A Bio-inspired Reputation Based Consensus Mechanism for Secure and Scalable Permissioned Blockchain in Electronic Health Record Systems
Md. Yusuf, Maftun Ahommed, Takia Nawrin, Fahmeda Hossain Orna, Iffat Jahan Kona, Nafees Mansoor
Conference Paper. 2025 IEEE International Conference on Biomedical Engineering, Computer and Information Technology for Health, BECITHCON 2025, pp. 523–528 (2025).
Abstract
Electronic Health Records (EHRs) are a crucial part of the current healthcare system, encompassing hospitals, laboratories, pharmacies, and insurers. Yet, they have serious threats, such as data manipulation, unauthorized access, insider threats, and the lack of trust in centralized servers, as they negatively affect patient privacy and system reliability. Permissioned blockchain is a smart choice to mitigate these risks, but widely used consensus algorithms in a permissioned setup often struggle with scalability, security, and do not consider dynamic leader selection. To overcome these challenges, this article suggests a Reputation-Based Consensus Mechanism (RBCM) inspired by Ant-Colony Optimization (ACO) clustering and dynamic reputation scoring, which is integrated into a permissioned blockchain infrastructure. In this context, only reputable nodes are authorized to handle sensitive medical transactions. RBCM dynamically assesses the credibility of nodes based on their past activity and behavior, evaluates validator reliability, selects trusted leaders adaptively, and integrates seamlessly with Hyperledger Fabric. It reduces the risk of malicious participants. Theoretical analysis suggests that the proposed algorithm for RBCM is more secure, scalable, resilient, and reliable than traditional consensus protocols such as Practical Byzantine Fault Tolerance (PBFT) and Proof-of-Authority (PoA) making it especially suitable in hospital networks to manage secure EHRs and telehealth. © 2025 IEEE.
Keywords
Electronic Health Records, Hyperledger Fabric, Permissioned Blockchain, Reputation-based Consensus