Secure Sharing of Health Data Using Hyperledger
Fabric Based on Blockchain Technology
Naveen Kumar S
M.Tech CNE, Student
Dept of ISE, B.M.S.College of Engg. Bengaluru,
Affiliated to VTU Belagavi.
Abstract— Permissioned block chain network ensures the
trust and security with the help of key features of block-chain
technology like distributed ledger, smart contract and
consensus. Currently the sharing of patient data between health
organisation is not safe without trusting each other may leads to
data privacy violation. Block chain provides the trust in sharing
of patient’s medical information between health organizations.
In this paper hyperledger fabric frame work based
permissioned block chain network is proposed and established
among patents and medical institutes to achieve the secured and
reliable sharing of the patient’s data. Block chain reliably
manage the electronic health records eefficiently using Hyper
ledger fabric frame work. Implementation results shows that,
the hyperledger fabric based Block chain removes the
unreliability in sharing of data among health care centres,
doctors, public health departments and hospitals. This network
also allows the organizations to quickly and safely move medical
data in a legally compliant manner as it is a transparent system.
The blockchain implemented has achieved the transparent and
secure transfer and also controls the access of health data of
patients by user policies with smart contracts as chain code.
Hyper ledger Fabric provides high levels of performance,
protection, and transaction privacy and the results have proved.
Keywords—Blockchain, Hyper ledger, distributed ledger,
smart contracts, data privacy.
I. INTRODUCTION
Block chain is actually an immutable and irreversible
ledger for recording all the valid transactions, maintained
with all the peers of distributed network. Every peer keeps up
a copy of the ledger. Few peers also execute a consensus-
protocol for validating the transactions. Any business
working network has the group of organizations or folks
which connect for transferring or sharing the assets. All
business network has the distributed ledger and that can be
transferred among the peers, with every peer having a record
of each transaction. Block-chains basically establishes the
trust across working business networks with the help of the
combination of smart contracts, distributed ledger and
consensus. The block-chain also involve business working
networks, which adds auxiliary trust using the benefits of
provenance, consensus, immutability and finality.
Immutability generally means that the transaction once
recorded in the ledger can never be changed. Any Changes in
the ledger requires the approval of participants based upon
endorsement policy. Block-chain also reduces the
complexity involved in sharing data and agreements between
physicians, hospitals and public health departments, allowing
all the organizations to securely and quickly move patient
medical data in a legal manner with trust each other in
organisation. All members of network or organisation needs
to know is other member is a valid member. Healthcare
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Dr. M Dakshayini
Professor & Head,
Dept of ISE, B.M.S.College of Engg. Bengaluru,
Affiliated to VTU Belagavi.
sector concentrating on the important aspect provided by the
Block-chain technology like immutability of the data in
ledger. Block-chain technology could also improve the
management of medical record and the process of claiming
insurance, accelerate biomedical and clinical research and
advance healthcare and biomedical data ledger.
These expectations are mainly based on key aspects of
block-chain technology such as decentralized and
distributed management of ledger, consensus, improved
security and privacy. Identification of thefts, financial data
crimes and spamming, as patients don’t have control over
their data the patient’s data could be misused. So hyper
ledger fabric provides the solution for such problems.
Transactions that are having patient’s health information are
recorded on the ledger with some unique IDs. Whenever any
healthcare provider needs to access data of patient, the
transaction ID assigned needs to be matched only then the
related information is displayed. Healthcare organizations
could submit their requests through APIs and then access
the non-identifiable data of patients through smart contracts.
Without private key the patient’s data is non-identifiable to
healthcare providers. Hyperledger Fabric is distributed
ledger technology for any business network. Following
four key characteristics of hyper-ledger fabric has made
it most suitable for implementing distributed ledger
technology.
a. Ability of creating Permissioned network
b. Confidential transactions
c. No cryptocurrency
d. Programmable
Hyperledger fabric provides the trust, transparency and
accountability. Hyper ledger Fabric is designed for many
business use cases, where the block chain is generally
operated by a set of identified and trusted participants and
this ability is called as permissioned block chain.
permissioned network restricts who can access and do what
on the network. It requires participant should be known.
Hyperledger fabric provide access control restrictions.
Transaction is validated by known validators. Hyperledger
fabric puts participants in control of visibility of
transactions. Hyper-ledger does not have concept of
cryptocurrency because no need to incentivize the network
for validations. Hyper ledger fabric is programmable by the
way of construct of chain code. Chain code automates the
entire business process. Assets represents the value that are
exchangeable on block chain system. Chain code defines the
structure of assets.
Block Chain
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 II. LITERATURE SURVEY
Liviu et.al [1] have proposed a block-chain-based
framework for sharing the personal health data of patients
securely, they have presented the block-chain supportive
framework for controlling the personal health information
using the policies with smart contracts. this framework
provides less risk to data after sharing with stronger
assurance. Sandro Amofa et.al [2] have presented the Block-
chain supported approach for managing the access to e-
health data protecting the privacy. This paper also presents
the information about how the medical data is shared
between health organizations using access policies defined
by the patients. In order to protect health data, solution
proposed involves the use of two types of chains: a private
one, which keeps real ID of the patient’s information, and a
public one, which stores information about patients’ health
data with a temporary ID.
Balaji Prabhu, et.al.[4] has also worked on making the
trading system of agriculture more transparent from farmer
to consumer by avoiding the middleman.
Abdelali El Bouchti, Houssine Bouayad and Youness Tribis
[3] proposed a Paper on A Systematic Mapping Study of
Management of Supply Chain using Blockchain. Their
effort was aims to analyze and explore the state-of the-art on
the BlockChain Technology applications for Supply Chain
Management. They have tried to identify the gaps available
in SCMs by blending the existing and available evidence.
Tara Salman, Maede Zolanvari et.al have discussed about
possible Security Services Using Blockchains.
Elaborated survey has shown that most of the authors have
presented their ideas of providing security services for
various applications or use cases like supply chain
management, efficient user verification and health care. Few
authors have also talked about the tools for implementation
of block-chain like etherium and Hyper ledger fabric. None
of the papers have proposed and implemented the solutions
for the major problems of Health care industry that is
patient’s permission based data access and data tampering.
Hence, we have proposed Hyper ledger fabric based
permissioned block chain network supported secure sharing
of health data of patients among various health care
organizations and people.
III. DESIGN AND ARCHITECTURE
The Blockchain Development environment proposed for
providing controlled access and secure transmission of
health information of patients among various Health care
organizations shown in above diagram. Development
environment proposed consists of many organizations like
Hospitals, public health departments, centers for disease
control, physician providers etc. Docker compose files
defines the multiple docker containers to make
infrastructure components for organizations. Each
organization has containers like Certification
authority(MSP), orderer, peer container and CouchDB
container. Peer container dependent on CouchDB for state
data. All of these containers maintained crypto folder has
crypto materials and config folder has config files for these
containers. Containers should have access to channel
information and genesis block. Each component in
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infrastructure needs certificates to be a valid member of the
block-chain network and managed in cryptoconfig files.
Crypto material is generated using cryptogen tool and
genesis block and channel transactions are created using
configtxgen tool.
The Certification authority (MSP-membership service
provider) is the key component in controlling or restricting
the access to the Healthcare block-chain network and hence
to patient’s records. It provides a construct of architecture
for membership operation. MSP attains this by issuing and
validating the certificates and user authentication using the
cryptographic approaches and protocols. MSP could also
define its own conception of characteristics and rules.
A hyperledger fabric based block-chain network could have
one or more MSPs. This provides effective and extensibility
of membership operations and interoperability. Ordering
service is another component to provide collective
communication channel to all the peers and clients. This
service allows peers to broadcast their transaction messages.
clients get connected to the channel and then broadcasts
their messages on the channel that delivered to all the peers
in the network supporting the total order delivery and
reliability. This ordering service is not capable of validating
the transactions. Basically blockchain network[BCN]
consists of cluster of peer nodes. These peers are the
important elements of BCN because they are the one which
hosts ledgers and smart contracts (chaincode). Such peer
nodes of BCN could be created, started, stopped,
reconfigured, and even deleted using APIs. They also
have a collection of APIs that enable administrators and
applications to interact with the services.
Hyper-ledger Fabric supports two types of databases
namely levelDB and CouchDB at every peer. LevelDB is
the state database by default embedded in each peer node
and stores the chaincode data as key-value pairs.
CouchDB is another state database to support rich set of
queries and effectively functions when chaincode data
values are modelled as JSON. CouchDB is JSON
document datastore that enables efficient indexing of the
contents of documents in the database. Fabric ledger has
the transaction log that contains all transactions invoked
against assets and state data is a representation of current
state of assets. Transaction log is immutable.
CRUD (create, retrieve, update and delete) operations is
applied to transaction log and state data. In transaction
log, the transactions could be created, retrieved and also
be tracked. The CRUD operations are applied on state
data and CouchDB supports creation of complex queries
in state data.

Fig 1. Hyperledger fabric network design.
Hyperledger Fabric is a distributed ledger technology for
the business. When new user or clients enter the
organization the MSP (membership service provider)
provide the unique certificate to user and this provide the
trust to members in network. In hyperledger fabric
network the endorsing peers as the endorsement policies.
client broadcast the transactions to orderers peers with
endorsement policies. The smart contract is providing
the rules and regulations and all members in network
should obey. When the transaction happens in the
organization then orderers provides the blocks in the
peers to store the transaction. These peers called Anchor
peer.
Algorithm
1. Block-chain network is established using Hyper
ledger fabric
2. Organization1 is created
3. Organization2 is created
4. Whenever any patient/user/client/peer tries to
enter the organization
Unique patient ID is generated using Hash code
MSP assigns a certificate and validates that peer
to become part of the organization.
E(PRk(PD)) - Ledger
ID(P) - Registry
5. Orderer creates the channel between all these
peers within the Organization and across the
organizations
6. the consensus protocol creates the irrefutable
agreement between organization
7. When same patient visits H(Org2)
Org2 raises the request to view the patient’s data
After patient permits, D(PR k(PD)) – Org2
8. Achieves transaction privacy.
Chain code deployment:
Chaincode is a program to implement a business logic
based on agreement between members of network.
Chaincode is also called as smart contract. Secured
Docker container where the chaincode runs. It manages
and initializes ledger through transactions submitted by
applications. Chaincode can be written in Go, node.js or
java languages. Chaincode is installed and instantiated
through an SDK or CLI onto network and provide the
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interaction with network shared ledger. In CLI deploying
chaincode without cli container install, instantiate and
invoke must executed on each peer. The deployment of
chaincode steps is shown below:
1. Create chaincode folder in root of the project.
2. Create package.json provides chaincode interface and
install node modules.
3. Mounting folder chaincode in cli container and
certificates.
4. Install chain code.
5. Instantiate.
6. Invoke chaincode.
Create a script handles install. Instantiate and invoke the
chaincode. Instantiate is the method create new docker
container, chaincode name and chaincode version.
Invoke method is to invoking transactions in chaincode.
IV. IMPLEMENTATION
In this work, Hyperledger fabric based block-chain network
is configured as shown in fig 2 with 2 organizations and
each organization would consist of peer nodes (Hospital and
Health care center). Organization 1 is constituted with 4
peers and organization 2 is designed with 3 peers. workflow
procedure of implementation of Hyperledger fabric based
Block-chain to provide the capability of interoperability and
security to patient’s data is shown in fig 2. Whenever any
patient say PA visits the Hospital at organization1, a unique
patient ID is created using Hash code and assigned to the
patient.
Fig. 2: Hyperledger based block-chain design for
healthcare application.
The patient PA’s medical data is encrypted, signed
cryptographically and stored in a ledger using smart contract
and patient ID also registered in a patient registry. the
membership service provider gives certificates to all the
components in the organization and hence creating the trust
across all the clients in organization. Also the consensus
protocol creates the irrefutable agreement between
organization. When same patient visit another hospital
situated in organization2, organization2 needs the
permission from the patient to view the patient’s medical
data with hospital of organization1 and organization2 raises
the access request for PA’s data and data is decrypted only
if the patient approves the access request of organization2
and patient ID is stored in patient registry. The patient
approves the access request of organization2 then only
patients’ data is visible in organization2. Based on the
access policy the patient data of other organization is
 updated in the ledger and this architecture ensures that all
peers have the same data in their ledger. The data in ledger }
of one organization is not visible to another organization The hyperledger Fabric based block-chain network created
without the permission of respective patient or client. This is is shown in fig. 3. In the network considered, organization1
how hyperledger fabric achieves better performance through is shown here with four containers i.e peer container,
its transaction privacy policy. this architecture provides the CouchDB container, orderer container and CA (Certificate
trustworthy network using the combination of smart Authority) container created in the organization1.
contract, distributed ledger, finality and consensus.
Fabric Network is launched using the command
./startFabric.sh #kills and remove the running containers
V. RESULTS and rerun the deployed application
After configuring and running the block-chain network
using Hyperledger fabric implementing the scenario of The Fabric network was shut down without losing deployed
patients visiting different hospitals and hospitals storing the application using the command
their data securely and allowed to share patient data of their ./fabricUtil.sh # stopped and re-run the deployed
ledger with other hospitals or healthcare centers across the application .
organizations with patient’s permission only. The snapshot
of patient’s data stored in the ledger through API using json The Fabric network was shutdown using the command
format is shown below. ./stopFabric.sh # stop the all containers that are in
Organization 1 running condition.
{
Hospital Name: “Hospital 1”
Hospital ID: “6e621fa2509d451735cc3a6371ddb5bc”
Hospital Address: “Bangalore”
Patient ID: “1dae3325e72f45e183431fb2bbd79377”
Patient Name: “Bheema”
Date: 18/11/2019
Patient Health Info: health condition- Injury
Treatment – surgery,
physical therapy and tests.
}
The above health information of patient PA is stored in the
ledger of organization1 that created in the network.
When the same patient PA visits hospital of organization2,
the doctor rganization2 needs to view the patient’s medical
records of PA then, the doctor needs the permission from
patient PA. Patient uses the API to approve the permission
using Gadgets or mobile phone using API format shown Fig. 3 Hyperledger Fabric Network with 4 Containers
below:
Patient Permission:
{ VI. CONCLUSION
Patient Name: “ABCD” Presently, when any patient goes to different hospitals, they
Patient ID: “1dae3325e72f45e183431fb2bbd79377” need to carry their medical history records (hard copy)
From: “Hospital 1” which is very much required for different doctors to
To: “Hospital 2” understand the patient’s health conditions before put them
} on to medication. Technology that could store the patient’s
medical data securely and allow doctors of different
Now the patient pA’s information is visible to the doctor of hospitals to share the patient’s medical data across the
organization 2 as shown in above and the new information is hospitals in more reliable manner was very much required.
stored in the another organization ledger as shown in below: So, in this work, Hyperledger fabric frame work based
permissioned block chain network is proposed, configured
Organization 2 and executed among 2 medical organizations to demonstrate
{ the secured storage and reliable sharing of the patient’s data
Hospital Name: “Hospital 2” cross the hospitals.
Hospital ID: “d9d9fa4f656ce9f56cc09aaf4633a588” The performance evaluated has shown 100% security in
Hospital Address: “Bangalore” storing patient’s data never allowing for tampering and
Patient ID: “5fb8835210967067ce0612ae341222ce” sharing of the same only with patient’s consent with
Patient Name: “Bheema” efficient key features distributed ledger, consensus and
Date: 20/11/2019 smart contracts of hyper ledger
Patient Health Info: health condition- Injury Hence it can be concluded that, Healthcare application using
Treatment – surgery, physical therapy, the Hyperledger fabric based blockchain network could
tests.
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 provide the trustworthy, protected and secured transaction
privacy.

VII. REFERENCES

[1] Blockchain-based approach for e-health data access

management with privacy protection: Liviu Hirtan
University Politehnica of Bucharest Bucharest Romania,
Piotr Krawiec National Institute of Telecommunications
Warsaw, Poland.

[2] A Blockchain-based Architecture Framework for Secure

Sharing of Personal Health Data: Sandro Amofa, Emmanuel
Boateng Sifah, Kwame O.-B Obour Agyekum, Smahi Abla,

[3]Abdelali El Bouchti, Houssine Bouayad and Youness

Tribis “A Systematic Mapping Study on Supply Chain
Management based on Blockchain” International workshop
on Transportation and supply chain-2018.

[4] M Dakshayini, Balaji Prabhu B V, “An Effective Big-

Data and Blockchain [BD-BC] based decision support
model for Sustainable Agriculture system”, published as
chapter 8 in Springer Sustainable Cognitive Computing,
EAI/Springer Innovations in Communication book Series,
pp 77-86, https://doi.org/10.1007/978-3-030-19562-5_8

[5] Hands-On Blockchain with Hyperledger -Building

decentralized applications with Hyperledger Fabric and
Composer :NitinGaur, LucDesrosiers, Venkatraman
Ramakrishna, Petr Novotny, Dr. Salman A. Baset, Anthony
O'Dowd.

[5] Developing a Blockchain Business Network with

Hyperledger Composer using the IBM Blockchain Platform
Starter Plan : Vance Morris, Rohit Adivi, Ratnakar Asara,

[6]Security Services Using Blockchains: A State of the Art

Survey : Tara Salman, Student Member, IEEE, Maede
Zolanvari, Student Member, IEEE, Aiman Erbad, Member,
IEEE, Raj Jain, Fellow, IEEE, and Mohammed Samaka,
Member, IEEE

Hyperledger fabric provides the high levels of performance,

protection and transaction privacy. Healthcare organizations
as the interoperability capability, security, integrity. The
workflow procedure of hyperledger fabric blockchain
network of healthcare organizations is as follows:
blockchain networks would have many organizations like
hospitals, public health departments, physician providers
etc. patient visit the hospital and organization creates the
patient ID.

Proceedings of the International Conference on Mainstreaming Block Chain Implementation (ICOMBI) 2020
978-93-5406-901-7 © 2020 IEEE

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