Access Control Development Within the Framework of an IOTA-Based Electronic Medical Record Management System.

Area of Science:

• Health Informatics
• Cybersecurity
• Distributed Ledger Technology

Background:

• Indonesia mandates Electronic Medical Records (EMRs), posing data security and patient access challenges.
• Current centralized EMR systems risk unauthorized access, data breaches, and compromised integrity.
• Need for a secure, patient-controlled EMR framework compliant with national regulations.

Purpose of the Study:

• To propose DecMed, a decentralized EMR management framework.
• To enhance patient-centric access control and data security for mandatory EMRs.
• To ensure data integrity and compliance with Indonesian healthcare regulations.

Main Methods:

• Developed DecMed using IOTA Distributed Ledger Technology (DLT).
• Integrated Capability-Based Access Control (CapBAC), Proxy Re-Encryption (PRE), and InterPlanetary File System (IPFS).
• Implemented using smart contracts in Move language on IOTA ledger; encrypted data stored on IPFS.

Main Results:

• DecMed enforces patient ownership and fine-grained control over medical data access.
• Demonstrated effective prevention of unauthorized access through unit testing.
• Preserved data confidentiality, integrity, and ensured regulatory compliance.

Conclusions:

• DecMed offers a robust, decentralized solution for EMR management.
• The framework successfully addresses security and access control challenges in mandatory EMR systems.
• Ensures patient empowerment and regulatory adherence in digital health records.