Patient Sovereignty in the Digital Age: A Blockchain-Based Framework for Controllable Health Information System

Abstract

The digitization of health records has created significant challenges, including data fragmentation, security vulnerabilities, and limited patient control over sensitive information. Blockchain technology provides a transformative foundation for patient-controlled health information systems through its decentralization, immutability, and cryptographic security features. This framework shifts control from institutions to patients by implementing a hybrid architecture that stores consent logs on-chain while securing protected health information off-chain. Smart contracts automate patient consent and access control, while standardized healthcare data ensures semantic interoperability. Real-world implementations demonstrate substantial improvements in security, efficiency, and patient engagement. Despite implementation challenges, including initial costs and technical complexity, blockchain-based systems provide significant economic benefits through reduced administrative overhead and security breach mitigation. Addressing ethical considerations such as regulatory compliance and digital equity is essential for these systems to advance healthcare access rather than exacerbating existing inequalities. The transition to patient-sovereign health information represents not only a technological advancement but a fundamental transformation of healthcare information management that empowers patients while improving system efficiency and security.