Mechanism for Universal Smart Contracts: Towards Blockchain Interoperability in Health Systems

Interoperability between blockchain platforms remains a key challenge, particularly in sensitive domains such as healthcare, where the secure and consistent exchange of clinical information between institutions is essential. While technical interoperability solutions exist, semantic interoperability at the level of smart contracts continues to be a significant limitation. This paper presents MUISCA, a mechanism based on Model-Driven Engineering that enables the automatic generation of interoperable smart contracts across different blockchain platforms. By defining metamodels, abstract models, and transformation rules, MUISCA produces platform-specific code for technologies such as Ethereum and Hyperledger Fabric. The mechanism was validated through a healthcare case study focused on patient transfers between medical institutions, demonstrating its ability to support the secure exchange of clinical data. Additionally, its acceptance was evaluated through expert surveys assessing perceived usefulness and ease of use. Results show that MUISCA improves smart contract portability, reduces implementation errors, and enhances system security. The proposed solution contributes to advancing semantic interoperability in blockchain-based health information systems and provides a foundation for broader application in other critical domains that require high levels of integration and data protection.