A Survey on Decentralized Electronic Health Record Management using Blockchain, Semantic Search, and Retrieval-Augmented Generation
Keywords:
Alexithymia, Emotional awareness, Interpersonal relationships, Mental health, Nursing educationAbstract
The rapid growth of Electronic Health Records (EHRs), telemedicine, and digital healthcare services has significantly improved healthcare delivery while introducing critical challenges related to data security, privacy, interoperability, and patient data ownership. Traditional centralized healthcare systems are vulnerable to cyberattacks, unauthorized access, data breaches, and fragmented information sharing across healthcare providers. Emerging technologies such as Blockchain, InterPlanetary File System (IPFS), and Retrieval-Augmented Generation (RAG) provide promising solutions to address these limitations. Blockchain ensures secure, decentralized, and tamper-resistant management of healthcare records, while IPFS enables efficient decentralized storage of large medical files. RAG enhances intelligent medical information retrieval by combining large language models with external medical knowledge, producing accurate and context-aware responses for clinical decision support. This review paper presents a comprehensive analysis of recent research on blockchain-based healthcare systems, RAG-powered medical applications, decentralized storage technologies, and healthcare interoperability standards such as HL7 FHIR. It compares existing approaches, identifies their strengths and limitations, and highlights current research gaps. The review concludes that integrating blockchain, IPFS, interoperability standards, and RAG can significantly improve secure healthcare data management while supporting intelligent and patient-centric clinical decision-making. These findings provide the foundation for developing advanced frameworks for secure, decentralized, and interoperable healthcare systems.
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