control model that specifies which FHIR resources an actor is allowed to access. To validate this role model, three new use cases are defined, in which the various stakeholders interact and access the FHIR resources. Moreover, specific smart contracts are detailed to implement the role model in an automated way and provide a robust access control mechanism within healthcare organizations. The feasibility of the proposed access control mechanism is demonstrated through proof-of-concept and test performance measurements. Finally, the solution is validated as a realistic solution adapted to the scale of a country based on health statistics. • Healthcare participants: This work researches the different healthcare participants found in this domain. This contribution clearly provides a basis for designing precise solutions regarding the healthcare actors. • Role-Based Access Control for Healthcare Data: This study proposes a comprehensive role-based access control model that defines which Fast Healthcare Interoperability Resources (FHIR) each healthcare stakeholder can access, ensuring secure and structured data management. • Smart Contract Implementation for Automated Security: The model is reinforced by smart contracts that automate access control, enhancing security, efficiency, and trust in digital healthcare environments. • Scalable and Validated Solution: The proposed access control mechanism is validated through proof-of-concept implementation, performance evaluations, and an analysis demonstrating its feasibility at a national scale based on healthcare statistics.