# Ensuring end-to-end privacy in IoT-based healthcare systems through hyperledger fabric and identity mixer

**Authors:** Maryam Nasr Esfahani, Behrouz Shahgholi Ghahfarokhi, Shahram Etemadi Borujeni

PMC · DOI: 10.1371/journal.pone.0343233 · PLOS One · 2026-03-27

## TL;DR

This paper proposes a blockchain-based system using Hyperledger Fabric and Idemix to ensure patient privacy and data security in IoT healthcare systems.

## Contribution

The novel integration of Hyperledger Fabric and Idemix ensures end-to-end privacy and resilience against security threats in IoT healthcare systems.

## Key findings

- The proposed system ensures data integrity, confidentiality, and mutual authentication in IoT healthcare.
- It provides patient anonymity and untraceability while resisting collusion among internal entities.
- Blockchain introduces computational overhead but significantly enhances security compared to centralized systems.

## Abstract

Healthcare information is often sensitive and confidential, and any unauthorized disclosure can jeopardize patient privacy. Centralized approaches currently used to protect patient information are vulnerable to a single point of failure and the risk of data breaches from central servers. Conversely, distributed blockchain-based methods tend to focus only on safeguarding data privacy for certain segments of the communication path from sensors to end users. This leaves a gap in methodologies that ensure both location and data privacy throughout the entire communication from sensors to healthcare data users via blockchain technology. In this paper, we propose using Hyperledger Fabric to ensure the immutability of patient data and to address the single point of failure issue. Additionally, to maintain end-to-end data and location privacy, our proposed scheme integrates the Idemix protocol suit alongside Hyperledger Fabric and employs a lightweight communication protocol for interactions between healthcare sensors and gateways. Compared to previous methods, our approach not only facilitates privacy features such as patient anonymity and untraceability but also guarantees data integrity, confidentiality, mutual authentication, and resilience against a variety of security threats, including collusion among internal entities. While the implementation of blockchain may introduce additional computational overhead for service providers compared to centralized systems, this trade-off is outweighed by the significant enhancements in security as evidenced by our analyses and evaluations.

## Full-text entities

- **Diseases:** ID (MESH:C537985)
- **Chemicals:** Beacon (-)
- **Species:** Acanthamoeba sp. PS (species) [taxon 348804], Homo sapiens (human, species) [taxon 9606]

## Full text

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## Figures

23 figures with captions in the complete paper: https://tomesphere.com/paper/PMC13028556/full.md

## References

102 references — full list in the complete paper: https://tomesphere.com/paper/PMC13028556/full.md

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Source: https://tomesphere.com/paper/PMC13028556